Biotech & Longevity · Thursday, 1 October 2026
Lilly's two-drug weight-loss treatment cut 23% of body weight in people with diabetes, and up to 27% stopped taking it
Eli Lilly's EloraTZP, Zepbound plus an experimental amylin drug, took off 23.3% of body weight in 48 weeks in people with type 2 diabetes. Stomach side effects made up to 27% stop.
23.3%
of body weight lost on the top dose of EloraTZP in 48 weeks
Zepbound alone took off 14.8%, and a dummy injection 3%
Up to 27%
of people on the two-drug combination stopped taking it
against 2.9% on Zepbound alone and 16.7% on a dummy injection
367
adults with type 2 diabetes and excess weight took part
in the US and Argentina, in a mid-stage trial
The lead story — what happened
-
Eli Lilly said on Wednesday that adults with type 2 diabetes and excess weight on the top dose of EloraTZP lost 23.3% of their body weight in 48 weeks.
[1] -
EloraTZP is two weekly injections given together: Zepbound, Lilly's approved weight-loss drug, and eloralintide, an experimental drug.
[3] -
People on Zepbound alone lost 14.8% of their weight, and people on a dummy injection lost 3%.
[1] [3] -
Zepbound copies two hormones that curb appetite, GLP-1 and GIP.
[3] Eloralintide copies amylin, a hormone made with insulin that slows digestion and tells the brain the body is full.[2] -
People with diabetes usually lose less weight on these drugs, which is why analysts at the bank Citi called the result notable.
[2] -
The usual blood-sugar measure, A1C, fell by up to 2.9% on the combination and 2.4% on Zepbound alone.
[1] -
Side effects were mostly nausea, diarrhoea and vomiting, and they were more common on the combination than on either drug alone.
[1] [3] -
Up to 27% of people on the combination stopped taking it, against 2.9% on Zepbound alone and 16.7% on the dummy injection.
[1] -
Lilly said people quit because both drugs' doses were raised at the same time, and it will raise them more slowly in final-stage trials starting before the end of 2026.
[1] [3] -
The 23.3% is worked out as if everyone had kept taking their injections as directed for all 48 weeks.
[2] -
On its own, eloralintide took off less weight at its top dose than at the dose below it: 11.1% of body weight against 12.3%.
[1] -
David Preiss, an Oxford researcher not involved in the trial, called the weight loss astonishing, and said not everyone needs to lose that much.
[3]
Who is involved
-
Eli Lilly
the US drugmaker that sells Zepbound and Mounjaro; it ran the trial and plans final-stage trials this year
-
Novo Nordisk
the Danish maker of Wegovy and Ozempic, Lilly's main rival; its shares are down more than 70% from their peak
-
Kenneth Custer
head of Lilly's heart and metabolism drugs; he said the combination might beat Lilly's retatrutide in later trials
-
David Preiss
a University of Oxford researcher who was not involved; he called the weight loss astonishing
How it unfolded
-
July Lilly reports first results for retatrutide, another experimental weight-loss drug
[4] -
Tue 29 Sep full retatrutide results appear in Milan and in The Lancet
[4] -
Wed 30 Sep EloraTZP results are presented at the European diabetes meeting in Milan
[3] -
Late 2026 final-stage trials of EloraTZP as one weekly injection begin
[1] [3] -
Early 2027 Lilly plans to ask the US regulator to approve retatrutide
[4]
Where this points
Watch whether the slower dose increase in Lilly's final-stage trials keeps weight loss near 23% while far fewer people stop taking it.
What is pushing on the whole day
The bar and the word are our reading of how hard each one is pushing today. The arrow is where it is heading. The evidence is in the stories below.
Lilly's two-drug treatment beat its own Zepbound in a mid-stage trial.
One person in a Bristol Myers Squibb trial for lung scarring died with liver damage.
Merck stopped supplying Recarbrio, a last-resort antibiotic, in the US.
The rest of the day
25 more stories on this beat.
Each with its own sources. None of these is a link to the story above.
-
02
US drug-price rule shrinks to four companies
The Trump administration published the final version of GLOBE, a rule meant to cut what Medicare, the US government's health plan for older people, pays for drugs given in doctors' offices.
