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[161.38.195.184]) by mx.google.com with UTF8SMTPS id af79cd13be357-9101f2dff04si135998985a.34.2026.05.13.07.53.13 for (version=TLS1_2 cipher=ECDHE-ECDSA-AES128-GCM-SHA256 bits=128/128); Wed, 13 May 2026 07:53:13 -0700 (PDT) Received-SPF: pass (google.com: domain of bounce+30b528.39b08c6-tjphuhs=gmail.com@mg-d1.substack.com designates 161.38.195.184 as permitted sender) client-ip=161.38.195.184; Authentication-Results: mx.google.com; dkim=pass header.i=@mg-d1.substack.com header.s=k1 header.b=SXavVNmH; dkim=pass header.i=@mailgun.org header.s=mg header.b="fn/DRE16"; spf=pass (google.com: domain of bounce+30b528.39b08c6-tjphuhs=gmail.com@mg-d1.substack.com designates 161.38.195.184 as permitted sender) smtp.mailfrom="bounce+30b528.39b08c6-tjphuhs=gmail.com@mg-d1.substack.com"; dmarc=pass (p=REJECT sp=REJECT dis=NONE) header.from=substack.com DKIM-Signature: a=rsa-sha256; v=1; c=relaxed/relaxed; d=mg-d1.substack.com; q=dns/txt; s=k1; t=1778683993; x=1778691193; h=List-Unsubscribe-Post: List-Unsubscribe: List-Post: List-Id: List-Archive: List-Owner: Reply-To: In-Reply-To: References: Sender: Sender: Date: Message-Id: To: To: From: From: Subject: Subject: Content-Type: Mime-Version: X-Feedback-Id; bh=lrB1ZTjC9Rnnf3dTFxYzKPvAHb1eKP6HdNYWWZKqyUg=; b=SXavVNmHAKlJ2SHTkmZxrhBSYeCN+mjQ9WNpmZJtxWo3FIyA8Tgc493/qMWYNpU3FmP2F2V1nusRCWRVABlXX4JdiVN1d8GcyTwvYKY4GOd+mqJ4e1bhyMOz0tqYpI2W3oWpsHUH5E43d6Woe8dj5v/h6a/qy/iP2Q4FrLPU+wM= DKIM-Signature: a=rsa-sha256; v=1; c=relaxed/relaxed; d=mailgun.org; q=dns/txt; s=mg; t=1778683993; x=1778691193; h=List-Unsubscribe-Post: List-Unsubscribe: List-Post: List-Id: List-Archive: List-Owner: Reply-To: In-Reply-To: References: Sender: Sender: Date: Message-Id: To: To: From: From: Subject: Subject: Content-Type: Mime-Version: X-Feedback-Id; bh=lrB1ZTjC9Rnnf3dTFxYzKPvAHb1eKP6HdNYWWZKqyUg=; b=fn/DRE16bwNAyCD5/xanh9ktDm/TOS0KAQX+KS9rZVtp5vOYRLrs0d9b96RXC33eMp9CRBFu485FELjzy411+6ZYNJ3ZctrZC0A74HL03NU2Pzby/4n1uEkn1snpDHawaBZP8em9N4sxBoENQvk2kpu5NyxTdC7xWKg+rzrs3Ck= X-Mailgun-Sid: WyIxMWU0ZSIsInRqcGh1aHNAZ21haWwuY29tIiwiMzliMDhjNiJd X-Feedback-Id: postmaster@mg-d1.substack.com:post:614a1297c57bbbe25fa40e08:mailgun Received: by 97b671ee806d1f9d39be1478deb4fc960f01fae620d67e468a87139c7017cb98 with HTTP id 6a04905933ab1b64f013be11; Wed, 13 May 2026 14:53:13 GMT X-Mailgun-Sending-Ip: 161.38.195.184 Mime-Version: 1.0 Content-Type: multipart/alternative; boundary="49f275c470d4387788f62fc4785a17bdb7d969bb62198d3521bb4949ea70" Subject: Massive GLP-1 Data From ECO 2026 From: Dave Knapp from On The Pen To: tjphuhs@gmail.com X-Mailgun-Tag: post X-Mailgun-Track-Clicks: false Message-Id: <20260513145249.3.f194493143f46a53@mg-d1.substack.com> Date: Wed, 13 May 2026 14:52:49 +0000 Feedback-Id: post-197519877:cat-post:pub-4808993:substack Sender: Dave Knapp from On The Pen References: In-Reply-To: Reply-To: Dave Knapp from On The Pen List-Owner: List-Url: List-Archive: List-Id: List-Post: List-Unsubscribe: List-Unsubscribe-Post: List-Unsubscribe=One-Click X-Mailgun-Variables: {"category": "post", "email_generated_at": "1778683993139", "is_freemail": "true", "post_audience": "everyone", "post_id": "197519877", "post_type": "newsletter", "pub_community_enabled": "true", "publication_id": "4808993", "subdomain": "onthepen", "user_id": "273622398"} --49f275c470d4387788f62fc4785a17bdb7d969bb62198d3521bb4949ea70 Content-Type: text/plain; charset="utf-8" Content-Transfer-Encoding: quoted-printable View this post on the web at https://onthepen.substack.com/p/massive-glp-1-= data-from-eco-2026 We spent time on the podcast last week walking through what the European Co= ngress on Obesity was likely to bring. The maintenance question was the one= we flagged as most important -- not whether these drugs work, but what =E2= =80=9Cstaying on them=E2=80=9D actually looks like for people navigating re= al lives, real costs, and real preferences about needles versus pills. Today, on the first day of the congress in Istanbul, that question got some= answers. Two major studies published simultaneously, a high-dose semagluti= de sub-analysis dropped from the STEPUP