EASD 2026: The Amylin Era Arrives — Lilly's EloraTZP Hits 23.3% Weight Loss, Novo's CagriSema Shows 22.4% Plus "Food Noise" Brain Data
At the European Association for the Study of Diabetes annual meeting in Milan (Sept. 28–Oct. 2, 2026), both GLP-1 majors pivoted the scientific narrative to amylin-based combination drugs — a next generation that promises more weight loss with fewer GI side effects. TIME's framing: with ~40% of people stopping GLP-1s within a year over GI side effects, "amylins don't seem to cause as many severe side effects such as nausea, vomiting, and stomach cramping."
Eli Lilly — EloraTZP (eloralintide + tirzepatide), Phase 2b in obesity + T2D (48 weeks):
- Highest dose produced 23.3% mean weight loss (54.1 lbs) and 2.9% A1C reduction — vs. 14.8% / 2.4% for tirzepatide 15 mg alone and 12.3% / 1.4% for eloralintide alone (NCT06603571). Per Clinical Trials Arena, the result "appears to have also topped the weight loss seen from Lilly's triple-G drug candidate retatrutide, though no head-to-head trial has been conducted," and cross-trial it beats Novo's CagriSema (15.7% at 68 weeks).
- BioSpace: the data sweep "propel[s] Lilly's amylin-GIP/GLP-1 combo into Phase 3," with a Phase 3 launch planned before the end of the year.
- Sell-side: Leerink's David Risinger forecasts $23B eloralintide sales in 2035; Evercore ISI's Umer Raffat suggests a sequencing strategy — "starting with more tolerable eloralintide and adding Zepbound if patients want greater weight loss."
Novo — CagriSema and the shot-to-pill pathway:
- CagriSema (semaglutide + amylin analogue cagrilintide) delivered 22.4% weight loss at one year vs. placebo in people with overweight/obesity, per TIME. Novo also showed fMRI brain-scan data that CagriSema "changed brain responses to food, potentially making food fixations less intense" (the "food noise" claim), and reduced harmful liver and pancreatic fat in T2D. CSO Martin Holst Lange added an early study suggesting CagriSema can reduce diabetic neuropathic pain: "beyond weight loss and glycemic control, CagriSema can do more to help people in their everyday life." The FDA decision on the CagriSema obesity NDA is expected by end of 2026 (watched).
- Real-world shot-to-pill data (with DTC partner Ro): patients who switched from the Wegovy shot or Zepbound to the Wegovy pill and stayed ≥3 months lost an additional 4.1% of body weight; the share classified obese fell from 87% to 66%. Investigator Louis Aronne (Weill Cornell): "These are exciting early insights on how the pill can individualize obesity care."
- Novo also reported Wegovy reduced liver fat to normal levels in 9 of 10 adults with obesity and excess liver fat — a MASH-adjacent market signal.
The challengers:
- Zealand/Roche petrelintide: Phase 2 published in The Lancet (Sept. 29) — 10% weight loss vs. 1.7% placebo, with side effects at the highest doses similar to placebo. Trial leader Dr. Timothy Garvey (U. Alabama): "The amylins still cause some nausea, but it's at less than half the rate of what we generally see in GLP-1 trials… Primary care physicians may have an easier time prescribing these since they are better tolerated. So I am personally very sanguine about amylins."
- Boehringer Ingelheim survodutide (GLP-1/glucagon, Zealand-licensed): SYNCHRONIZE 2 in obesity + T2D — 13% weight loss vs. 3% placebo in completers, extending the April Phase 3 obesity win into the harder diabetes population.
- AbbVie ABBV-295 (Gubra long-acting amylin): Phase 1 at EASD — up to 10% weight loss at week 12 on weekly dosing and 8% on monthly dosing, pointing toward monthly-injection convenience.
Investor takeaway: The competitive frontier is bifurcating — (1) maximum-efficacy amylin+incretin combos (EloraTZP, CagriSema) where Lilly now owns the cross-trial narrative, and (2) tolerability-first amylin monotherapy as a primary-care, moderate-weight-loss, possibly monthly-dosed product (petrelintide, ABBV-295, eloralintide alone). The WSJ's headline captures the shift: "The Next Frontier for Obesity Drugs Isn't How Much Weight You Lose, But What Kind." Watch EloraTZP's Phase 3 start (registered), the CagriSema FDA decision (~Nov 15), and whether Novo's zenagamtide Phase 3 T2D start (watched) restores its next-gen credibility.