[7] GLOBE ties those prices to what other rich countries pay.[7] Companies that signed separate voluntary price deals with the Trump administration are exempt, so the rule now covers only four companies, and it does not name them.[7] Medicare's own forecasters expect savings of $440 million, down from nearly $12 billion in the draft.[7] $12bnDraft rule$440mFinal ruleExpected Medicare savings from GLOBE. Exempting every company with its own price deal cut the expected savings by about 96%. Why it matters — The deals the Trump administration struck one company at a time now decide who escapes the rule.
[7] A Harvard researcher who studied GLOBE said the smaller savings match his own estimate.[7] -
03
Lilly's three-hormone drug: full results
On Tuesday Eli Lilly gave full results for retatrutide, a weekly injection that copies three hormones, in Milan and in The Lancet, a medical journal.
[4] In 1,152 adults with obesity and type 2 diabetes, the top dose cut weight by 20.8% over 80 weeks, against 4% on a dummy injection.[4] More than half on the top dose no longer counted as obese.[4] All three doses lowered A1C, the blood-sugar measure, by about the same amount, 1.4% to 1.6%.[4] Lilly plans to ask the FDA, the US drug regulator, for approval early next year.[4] Why it matters — Lilly now has two drugs aiming past its own Zepbound, and its executive Kenneth Custer said the new combination might beat retatrutide in later trials.
[1] -
04
A trial death raises liver questions
Bristol Myers Squibb, a large US drugmaker, changed a final-stage trial of admilparant to watch more closely for liver damage, a spokesperson said on Wednesday.
[8] Admilparant is an experimental drug for idiopathic pulmonary fibrosis, a disease that scars the lungs.[8] A limited number of liver problems were seen, and one participant died of multi-organ failure with liver damage.[8] It is not clear whether that person received the drug, and outside monitors have each time advised that the trial continue.[8] Results are due by the end of the year.[8] Why it matters — Bristol Myers dropped an earlier drug of the same type over liver damage, and shares in Contineum Therapeutics, which is testing a similar drug, also fell on Tuesday.
[8] -
05
FDA reviews Roche's multiple sclerosis pill
The FDA agreed to review fenebrutinib, an experimental pill for multiple sclerosis from Roche, the Swiss drugmaker.
[9] It could become the first drug of its type approved for both the relapsing form of the disease and the primary progressive form, which worsens steadily.[9] It met its main goals in three final-stage trials, and the review is on a six-month fast track.[9] But eight people taking it died across two of those trials, against one on the comparison drug.[9] Roche says the deaths happened at different times and had various causes.[9] Why it matters — Two rival pills of the same type, from Merck KGaA and Sanofi, were slowed by liver side effects, and Sanofi's was turned down in the US partly over safety.
[9] -
06
Legal immigrants lose US health cover
From 1 October many immigrants living legally in the US lose Medicaid, the US government health plan for people on low incomes.
[18] The change comes from the One Big Beautiful Bill Act, the 2025 law expected to cut Medicaid spending by more than $900 billion through 2034.[18] Refugees, people granted asylum and victims of sex trafficking are among those affected; green-card holders are not.[18] Nine states and Washington DC told KFF Health News that more than 281,000 people will lose cover this month, nearly 177,000 of them in Florida.[18] Why it matters — They can still get emergency care through a separate programme.
[18] A change starting in January will also take help buying private cover from about a million immigrants by 2034, the Congressional Budget Office estimates.[18] -
07
Merck stops selling a last-resort antibiotic
Merck, one of the biggest US drugmakers, stopped supplying the antibiotic Recarbrio in the US earlier this month, STAT reported.
[12] Recarbrio is a three-drug injection approved seven years ago for serious infections, such as pneumonia caught in hospital or on a ventilator.[12] The FDA marked it from the start as a treatment of last resort, to slow the spread of germs that resist antibiotics.[12] That also limited how much of it could be sold.[12] Merck did not explain its decision or disclose its sales.[12] Why it matters — It was used for adults and children with few or no other treatment options, which is the group that loses it.
[12] -
08
Roche's amylin drug peaks at the middle dose
Roche and its Danish partner Zealand Pharma published fuller results for petrelintide, an experimental weekly injection that copies amylin, in a Lancet journal.