trial, and Viking Therapeutics pres= ented phase 2 oral data. It was a full day. Here is what came back, and what it means if you are on one of these medica= tions or thinking about it. 1. If you got to the higher doses of tirzepatide, you will likely need tirz= epatide, the higher doses give you a greater =E2=80=9Cshot=E2=80=9D at succ= essful maintenance SURMOUNT-MAINTAIN is the study Zepbound users have been waiting for. The qu= estion it asked: if you spent over a year losing weight on tirzepatide at y= our maximum dose, what happens when you step down? Participants spent 60 weeks losing weight on tirzepatide at their maximum t= olerated dose (10 or 15mg, depending on what each person could handle), the= n split into three groups for 52 weeks of maintenance. One group stayed on = their maximum tolerated dose. One dropped to 5mg. One switched to placebo. At week 112, measured from where everyone started: Tirzepatide maximum tolerated dose: -21.9% body weight Reduced to 5mg: -16.6% Switched to placebo: -9.9% The gap between maximum tolerated dose and 5mg is real, about 5 percentage = points. For some people that will matter a lot, and for others it will not.= The number that matters most for patients considering a step-down is this:= roughly one in three people on 5mg maintenance retained 85% or more of the= ir initial weight loss. That is not everyone. But it is a real and meaningf= ul subset. If you lost 50 lbs on your highest tolerated dose and are wonder= ing whether dropping to 5mg is workable, the data says that for about a thi= rd of people in that situation, it largely holds. That conversation with yo= ur doctor just got more grounded in evidence. The headline, though, is that the maximum tolerated dose performed best. If= keeping as much of your loss as possible is the priority, the data says st= aying on your highest tolerated dose is still your best bet. The placebo arm tells a story this community already knows, stop the medica= tion and the weight starts coming back. Not because of willpower. Because o= besity is a chronic disease and the biology does not stop just because the = prescription does. The data keeps confirming this, and it keeps mattering t= hat we say it clearly. One design detail worth noting: patients on placebo who regained more than = half of their initial weight loss could restart tirzepatide. That rescue pr= otocol is why the placebo arm did not regain everything, and it reflects a = shift in how researchers are approaching these trials. They are increasingl= y unwilling to simply watch patients regain weight in the name of clean dat= a. That=E2=80=99s news worth celebrating. ON THE PEN is a reader-supported publication. To receive new posts and supp= ort my work, consider becoming a free or paid subscriber. 2. Orforglipron is likely best suited to maintain weight loss from a GLP-1 = agonist like semaglutide: around 85% for Wegovy users, around 74% for Zepbo= und users ATTAIN-MAINTAIN is the study that deserves the most attention out of yester= day=E2=80=99s news, because the question it is asking is genuinely new. And= the answer matters directly for a lot of people in this community. Here is the scenario it tested: you spent 72 weeks on Wegovy or Zepbound, l= ost a meaningful amount of weight, and plateaued. Now you want to switch to= a daily pill (Foundayo) instead of a weekly injection. Maybe you are tired= of injecting. Maybe access or cost is changing. Maybe you just want a diff= erent option. Can orforglipron (Lilly=E2=80=99s once-daily oral GLP-1), hol= d what you built on an injectable? Participants who completed the SURMOUNT-5 head-to-head trial were re-random= ized to orforglipron or placebo for 52 weeks. Two cohorts: those coming off= Zepbound and those coming off Wegovy. 