Prime Highlights:
A dozen drugmakers are developing new weight-loss treatments that prioritize muscle mass preservation alongside fat reduction.
Drugs like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound have shown significant weight loss but also caused muscle decline, prompting a shift toward muscle-sparing options.
Key Background:
A dozen pharmaceutical companies are currently developing novel weight-loss treatments aimed at preserving muscle mass, a crucial aspect of health that has become a focal point in the battle against obesity. While drugs such as Wegovy by Novo Nordisk and Zepbound by Eli Lilly have demonstrated significant weight loss, concerns remain regarding muscle depletion during treatment. In clinical trials of Wegovy, up to 40% of weight loss was attributed to a reduction in lean or fat-free mass, not just excess fat.
These new drugs, still years away from approval, target proteins associated with muscle preservation and growth. Companies such as Eli Lilly, Regeneron, Scholar Rock, and Veru are leading the charge. The drugs work by targeting proteins like myostatin and activin, which play roles in muscle growth and fat reduction. Veru’s enobosarm, for example, showed promising results in a trial where it helped older patients retain 71% more muscle mass when taken alongside Wegovy. Similarly, Eli Lilly’s bimagrumab, set for trials later this year, aims to preserve muscle mass while facilitating weight loss.
These treatments have the potential to generate substantial market value. The New England Consulting Group estimates that these drugs could generate between $1 billion to $5 billion annually by the end of the decade. Additionally, obesity drug sales are predicted to reach $150 billion by the early 2030s. Medical experts believe that muscle-preserving weight-loss drugs could greatly benefit older individuals, reducing their risk of falls and fractures.
However, the FDA’s approval process presents challenges, with experts questioning whether muscle preservation alone will be sufficient for approval. The agency’s latest guidelines suggest that measuring muscle-to-fat ratios in trials is essential, and that functional outcomes, such as improved strength or cardiovascular health, may be required to gain approval. Ultimately, as these drugs progress through clinical trials, they must not only demonstrate the ability to preserve lean mass but also deliver broader health benefits, such as improved physical performance and fewer side effects.