[5] At 28 weeks, weight loss was 7.9% on the two lowest doses, 1 mg and 2.5 mg, and 9.8% on 5 mg.[5] The 7 mg and 9 mg doses did no better, at 9.3% and 9.4%.[5] Nausea hit 20% of people on the drug, against 6% on a dummy injection.[5] Roche was due to start three final-stage trials on Wednesday.[5] Why it matters — Roche paid $1.65 billion up front for the drug in 2025.
[5] Comparisons across different trials suggest it will not lead on weight loss, so Roche and Zealand point to milder side effects instead.[5] -
09
Switching from jabs to Novo's pill
Novo Nordisk, the Danish maker of Wegovy, presented a study of 194 people who moved from weight-loss injections to its daily Wegovy pill.
[6] Over three months they lost a further 4.1% of their body weight on average.[6] The share counted as obese fell from 87.1% to 65.5%.[6] Novo compiled the data with Ro, a US online clinic, and part of it is what patients reported themselves.[6] With no comparison group, the study cannot show that the pill caused the loss.[6] Why it matters — Novo's own presentations say pills now make up about a third of US obesity prescriptions, and that Novo takes more than 80% of new pill prescriptions.
[6] -
10
Beam sues a rival over gene-editing secrets
Beam Therapeutics, a US company that edits single letters of DNA, sued a former scientist and two companies in a Massachusetts court on 25 September.
[10] It says Zi Jun Wang secretly founded YolTech Therapeutics in China in 2021 while still working at Beam, and opened Beam files far outside her own work at night and on weekends.[10] [11] Beam says YolTech's treatment for alpha-1 antitrypsin deficiency, an inherited disease, is strikingly similar to its own.[10] Serapha Bio, which licensed YolTech's treatment outside China, rejects the claims.[10] Why it matters — Serapha launched in June with $230 million.
[10] The case lands amid rising tension between US and Chinese biotech companies.[10] [11] -
11
Merck's drug clears painful skin lumps
Merck released results for tulisokibart in hidradenitis suppurativa, a long-lasting disease that causes painful lumps under the skin.
[14] In a mid-stage trial of 149 people, 72% on the highest dose had at least half their lumps and abscesses go within 16 weeks, against 35% on a dummy injection.[13] [14] The middle dose reached 64% and the low dose 52%.[13] Merck plans a final-stage trial.[13] It got the drug when it bought Prometheus Biosciences for $10.8 billion in 2023.[13] Dummy injection35%Low dose52%Middle dose64%High dose72%Share of people whose lumps and abscesses at least halved in 16 weeks. In this trial, each higher dose did better. Why it matters — Merck is counting on drugs like this to help replace sales of Keytruda, its best-selling cancer drug, which loses its patent protection later this decade.
[14] -
12
Fewer return trips for a lung disease
Connect Biopharma, a San Diego company, tested rademikibart in 159 people with COPD, a long-term lung disease, who had just had a flare-up.
[16] Added to usual care, it cut the rate of treatment failure over four weeks by 81% against a dummy injection.[16] No one on the drug needed a hospital or emergency visit in that time.[16] It missed a goal on a breathing test after seven days.[16] A sister trial in asthma, reported weeks earlier, fell short.[16] Why it matters — Simcere, a Chinese drugmaker, paid $21 million for the China rights amid hopes it could rival Dupixent, the big-selling asthma and COPD drug from Sanofi and Regeneron.
[16] Connect plans to ask the FDA about a final-stage trial.[16] -
13
A lupus antibody works on skin sores
Amgen, a large US biotech company, published results for daxdilimab in 72 people with discoid lupus, an immune disease that causes sores on the skin.
[15] After 24 weeks about 62% on either dose had their disease score at least halved, against 23.7% on a dummy injection.[15] The lower dose did slightly better on the main skin score, cutting it by 6 points against 5.7 for the higher dose.[15] No serious side effects or deaths were reported.[15] The same antibody failed in 2023 in the more common form of lupus.[15] Why it matters — Amgen got the drug in its $27.8 billion purchase of Horizon Therapeutics, and is moving it towards the final stage of testing.
[15] -
14
An injection shrinks a common skin cancer
Highlight Therapeutics, a Spanish company, injected its drug BO-112 straight into basal cell carcinoma in 46 patients.