376 participants total. They started= orforglipron at 12mg and titrated up every four weeks, targeting a maximum= of 36mg. A rescue protocol allowed escalation or a switch from placebo to = orforglipron after week 24 for anyone who regained more than half their ori= ginal loss. One detail to keep in mind: there was a two-week screening gap = between studies, so some regain occurred before orforglipron began. The results split cleanly by which injectable you came from. The Wegovy coh= ort on orforglipron maintained 85.9% of their body weight reduction at 52 w= eeks, compared to 40.2% on placebo. The Zepbound cohort maintained 74.4%, c= ompared to 49.7% on placebo. The weight trajectories in pounds make it concrete. The Wegovy cohort start= ed SURMOUNT-5 at an average of 250 lbs, got down to 209 lbs on injections, = and finished ATTAIN-MAINTAIN at 211 lbs on orforglipron. Essentially flat f= or a full year on a daily pill. The Zepbound cohort started at 255 lbs, got= down to 200 lbs on their highest tolerated dose of injections, and ended a= t 211 lbs, or an 11 lb regain from their injectable low point, though still= 44 lbs below where they started. Lilly=E2=80=99s press release leaned into the fact that both cohorts ended = at the same weight, 211 lbs, framing it as a unified success. That converge= nce is technically accurate, but it tells a more complicated story: the peo= ple who lost more on the more powerful drug gave back more when they steppe= d down to a GLP-1 pill. That is not a reason to panic. A 74.4% maintenance = rate after switching off a dual agonist injection to a once-daily pill is a= genuinely good outcome. It just deserves to be seen clearly, not averaged = away. The reason for the gap comes down to mechanism. Switching from Wegovy to or= forglipron is a like-for-like swap, GLP-1 to GLP-1. Switching from Zepbound= to orforglipron means losing the GIP component, which is part of what make= s tirzepatide more potent. Some of that potency goes with it. The practical takeaway: if you are on Wegovy and thinking about switching t= o Foundayo, the data is quite encouraging. If you are on Zepbound, the pict= ure is still positive, but expect some drift and definitely factor that int= o the conversation with your doctor. On tolerability, the transition went relatively smoothly. GI effects were m= ild to moderate, discontinuation rates were low across all arms, and (perha= ps most importantly) no liver safety concerns emerged. 3. When measured by MRI, the gold standard for body composition, semaglutid= e does not come close to decimating muscle: around 16% of weight lost was l= ean mass The muscle loss argument against GLP-1 medications has been circulating for= years. Today=E2=80=99s STEPUP sub-analysis adds the most rigorous data yet= to the rebuttal. The sub-analysis looked at semaglutide at 7.2mg, three times the currently = approved Wegovy dose, in 1,407 adults with obesity over 72 weeks. Nested wi= thin it was an MRI body composition sub-study of 55 participants. MRI is th= e gold standard for measuring body composition, more precise than the DEXA = scans more commonly cited in this debate. The findings: 84% of the weight lost was fat mass. Around 16% was lean mass= =2E Visceral fat dropped more than 30%.= And muscle function as measured by si= t-to-stand testing was unchanged. Yes, 16% of lost weight being lean mass is a real number and worth acknowle= dging honestly. But functional muscle preservation, the thing that actually= determines whether your body works well, held up. Why? It=E2=80=99s pretty= simple. A 300 pound man doesn=E2=80=99t require the same amount of muscle = to move functionally as a 200 pound man. When it came to function, the data= held up. Critics of GLP-1s on the muscle loss question have been working w= ith increasingly thin evidence, and MRI data showing preserved function at = a higher semaglutide dose is another data point they will need to reckon wi= th. The broader efficacy picture from the STEPUP sub-analysis is also worth not= ing. At 7.2mg overall, patients lost 20.7% of their body weight versus 17.5= % at the currently approved 2.4mg dose. And early responders (those who los= t 15% or more in the first 24 weeks, about one in four patients) reached 27= =2E7% total body weight loss by week 72= =2E Even the slower responders averaged=20= 15.4%, which means the floor is higher than what most people experience at = the current approved dose. Wegovy at 7.2mg is now approved in the US for prescription, and it was rece= ntly announced that