Novo's ZEUS trial fails and shares drop 9%

Novo Nordisk said on July 31, 2026 that its phase 3 ZEUS trial of ziltivekimab — tested in people with atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD) and inflammation — did not meet its primary endpoint ^[1][2]. The company's shares fell about 9% that day, adding to a string of pipeline setbacks ^[2].

Novo disclosed the result in a company announcement titled "Novo Nordisk provides update on the ZEUS phase 3 trial in people with ASCVD, CKD and inflammation," filed as an investor communication rather than a general press release ^[1]. The detailed trial numbers — how many people were enrolled, the size of the difference versus placebo, and the safety findings — are not included in the sources available here, so they are not yet known from this reporting.

Ziltivekimab is not a weight-loss or diabetes drug. It was Novo's attempt to build a cardiometabolic franchise outside of GLP-1 medicines, and the ZEUS failure set that effort back; a non-cash impairment was expected to land in the third quarter of 2026 ^[2].

Where this sits in Novo's year

The miss came during a difficult stretch for the company. Novo, which created the obesity drug market, has slipped behind Eli Lilly after a CEO change — Mike Doustdar took over in August 2025 — roughly 9,000 layoffs, and a CagriSema result of about 22.7% weight loss that fell short of the roughly 25% some had hoped for ^[2]. Its oral Wegovy pill brought in DKK 3.22 billion in the second quarter of 2026, just under the DKK 3.27 billion expected ^[2].

The financial picture was not all negative. Four days after the ZEUS announcement, on August 4, 2026, Novo reported adjusted operating profit of DKK 33,389 million for the second quarter and raised its full-year outlook ^[1]. Its 2026 outlook moved to a range of 0 to -6%, up from -12 to -4% ^[2].

For comparison, Lilly reported $23.0 billion in second-quarter 2026 revenue, up 48%, with Mounjaro and Zepbound at $9.9 billion (up 91%) and $4.9 billion in the US (up 44%), and $98 million in the first full quarter for Foundayo (orforglipron), the oral GLP-1 approved by the FDA in April 2026 ^[2].

Why it matters for patients

The most practical point is what the ZEUS result does not change. Ziltivekimab is a separate investigational medicine, not semaglutide. Nothing in these sources indicates any effect on the availability, labeling or approval status of Ozempic, Wegovy or Rybelsus, all of which are semaglutide, or on Mounjaro and Zepbound, which are tirzepatide.

What the failure does affect is the pipeline of future options. People with heart disease and chronic kidney disease who also have signs of inflammation have been a target group for new treatments beyond cholesterol and blood pressure drugs. A missed primary endpoint in a phase 3 trial means that approach did not produce the benefit the trial was designed to show in this population, and the sources give no indication of a path forward for the drug in this setting.

It also matters competitively. Analysts tracking the sector frame Novo's position as number two behind Lilly, with ZEUS deepening the gap ^[2]. Competition among manufacturers has been one force shaping US pricing and access, so investors' read on who is ahead is not purely an abstraction for people paying for these drugs — though the sources here do not describe any specific price or coverage change tied to ZEUS.

What happens next

• Q3 2026: Novo expected a non-cash impairment related to the program ^[2].
• Second half of 2026: An FDA decision is expected on CagriSema, which would be the first once-weekly GLP-1 plus amylin combination for weight management, with roughly 23% weight loss in trials; approval would help Novo close the gap, while a delay or rejection would widen it ^[2].

Full ZEUS data, including safety results and any presentation at a medical meeting, had not been detailed in the sources reviewed here.