[17] Basal cell carcinoma is the most common skin cancer, usually found on the face, head, neck and arms.[17] After 24 weeks, 61% responded, judged both by eye and under the microscope.[17] In high-risk cancers of the head and neck, 56% had no cancer cells left in the tissue examined.[17] The trial had no comparison group.[17] Why it matters — Surgery is the usual treatment, and the company wants to offer this as a non-surgical option, especially for high-risk cancers on the head and neck.
[17] -
15
US moves against a strong kratom chemical
Kratom is a Southeast Asian plant with opioid-like effects, sold in the US as a supplement in petrol stations and shops.
[19] The DEA, the US drug-enforcement agency, has proposed temporarily listing 7-OH, a strong chemical from kratom, as Schedule I above a set strength.[20] Schedule I is for the riskiest drugs with no accepted medical use.[20] Pressure grew after kratom was found with two University of Mississippi students who died this month.[19] [20] Authorities have not said that kratom caused either death.[20] Why it matters — Milder kratom leaf products would stay on sale, and 11 US states already ban kratom outright.
[20] [19] -
16
Measles deaths: the CDC counts two, Pennsylvania four
The CDC, the US public-health agency, updated its website to show two measles deaths in the US this year.
[20] Pennsylvania, which is in a historic outbreak, counts four measles-related deaths of its own.[20] It is not clear which of those four the CDC added.[20] A University of Pennsylvania survey found 31% of US adults think Health Secretary Robert F. Kennedy Jr. recommends the measles vaccine for children, 29% think he does not, and 40% are unsure.[20] 2 deathsCDC, whole US4 deathsPennsylvania aloneThe national count is lower than one state's own count, and the CDC has not said which of Pennsylvania's deaths it included. Why it matters — Kennedy, the US health secretary, has made misleading claims about vaccines, STAT reports.
[20] -
17
Two charged over fake Ozempic
A US grand jury charged two Indian nationals with smuggling and selling fake Ozempic, the weight-loss drug, the US Justice Department said on Tuesday.
[21] Prosecutors say the two bought the fakes in China between July 2023 and April 2024 and sold them to US distributors at a discount.[21] The fakes came with packaging, leaflets and labels made to look real.[21] One pleaded not guilty after being sent from Italy; the other has not been caught.[21] Why it matters — The selling went on after the FDA seized some of the fakes in December 2023 and warned the public.
[21] The charges carry up to 71 years in prison.[21] -
18
Lawmakers press on an estrogen patch shortage
The 96-member Democratic Women's Caucus in the US House wrote to Health Secretary Robert F. Kennedy Jr. on Monday about a long shortage of estrogen patches.
[22] The patches deliver the hormone through the skin and ease menopause symptoms such as hot flushes and poor sleep.[22] Many women have had to cut or change their dose, or switch brands, Reuters has reported.[22] The FDA says it is working with all six makers to raise supply.[22] Why it matters — The lawmakers asked the FDA to consider adding the patches to its official shortage list, and wrote that a letter in July had produced no meaningful action.
[22] -
19
Drug industry picks Eric Cantor as its chief
PhRMA, the lobbying group for the brand-name drug industry in the US, named Eric Cantor as its next chief executive.
[11] Cantor is a former Republican majority leader of the US House of Representatives.[11] He starts on 9 November.[11] He arrives as the Trump administration tries to write into law its voluntary deals with more than two dozen companies to bring US medicine prices down to levels in similar countries.[11] Why it matters — He will face mounting pressure on drug prices from both main US parties, STAT notes.
[11] -
20
Lawmakers push back on a mailed-medicine rule
A growing number of US lawmakers are urging the Trump administration to rethink a rule that takes effect next month.
[20] It requires medicines mailed into the US from abroad to clear customs through a licensed customs broker, with a money guarantee called an entry bond.[20] Lawmakers fear it will stop Americans getting prescriptions from licensed pharmacies in other countries.[20] The extra steps could add costs that the person receiving the medicine has to pay.[20] Why it matters — It reaches anyone in the US who gets prescription medicine posted from a pharmacy abroad.
[20] -
21
New endometriosis tests, little proof yet
Several start-ups now sell tests for endometriosis that use saliva, blood or electrical signals from the gut, The New York Times reported.
[23] Endometriosis is a disease in which tissue like the womb lining grows outside the womb, and it affects at least one in ten women of child-bearing age.[23] Diagnosis takes seven to nine years on average and often needs surgery.[23] Experts say the evidence for the new tests comes from small studies.[23] Why it matters — The FDA has approved no test that avoids surgery, and some of these are sold for research only or through a loophole the FDA has failed to close.