it would be included in the medicare BRIDGE program beg= inning on July 1 of this year. 4. Viking=E2=80=99s dual agonist pill could be among the strongest oral opt= ions on the market -- 12% weight loss after just 13 weeks, though the 120mg= dose raises real questions Viking Therapeutics presented phase 2 results from their VENTURE-Oral study= , a dose-finding trial of the oral version of VK2735, a dual GLP-1/GIP agon= ist similar in mechanism to Zepbound. At the highest dose tested, 120mg once daily over 13 weeks, participants lo= st 12.2% of body weight. GI side effects were mild to moderate and largely = resolved as doses were titrated up. Thirteen weeks is a short window, and dose-finding studies are designed to = map the dose-response curve, not to show peak efficacy. But 12.2% at 13 wee= ks puts oral VK2735 in serious company. For context, most injectable trials= at similar timepoints are not showing numbers that much higher. The phase = 3 for the oral formulation is expected to read out next year. The caveat worth sitting with: 120mg is a very large amount of active pharm= aceutical ingredient for a daily pill. Viking Therapeutics has publically a= knowledged that they only intend to bring the 75mg version to market, which= will undoubtedly bring these numbers back down to earth. But for our commu= nity, the broader point is simple: the oral pipeline is thickening. More op= tions with strong efficacy profiles means more competition, and more compet= ition is good for access and affordability over time. What It All Means Four datasets, one day. The throughline across all of them is the same ques= tion this community has been asking for years: what does long-term treatmen= t actually look like, and what options do people have when circumstances ch= ange? SURMOUNT-MAINTAIN says staying on your full tirzepatide dose gives you the = best shot at keeping what you lost, but stepping down to 5mg is viable for = a meaningful subset. ATTAIN-MAINTAIN says switching from an injectable to a= daily pill is a real option, not a theoretical one -- with results that va= ry depending on which injectable you came from and deserve to be understood= on their own terms. The STEPUP sub-analysis says there is more efficacy he= adroom above the current Wegovy dose, and the body composition data from MR= I continues to undercut the muscle loss argument. And VENTURE-Oral says the= oral pipeline is filling in, with real numbers to back it up. We will unpack this all on today=E2=80=99s live at 12PM eastern on Youtube/= X/Linkedin. A a reminder, we are live every M/W/F at the same time, on the = same platforms! ATTAIN/SURMOUNT-MAINTAIN PRESS RELEASE: https://investor.lilly.com/news-rel= eases/news-release-details/lillys-foundayo-and-lower-dose-zepbound-helped-p= eople-maintain STEP UP PRESS RELEASE: https://www.novonordisk.com/content/nncorp/global/en= /news-and-media/news-and-ir-materials/news-details.html?id=3D916545 VENTURE-ORAL PRESS RELEASE: https://ir.vikingtherapeutics.com/2026-05-12-Vi= king-Therapeutics-Presents-Data-from-its-13-Week-Phase-2-VENTURE-Oral-Dosin= g-Trial-of-VK2735-at-European-Congress-on-Obesity-ECO-2026 Unsubscribe https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9vbnRoZXBlbi5= zdWJzdGFjay5jb20vYWN0aW9uL2Rpc2FibGVfZW1haWw_dG9rZW49ZXlKMWMyVnlYMmxrSWpveU= 56TTJNakl6T1Rnc0luQnZjM1JmYVdRaU9qRTVOelV4T1RnM055d2lhV0YwSWpveE56YzROamd6T= 1RrekxDSmxlSEFpT2pFNE1UQXlNVGs1T1RNc0ltbHpjeUk2SW5CMVlpMDBPREE0T1Rreklpd2lj= M1ZpSWpvaVpHbHpZV0pzWlY5bGJXRnBiQ0o5LnRvUXQxNTJtbGVHOTRYSlZheHNFUzhfV25ZdWM= 2YjYyUlU4cXVvTlJNTWMiLCJwIjoxOTc1MTk4NzcsInMiOjQ4MDg5OTMsImYiOnRydWUsInUiOj= I3MzYyMjM5OCwiaWF0IjoxNzc4NjgzOTkzLCJleHAiOjIwOTQyNTk5OTMsImlzcyI6InB1Yi0wI= iwic3ViIjoibGluay1yZWRpcmVjdCJ9.ErfkaK8nIAybc1p6t_Qw9W75zSG3LTZpurDAPKPTyk0= ? --49f275c470d4387788f62fc4785a17bdb7d969bb62198d3521bb4949ea70 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable = Massive GLP-1 Data From ECO 2026=3D""
My biggest takeaways from day one of ECO 2026,= and the data behind each one.
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=
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Massive GLP-1 Data F= rom ECO 2026

