Obesity

Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment

N Engl J MedPublished Randomised controlled trial

Authors' conclusion

In adults with obesity, 72-week treatment with orforglipron led to significantly greater reductions in body weight than placebo; the adverse-event profile was consistent with that of other GLP-1 receptor agonists.

Study context

Population
Adults with obesity without DMrandomized 3:3:3:4
Participants
3,127 adults
Comparison
Once-daily oral orforglipron 6 mg, 12 mg or 36 mg vs placebo, adjunct to healthy diet and physical activity
Primary endpoint
Percent change in body weight from baseline
Follow-up
Week 72
Methodological detailsphase 3, multinational, double-blind, placebo-controlled
  • Phase 3
  • Multinational
  • Double-blind
  • Placebo-controlled

Primary result

As reported in the abstract

Mean change in body weight · baseline to week 72

Orforglipron 6 mg

−7.5

mean · 95% CI −8.2–-6.8 · %

Orforglipron 12 mg

−8.4

mean · 95% CI −9.1–-7.7 · %

Orforglipron 36 mg

−11.2

mean · 95% CI −12.0–-10.4 · %

Placebo

−2.1

mean · 95% CI −2.8–-1.4 · %

Orforglipron 6 mg vs Placebo: P < 0.001 for all comparisons with placebo · Orforglipron 12 mg vs Placebo: P < 0.001 for all comparisons with placebo · Orforglipron 36 mg vs Placebo: P < 0.001 for all comparisons with placebo

Further findings

OutcomeOrforglipron 36 mgPlacebo
Body weight reduction ≥10% · week 7254.6%12.9%
Body weight reduction ≥15% · week 7236.0%5.9%
Body weight reduction ≥20% · week 7218.4%2.8%

Cardiometabolic risk factors

Waist circumference, systolic blood pressure, TG and non-HDL cholesterol significantly improved with orforglipron vs placebo

Safety

Adverse events leading to treatment discontinuation — Placebo
2.7%
Adverse events leading to treatment discontinuation — Discontinuation due to adverse events, orforglipron groups
5.3 to 10.3%

Adverse events leading to treatment discontinuation

Most common adverse events with orforglipron were gastrointestinal, mostly mild to moderate

Original publication

Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment. N Engl J Med. Published 16 September 2025. doi:10.1056/nejmoa2511774

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