[23] -
22
Zepbound may switch on fat burning, in mice
Researchers at the University of Barcelona gave tirzepatide, the drug in Zepbound and Mounjaro, to obese mice.
[24] They compared them with mice given no drug but fed the same amount of food.[24] The drug switched on brown fat, a kind of fat that burns energy instead of storing it.[24] That suggests the drug does more than cut appetite.[24] The finding is in mice and has not been tested in people.[24] Why it matters — Earlier drugs that switched on brown fat were held back by harm to the heart, and the researchers say tirzepatide does not have that effect.
[24] -
23
Stem cells behind a narrowing spine
Researchers at Weill Cornell Medicine in New York found the stem cells that build the body's tendons and ligaments, they reported in the journal Cell on 7 September.
[25] In lumbar spinal stenosis, thickened ligaments squeeze nerves in the lower back, causing pain and trouble walking, and it affects an estimated 103 million people.[25] People with the condition had more of these cells in their ligaments.[25] Turning down calcium signals inside the cells stopped the overgrowth in mice.[25] Why it matters — Calcium channel blockers, common blood-pressure pills, could one day be tested against it, though trials in people would come first.
[25] -
24
A search for drugs against heart scarring
A team writing in Science, a major journal, tested about 4,000 known chemicals on heart cells grown from human stem cells.
[26] They were looking for one that stops cardiac fibrosis, the scarring that stiffens the heart in heart failure.[26] No approved drug treats that scarring directly.[26] The best chemical blocks all three of the heart cells' receptors for adenosine, a natural signal, and it worked in mice with failing hearts.[26] Why it matters — Drugs that blocked only one of these receptors gave mixed results before.
[26] The study found all three feed one shared signal inside the cell, so blocking all three works better.[26] -
25
An old pill helps bladder cells kill hidden germs
Researchers at EPFL, a Swiss university, studied OM-89, sold as Uro-Vaxom and used for decades to prevent repeat urinary infections.
[27] E. coli bacteria can hide inside bladder cells, out of reach of antibiotics and the immune system.[27] In lab-grown bladder cells from mice and people, OM-89 strengthened the cells' own germ-destroying machinery and let more antibiotic in.[27] The study was published in PLOS Pathogens.[27] Why it matters — The results come only from lab models and do not change how the drug is approved for use, its maker OM Pharma says.
[27] -
26
Rare chemicals found in cannabis leaves
Chemists at Stellenbosch University in South Africa analysed leaves from three commercially grown cannabis strains.
[28] They found 79 phenolic compounds, a family of plant chemicals, and 25 of them had never been reported in cannabis.[28] Sixteen were tentatively identified as flavoalkaloids, a rare group never seen in the plant before.[28] Most of those turned up in just one strain.[28] The work appeared in the Journal of Chromatography A.[28] Why it matters — Cannabis leaves are often thrown away as waste.
[28] Related plant chemicals interest drug researchers, but this study only identified the compounds and did not test what they do.[28]
Why a bigger dose can stop helping
A drug works by attaching to receptors on cells, and once most are taken, a bigger dose adds side effects faster than it adds benefit.
The twist
The strongest dose is not always the best one. Above a certain amount the benefit stops rising, while side effects keep rising and push people to stop.
The picture
How it works
- A drug works by attaching to receptors, the parts of cells that read a hormone
- A bigger dose attaches to more receptors, so the effect grows
- Once most receptors are taken, extra drug has little left to attach to
- Side effects such as nausea can keep growing with the dose
- More people stop taking it, so the average result stalls or even falls
- So trials test several doses to find where the gain stops
The same force, elsewhere today
Where this chain is also running, in today's other stories.
-
Roche's amylin drug
Weight loss rose from 7.9% to 9.8% as the dose went up to 5 mg, then stayed near 9.4% at 7 mg and 9 mg.
-
Lilly's eloralintide on its own
The top dose took off 11.1% of body weight, less than the 12.3% on the dose below it.
-
Amgen's lupus antibody
The lower dose cut the skin score by 6 points and the higher dose by 5.7, so the extra drug added nothing.