My biggest takeaways from day one of ECO 2026, and the dat= a behind each one.

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On The Pen GLP-1 News
 
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READ IN APP3D""
 

We spent time on the podcast last week walking through = what the European Congress on Obesity was likely to bring. The maintenance = question was the one we flagged as most important -- not whether these drug= s work, but what “staying on them” actually looks like for peop= le navigating real lives, real costs, and real preferences about needles ve= rsus pills.

Today, on the first day of th= e congress in Istanbul, that question got some answers. Two major studies p= ublished simultaneously, a high-dose semaglutide sub-analysis dropped from = the STEPUP trial, and Viking Therapeutics presented phase 2 oral data. It w= as a full day.

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On The Pen™
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@ManOnThePen
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My biggest takeaways from day 1 of #ECO2= 026 1. You’ll likely need tirzepatide for the best shot at maintainin= g most of your weight loss from tirzepatide 2. Orforglipron is best suited = to maintain weight loss from a GLP-1 agonist like semaglutide. ~85% for Weg= ovy users,
12:21 PM · May 13, 2026 · 2.54= K Views
2 Replies · 2 Reposts · 35= Likes
=

Here is what came back, and what it = means if you are on one of these medications or thinking about it.

1. If you got to the higher doses of tirzepatide, you wil= l likely need tirzepatide, the higher doses give you a greater “shot&= #8221; at successful maintenance

SURMOUNT-MAINTAIN is the = study Zepbound users have been waiting for. The question it asked: if you s= pent over a year losing weight on tirzepatide at your maximum dose, what ha= ppens when you step down?

Participants spent 60 weeks losin= g weight on tirzepatide at their maximum tolerated dose (10 or 15mg, depend= ing on what each person could handle), then split into three groups for 52 = weeks of maintenance. One group stayed on their maximum tolerated dose. One= dropped to 5mg. One switched to placebo.

