Novo's Amycretin: Dual-Action Drug Aims to Redefine Metabolic Care

BAGSVÆRD, Denmark – November 25, 2025

Novo Nordisk has once again signaled its intent to aggressively defend and expand its dominance in the metabolic disease space, announcing strikingly positive headline results from a phase 2 trial of its next-generation drug, amycretin. The data, showing significant weight loss and blood sugar reduction in people with type 2 diabetes, positions amycretin as a formidable future competitor in a market currently captivated by the success of GLP-1 agonists.

The trial demonstrated that a once-weekly subcutaneous injection of amycretin led to a weight loss of up to 14.5% over 36 weeks. An oral version of the drug also showed strong efficacy, achieving up to 10.1% weight loss in the same timeframe. These results, coupled with substantial improvements in glycemic control, confirm that the Danish pharmaceutical giant has a powerful new asset in its pipeline, one that leverages a novel mechanism to build upon the blockbuster success of Ozempic and Wegovy.

A New Frontier in Dual-Mechanism Therapy

At the heart of amycretin's promise is its unique scientific design. It is a unimolecular agonist, meaning a single molecule activates two distinct hormone receptors: GLP-1 (glucagon-like peptide-1) and amylin. While the industry has become well-acquainted with GLP-1 agonists and the recent emergence of dual GIP/GLP-1 agonists like Eli Lilly's tirzepatide (Mounjaro), amycretin's combination is a strategic pivot.

Amylin is a hormone co-secreted with insulin that plays a natural role in slowing gastric emptying and promoting a feeling of fullness, or satiety. By combining this action with the established appetite-suppressing and glucose-regulating effects of GLP-1, Novo Nordisk is betting on a synergistic effect that could offer a superior clinical profile.

The phase 2 data provides a compelling early case. In the 36-week trial involving 448 participants with type 2 diabetes, the highest dose of subcutaneous amycretin not only produced the 14.5% weight loss but also reduced HbA1c levels by up to 1.8 percentage points from a baseline of 7.8%. For context, this level of efficacy rivals and in some cases exceeds that of existing market leaders over similar timeframes. Notably, the company reported that for the higher doses, no weight loss plateau was observed at the 36-week mark, suggesting the potential for even greater results in longer-term studies.

When compared to the competition, amycretin’s performance is noteworthy. Eli Lilly’s Mounjaro, in its SURMOUNT-2 trial for type 2 diabetes and obesity, showed weight loss of up to 15.7% over a much longer 72-week period. Novo Nordisk’s own Wegovy (semaglutide) demonstrated an average weight loss of around 15% over 68 weeks in its pivotal STEP trials. Amycretin's ability to achieve a 14.5% reduction in just 36 weeks places it squarely in the top tier of metabolic therapies, pending confirmation in larger, longer Phase 3 trials.

Reshaping the Competitive Battlefield

The development of amycretin is a clear strategic maneuver in the high-stakes chess game for control of the multi-billion-dollar diabetes and obesity markets. As competitors like Eli Lilly gain ground with dual-agonist therapies, Novo Nordisk is not merely defending its GLP-1 franchise but diversifying its attack with a different biological approach.

“Amycretin is built on the complementary biology of GLP-1 and amylin, and we are looking forward to bringing amycretin into an extensive phase 3 development programme across multiple indications in 2026,” said Martin Holst Lange, executive vice president of Research and Development at Novo Nordisk, in the company's official announcement. This statement underscores the firm’s confidence and its ambition to move beyond type 2 diabetes into broader indications, almost certainly including obesity as a standalone treatment.

The most significant strategic advantage, however, may lie in its dual-formulation approach. The development of both a once-weekly injection and a once-daily oral pill could be a market-shaping move. While injectable therapies have proven immensely popular, a significant portion of patients remains hesitant about needles. An oral option with efficacy that approaches that of leading injectables—as amycretin’s 10.1% weight loss at 36 weeks suggests—could unlock a vast, underserved patient population and dramatically improve treatment adherence.

This two-pronged strategy positions Novo Nordisk to compete on all fronts: against existing injectable GLP-1s, against dual-agonist injectables like Mounjaro, and in the nascent but rapidly growing market for effective oral weight-loss medications. The company is effectively building a moat around its metabolic health empire, ensuring it has a leading candidate for nearly every patient preference and clinical need.

From Lab to Life: Promise and Practical Hurdles

For the millions of individuals struggling with type 2 diabetes and obesity, the clinical numbers translate into the potential for life-changing health improvements. However, the journey from promising trial data to widespread patient benefit is fraught with practical challenges, beginning with safety and tolerability.

According to the press release, amycretin appeared to have a safe profile consistent with its class. The most common adverse events were gastrointestinal—primarily nausea, vomiting, and diarrhea—and were mostly mild to moderate. This side-effect profile is familiar to anyone acquainted with GLP-1 therapies, where such symptoms are common, especially during initial dose escalation. The detailed data shows rates of nausea and diarrhea that are comparable to those seen in trials for Wegovy and Mounjaro, suggesting that while GI effects are present, they are not a new or unexpected barrier for this class of drug.

The more formidable hurdles will likely be cost and access. The current generation of highly effective weight-loss drugs carry list prices exceeding $1,000 per month in the United States. This has created a significant access crisis, with insurers often balking at the cost and erecting barriers like prior authorizations and step-therapy requirements. Coverage for obesity as an indication, in particular, remains inconsistent, with many employer-based plans and government programs like Medicare currently excluding anti-obesity medications.

Should amycretin reach the market, it will enter this contentious environment. While its potential best-in-class efficacy and oral formulation could provide strong arguments for reimbursement, it will almost certainly command a premium price. Novo Nordisk will need to generate robust health economics data from its upcoming Phase 3 trials to convince payers that the long-term benefits of reduced diabetes complications and cardiovascular events justify the high upfront cost. The ultimate success of this promising drug will therefore be measured not only by its clinical trial endpoints but by its ability to navigate the complex and often frustrating realities of healthcare access and affordability.