-
Lilly's retatrutide
All three doses lowered blood sugar by about the same amount, 1.4% to 1.6%.
Where you've seen this
Fertiliser on a field
past a point the crop stops growing more, and the extra washes into rivers
Studying late
after a few hours, more hours add tiredness faster than they add learning
Watering a garden
once the soil is soaked, more water runs off instead of reaching the roots
The catch
Some drugs do keep improving with the dose: Merck's skin drug helped 52% on its low dose and 72% on its high dose. And a small dip at the top dose can be chance in a small trial.
And the whole of it
The dose printed on a medicine box was chosen from a handful of amounts tried on a few hundred people. No patient can know in advance whether that dose is past the point where more stops helping them, and neither can their doctor.
What is really going on
The day's biggest numbers came from drug companies presenting their own trials at a diabetes meeting in Milan.
Why it works on us — One big percentage on the top dose is easy to repeat, and the people who quit because they felt sick are a smaller number further down the page.
Who gains
-
Eli Lilly
— Beating its own Zepbound gives it another drug to sell in a race with Novo Nordisk for a market some analysts put at $100 billion to $150 billion a year by 2030.
[1] -
Drugmakers with their own price deals
— Signing a voluntary deal with the Trump administration exempts them from the mandatory GLOBE rule.
[7] -
Novo Nordisk
— A study it compiled with the online clinic Ro lets it say people do well after switching from injections to its pill.
[6] -
Roche
— Its multiple sclerosis pill gets a six-month fast review despite an imbalance in deaths.
[9]
Who pays
-
People on EloraTZP who felt sick
— Raising two drugs' doses at once caused nausea and vomiting, and up to 27% stopped.
[1] -
Medicare
— Its expected savings from GLOBE fell from nearly $12 billion to $440 million.
[7] -
Immigrants living legally in the US
— More than 281,000 in nine states and Washington DC lose Medicaid this month.
[18] -
Patients with few antibiotic options left
— Merck stopped supplying Recarbrio, a three-drug injection kept for infections with limited or no alternatives.
[12] -
Women who use estrogen patches
— A long shortage has forced many to cut or change their dose, or switch brands.
[22]
What nobody knows yet
Open questions from across today’s stories — ours included.
-
01
How much weight people on EloraTZP lose once those who stopped are counted.
The 23.3% assumes everyone took the drug as directed for 48 weeks, and up to 27% did not.
[1] [2] -
02
Which four companies the GLOBE rule covers.
The final rule says four companies remain and does not name them.
[7] -
03
Whether the person who died in Bristol Myers Squibb's lung trial had taken the drug.
A spokesperson said it is unclear, and analysts said several other things could have caused the death.
[8] -
04
Whether the eight deaths among people taking Roche's fenebrutinib had anything to do with it.
Roche says they happened at different times and had various causes, and the FDA has only just begun its review.
[9] -
05
Why Merck stopped selling Recarbrio.
Merck did not explain the decision and has never disclosed the antibiotic's sales.
[12] -
06
How many US measles deaths there have been this year.
The CDC counts two for the whole country, Pennsylvania counts four of its own, and nobody has said which of the four the CDC included.
[20] -
07
Whether Beam's claims against YolTech and Serapha are true.
Beam's account comes from its own lawsuit, Serapha rejects it, and YolTech had not answered.
[10] -
08
How many immigrants lose Medicaid across the US this month.
Only nine states and Washington DC gave figures, and final numbers will not be ready until later this autumn.
[18] -
09
Whether people who switched to Novo's Wegovy pill lost weight because of the pill.
The study had no comparison group and partly relied on what patients reported themselves.
[6]
In a trial of 159 people who had just had a flare-up of COPD, a long-term lung disease, nobody given Connect Biopharma's rademikibart needed a hospital or emergency visit in the next four weeks.
Also true today
- After 24 weeks on Amgen's daxdilimab, about 62% of people with discoid lupus, which causes sores on the skin, had their disease score at least halved, against 23.7% on a dummy injection.
- In Merck's trial for hidradenitis suppurativa, which causes painful lumps under the skin, 72% on the highest dose of tulisokibart saw at least half their lumps and abscesses go in 16 weeks, against 35% on a dummy.
- More than half of the adults with obesity and type 2 diabetes on the top dose of Lilly's retatrutide no longer counted as obese after 80 weeks.
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