ADA: AZ’s oral GLP‑1 shows competitive efficacy in phase 2, setting stage for pivotal program

AstraZeneca has presented phase 2b data for its oral GLP‑1 agonist elecoglipron (AZD5004) at the 2026 American Diabetes Association (ADA) meeting, showing competitive weight‑loss and glucose‑lowering efficacy that support a phase 3 development programme in obesity and type 2 diabetes.

In the VISTA obesity/overweight trial (310 adults with at least one comorbidity), 75 mg daily elecoglipron produced mean weight loss of 10.5% at 26 weeks and 11.8% at 36 weeks versus roughly negligible placebo losses; nearly 40% of patients on 75 mg achieved ≥15% weight loss and up to 89% lost ≥5% body weight at 26 weeks, with no plateau in weight loss.

In the SOLSTICE type 2 diabetes trial (about 404 adults), elecoglipron 75 mg brought mean HbA1c reductions of about 1.9% at 26 weeks versus 0.2% with placebo, with 90% of patients reaching HbA1c <7% and 85% at ≤6.5%; mean weight loss was 7.7% versus 1.7% with placebo, accompanied by improvements in blood pressure and inflammation markers.

The safety profile was typical of the GLP‑1 class, dominated by gastrointestinal side effects (nausea, constipation, diarrhoea, vomiting), but discontinuations due to adverse events were infrequent, strengthening AstraZeneca’s case to move into pivotal phase 3 trials of elecoglipron in both obesity and diabetes indications.