AstraZeneca's Development of a Weight Loss Drugs

AstraZeneca is actively developing an experimental oral (pill) weight loss drug called AZD5004 (previously known as ECC5004). 

This is a small-molecule GLP-1 receptor agonist aimed at treating obesity, type 2 diabetes, and related cardiometabolic conditions. It's designed to be taken once daily, potentially with fewer gastrointestinal side effects than injectable GLP-1 drugs like Novo Nordisk's Wegovy or Eli Lilly's Zepbound, and it could be combined with other therapies for patients with comorbidities (affecting over 60% of obese individuals).

Key Development Details

• Origin: Licensed from China's Eccogene in November 2023 for $185 million upfront, plus up to $1.8 billion in milestones (total potential value ~$2 billion). AstraZeneca has global rights outside China.
• Current Stage:
  • Phase I trials (completed early 2024) showed promising results: safe and tolerable with side effects typical of GLP-1 class (e.g., mild nausea); 5.8% average weight loss in type 2 diabetes patients over 4 weeks; reduced fasting plasma glucose.
  • Now in two Phase IIb trials (as of November 2024):
    • Solstice Study: 384 participants with type 2 diabetes; results expected early 2026.
    • Unnamed Obesity Study: 304 participants with obesity/overweight; focuses on ≥5% weight loss at 26 weeks; expected completion by end of 2025.
• Differentiation: Easier to manufacture than peptides; targets patients intolerant to injectables; potential for combo therapies.
• Market Outlook: AstraZeneca projects peak sales of $800 million+ by 2032 if approved, part of a broader $5 billion metabolic business goal. However, analysts (e.g., BMO Capital) remain conservative until Phase II data de-risks efficacy.

AstraZeneca is also advancing injectable obesity candidates (e.g., AZD6234, an amylin agonist in Phase IIb for weekly subcutaneous use), but AZD5004 is their lead oral entrant in a crowded race against Novo, Lilly, Pfizer, and others. They're "a few years behind" leaders but bullish on oral formats for broader access, especially in emerging markets. No approval timeline yet—likely 2028+ if trials succeed.