At week 112, meas= ured from where everyone started:

    Tirzepatide max= imum tolerated dose: -21.9% body weight

  • Reduced t= o 5mg: -16.6%

  • Switched to placebo: -9.9%

The gap between maximum tolerated dose and 5mg= is real, about 5 percentage points. For some people that will matter a lot= , and for others it will not. The number that matters most for patients con= sidering a step-down is this: roughly one in three people on 5mg maintenanc= e retained 85% or more of their initial weight loss. That is not everyone. = But it is a real and meaningful subset. If you lost 50 lbs on your highest = tolerated dose and are wondering whether dropping to 5mg is workable, the d= ata says that for about a third of people in that situation, it largely hol= ds. That conversation with your doctor just got more grounded in evidence.<= /p>

The headline, though, is that the maximum tolerated dose pe= rformed best. If keeping as much of your loss as possible is the priority, = the data says staying on your highest tolerated dose is still your best bet= =2E

The placebo arm tells a story this community already know= s, stop the medication and the weight starts coming back. Not because of wi= llpower. Because obesity is a chronic disease and the biology does not stop= just because the prescription does. The data keeps confirming this, and it= keeps mattering that we say it clearly.

One design detail = worth noting: patients on placebo who regained more than half of their init= ial weight loss could restart tirzepatide. That rescue protocol is why the = placebo arm did not regain everything, and it reflects a shift in how resea= rchers are approaching these trials. They are increasingly unwilling to sim= ply watch patients regain weight in the name of clean data. That’s ne= ws worth celebrating.

ON THE PEN is a reader-sup= ported publication. To receive new posts and support my work, consider beco= ming a free or paid subscriber.

Upgrade = to paid

2. Orforgl= ipron is likely best suited to maintain weight loss from a GLP-1 agonist li= ke semaglutide: around 85% for Wegovy users, around 74% for Zepbound users<= /h2>

ATTAIN-MAINTAIN is the study that deserves the most attent= ion out of yesterday’s news, because the question it is asking is gen= uinely new. And the answer matters directly for a lot of people in this com= munity.

Here is the scenario it tested: you spent 72 weeks = on Wegovy or Zepbound, lost a meaningful amount of weight, and plateaued. N= ow you want to switch to a daily pill (Foundayo) instead of a weekly inject= ion. Maybe you are tired of injecting. Maybe access or cost is changing. Ma= ybe you just want a different option. Can orforglipron (Lilly’s once-= daily oral GLP-1), hold what you built on an injectable?

Pa= rticipants who completed the SURMOUNT-5 head-to-head trial were re-randomiz= ed to orforglipron or placebo for 52 weeks. Two cohorts: those coming off Z= epbound and those coming off Wegovy. 376 participants total. They started o= rforglipron at 12mg and titrated up every four weeks, targeting a maximum o= f 36mg. A rescue protocol allowed escalation or a switch from placebo to or= forglipron after week 24 for anyone who regained more than half their origi= nal loss. One detail to keep in mind: there was a two-week screening gap be= tween studies, so some regain occurred before orforglipron began.

<= p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);margin-left: 20px;line-h= eight: 26px;font-size: 16px;">The results split cleanly by which injectable= you came from. The Wegovy cohort on orforglipron maintained 85.9% of their= body weight reduction at 52 weeks, compared to 40.2% on placebo. The Zepbo= und cohort maintained 74.4%, compared to 49.7% on placebo.

=

The weight trajectories in pounds make it concrete. The Wegovy= cohort started SURMOUNT-5 at an average of 250 lbs, got down to 209 lbs on= injections, and finished ATTAIN-MAINTAIN at 211 lbs on orforglipron. Essen= tially flat for a full year on a daily pill. The Zepbound cohort started at= 255 lbs, got down to 200 lbs on their highest tolerated dose of injections= , and ended at 211 lbs, or an 11 lb regain from their injectable low point,= though still 44 lbs below where they started.

