Obesity Race Heats Up—K-Bio Gains Edge with Fewer Side Effects

Global pharmaceutical companies are doubling down on obesity treatment despite multiple clinical setbacks. As they pivot to new mechanisms and combinations to overcome the limitations of GLP-1-based drugs, Korean firms are seizing niche opportunities by reducing side effects and improving dosing convenience.

Roche recently halted development of its long-acting PYY analog CT-173, yet it is making aggressive moves to re-enter the obesity drug market. In June, the company signed a $5.3 billion licensing deal with Zealand Pharma to co-develop and commercialize petrelintide, an amylin analog. The partnership also includes plans for a fixed-dose combination with Roche’s GLP-1/GIP dual agonist CT-388. Zealand will co-market the therapies in the U.S. and Europe, with Roche holding exclusive rights elsewhere.

This follows Roche’s $2.7 billion acquisition of Carmot Therapeutics last year. With CT-173 discontinued due to internal performance criteria, Roche is shifting focus to the amylin pathway, which regulates appetite and leptin sensitivity. Petrelintide has shown promising Phase 1b results and will be paired with CT-388 for expanded treatment options.

Pfizer withdrew its GLP-1 candidate danuglipron in April after liver enzyme elevations were observed, even after reformulating the drug for once-daily dosing. The company is now turning to early-stage GIP receptor antagonists and plans to reinvest R&D savings into pipeline development.

Amgen also exited its oral obesity program in May, shelving AMG 786 in favor of maridebart cafraglutide (MariTide), an injectable GLP-1/GIP compound designed for less-than-monthly dosing. Currently in global Phase 3 trials, MariTide is expected to yield key data by 2027.

AstraZeneca, shifting away from neuroscience, is bolstering its obesity pipeline with AZD5004, an oral GLP-1 licensed from Eccogene. AbbVie joined the field in March by licensing a dual amylin/calcitonin analog from Gubra, now in Phase 1.

While Novo Nordisk and Eli Lilly currently lead the obesity drug market, both face growing challenges.

Novo Nordisk’s blockbuster drug Wegovy continues to expand globally, yet recent demand slowdowns in the U.S. and underperformance in other markets have triggered concern. On July 25, the company slashed its sales and profit forecasts, causing a 23% stock drop. It also announced a leadership change, appointing longtime executive Maziar Mike Doustdar as CEO. The move has raised questions about whether internal leadership can drive needed innovation amid intensifying global competition.

In contrast, Lilly is gaining momentum. Sales of its GLP-1-based Zepbound are rising, and its oral GLP-1 candidate, orforglipron, showed strong Phase 3 weight-loss results and is expected to be submitted for approval later this year. With more convenient dosing, orforglipron could disrupt the market currently dominated by injectable options like Wegovy.

Market analysts project the global obesity drug market to reach $50 billion by 2028. But success hinges on more than efficacy. Patient adherence is being threatened by side effects such as nausea, diarrhea, liver toxicity, and muscle loss—common issues with long-acting GLP-1 therapies that lead to higher discontinuation rates and diminished real-world outcomes.

Korean pharmaceutical companies are refining their development strategies to differentiate themselves in the competitive obesity treatment market by prioritizing safety, dosing convenience, and muscle preservation.

Hanmi Pharmaceutical is progressing three parallel programs under its "H.O.P (Hanmi Obesity Pipeline)" initiative. The first, efpeglenatide, a GLP-1 analog, has completed patient enrollment for a global Phase 3 trial in Korea and is expected to reach the market between late 2026 and 2027. The second, HM15275, is a triple agonist targeting GLP-1, GIP, and glucagon receptors, aimed at promoting weight loss and improving energy metabolism. Currently in Phase 1 development, it is expected to be commercialized after 2030. The third, HM17321, is designed to support muscle cell proliferation while promoting weight loss, particularly for older adults. This candidate is currently undergoing preclinical and early safety studies.

Dong-A ST, through its U.S. subsidiary MetaVia, is developing DA-1726, a GLP-1/glucagon dual agonist. In a global Phase 1 trial, the drug demonstrated a weight reduction of 4.3 to 6.3 percent at 12 weeks, along with high satiety, reduced waist circumference, and improved muscle preservation compared to existing GLP-1 treatments. The company is pursuing a strategy that combines in-house commercialization with global co-development partnerships.

Caregen is developing Coglutide, an oral peptide therapy that activates both GLP-1 and IGF-1 receptors to reduce fat and preserve muscle mass. With a short half-life of under 30 minutes, the drug is designed to minimize liver toxicity. In a clinical study conducted in India, Coglutide achieved a 10.75 percent reduction in body weight, lowered HbA1c by 0.9 percent, and limited muscle loss to just 0.27 kilograms, while also improving visceral fat levels and waist-to-hip ratio. The company has completed product registration in Mexico, Lebanon, and Ecuador and is currently pursuing New Dietary Ingredient (NDI) registration with the U.S. FDA to accelerate global market entry.

Meanwhile, D&D Pharmatech, through its U.S. subsidiary Neuraly, is developing a long-acting GLP-1 formulation designed for once-weekly or monthly dosing. Preclinical studies have shown strong improvements in glucose metabolism and insulin sensitivity with favorable tolerability. The company is preparing to initiate clinical trials in both Korea and the U.S., while engaging in discussions with global pharmaceutical companies for co-development and licensing agreements.