The GLP-1 You Probably Haven't Heard Of
A look into what Lilly is trying to accomplish with once-monthly brenipatide
The GLP-1 field is off like a rocket ship and is highly competitive. Atop the leaderboard, sits Eli Lilly LLY 0.00%↑ , the most valuable healthcare company in the world. They got there largely on the backs of the performance and potential of three products:
tirzepatide: Lilly’s once-weekly GLP-1/GIP agonist that quickly displaced Novo’s NVO 0.00%↑ semaglutide as the market leader.
orforglipron: Lilly’s small-molecule oral GLP-1 offering market-leading convenience and strategically advantageous pricing flexibility.
retatrutide: Lilly’s triple agonist (GLP-1/GIP/GCG) that is shattering the upper limit of weight loss that can be achieved by pharmacotherapy.
Perhaps little known to some, Lilly actually has a fourth GLP-1 based molecule in late-stage studies, called brenipatide. It has 14 active clinical trials, is targeting enrollment of almost 5,000 patients, but gets almost no mainstream coverage. However, when we look at where, how, and why Lily is developing brenipatide, we might come to see it as its most important GLP-1 offering yet.
Where it is different
Brenipatide, as far as I can tell, doesn’t have anything super special to it other than it is sort of a long-acting version of tirzepatide. Just like ZEPBOUND (tirzepatide), it’s a dual GLP-1/GIP receptor agonist and a peptide-based biologic that requires a subcutaneous injection, but instead of once-a-week dosing, it’s once-monthly dosing.
Beyond that, perhaps the most interesting aspect of brenipatide is its clinical development plan. Whereas Lily’s three other leading GLP-1-based programs are largely all focused on cardiovascular and metabolic indications (with some exceptions), brenipatide is unique in its development plan, which focuses largely on addiction, neuropsychiatry, and respiratory disease. If successful, it would expand GLP-1 treatment into an an entirely new therapeutic frontier.
Looking at a breakdown of the larger studies , we can get a sense of both what Lilly’s strategy is with this molecule as well as where they see the highest level of confidence.