Lilly’= s press release leaned into the fact that both cohorts ended at the same we= ight, 211 lbs, framing it as a unified success. That convergence is technic= ally accurate, but it tells a more complicated story: the people who lost m= ore on the more powerful drug gave back more when they stepped down to a GL= P-1 pill. That is not a reason to panic. A 74.4% maintenance rate after swi= tching off a dual agonist injection to a once-daily pill is a genuinely goo= d outcome. It just deserves to be seen clearly, not averaged away.

The reason for the gap comes down to mechanism. Switching from Wego= vy to orforglipron is a like-for-like swap, GLP-1 to GLP-1. Switching from = Zepbound to orforglipron means losing the GIP component, which is part of w= hat makes tirzepatide more potent. Some of that potency goes with it.

The practical takeaway: if you are on Wegovy and thinking about = switching to Foundayo, the data is quite encouraging. If you are on Zepboun= d, the picture is still positive, but expect some drift and definitely fact= or that into the conversation with your doctor.

On tolerabi= lity, the transition went relatively smoothly. GI effects were mild to mode= rate, discontinuation rates were low across all arms, and (perhaps most imp= ortantly) no liver safety concerns emerged.

4. Viking’s dual = agonist pill could be among the strongest oral options on the market -- 12%= weight loss after just 13 weeks, though the 120mg dose raises real questio= ns

Viking Therapeutics presented phase 2 results from thei= r VENTURE-Oral study, a dose-finding trial of the oral version of VK2735, a= dual GLP-1/GIP agonist similar in mechanism to Zepbound.

A= t the highest dose tested, 120mg once daily over 13 weeks, participants los= t 12.2% of body weight. GI side effects were mild to moderate and largely r= esolved as doses were titrated up.

Thirteen weeks is a shor= t window, and dose-finding studies are designed to map the dose-response cu= rve, not to show peak efficacy. But 12.2% at 13 weeks puts oral VK2735 in s= erious company. For context, most injectable trials at similar timepoints a= re not showing numbers that much higher. The phase 3 for the oral formulati= on is expected to read out next year.

The caveat worth sitt= ing with: 120mg is a very large amount of active pharmaceutical ingredient = for a daily pill. Viking Therapeutics has publically aknowledged that they = only intend to bring the 75mg version to market, which will undoubtedly bri= ng these numbers back down to earth. But for our community, the broader poi= nt is simple: the oral pipeline is thickening. More options with strong eff= icacy profiles means more competition, and more competition is good for acc= ess and affordability over time.

What It All Mean= s

Four datasets, one day. The throughline across all of th= em is the same question this community has been asking for years: what does= long-term treatment actually look like, and what options do people have wh= en circumstances change?

SURMOUNT-MAINTAIN says staying on = your full tirzepatide dose gives you the best shot at keeping what you lost= , but stepping down to 5mg is viable for a meaningful subset. ATTAIN-MAINTA= IN says switching from an injectable to a daily pill is a real option, not = a theoretical one -- with results that vary depending on which injectable y= ou came from and deserve to be understood on their own terms. The STEPUP su= b-analysis says there is more efficacy headroom above the current Wegovy do= se, and the body composition data from MRI continues to undercut the muscle= loss argument. And VENTURE-Oral says the oral pipeline is filling in, with= real numbers to back it up.

We will unpack this all on tod= ay’s live at 12PM eastern on Youtube/X/Linkedin. A a reminder, we are= live every M/W/F at the same time, on the same platforms!

=

ATTAIN/SURMOUNT-MAINTAIN PRESS RELEASE: https://investor.l= illy.com/news-releases/news-release-details/lillys-foundayo-and-lower-dose-= zepbound-helped-people-maintain

STEP UP PRESS RELEASE: http= s://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir= -materials/news-details.html?id=3D916545

VENTURE-ORAL PRESS= RELEASE: https://ir.vikingtherapeutics.com/2026-05-12-Viking-Therapeutics-= Presents-Data-from-its-13-Week-Phase-2-VENTURE-Oral-Dosing-Trial-of-VK2735-= at-European-Congress-on-Obesity-ECO-2026

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