Why amylin is gaining pharma attention in obesity drug development: From amycretin to AZD6234
Discover how Novo Nordisk, AstraZeneca, and others are betting on amylin-based obesity drugs like amycretin and AZD6234 to reshape metabolic care.
Novo Nordisk A/S (CPH: NOVO-B), AstraZeneca PLC (LON: AZN), AbbVie Inc. (NYSE: ABBV), and Roche Holding AG are intensifying their efforts in a new frontier of metabolic drug innovation—amylin agonism. Historically considered a niche hormone in diabetes care, amylin has re-emerged as a pivotal axis in next-generation obesity therapies. This resurgence is being driven by clinical data showing that amylin analogs can significantly enhance satiety, reduce food intake, and potentially preserve lean muscle mass—making them attractive candidates for combination or standalone obesity treatments.
With experimental assets such as amycretin (Novo Nordisk), AZD6234 (AstraZeneca), petrelintide (Roche), and GUB014295 (AbbVie) now advancing through clinical trials, the obesity drug pipeline is beginning to shift from single-hormone dominance to multi-hormonal strategies. Several phase 2 readouts are expected by late 2025, potentially reshaping how patients, payers, and prescribers evaluate obesity pharmacotherapy.

What is the role of amylin in regulating appetite and how is it being targeted in obesity drugs?
Amylin is a peptide hormone co-secreted with insulin from pancreatic β-cells. It acts centrally on the area postrema in the brainstem to slow gastric emptying, enhance satiety, and suppress glucagon secretion. Unlike GLP-1 receptor agonists that primarily act through insulin potentiation and appetite suppression, amylin exerts control over postprandial glycemic spikes and prolongs inter-meal intervals by delaying gastric motility.
Although the concept of using amylin analogs in metabolic disease is not new—pramlintide (Symlin) was FDA-approved in 2005 as an adjunct for diabetes—the development of long-acting and more tolerable formulations has reignited pharmaceutical interest. Cagrilintide, an amylin analog developed by Novo Nordisk, demonstrated up to 10.8% weight loss in Phase 2 trials. When combined with semaglutide in the CagriSema formulation, weight loss reached 17.1% over 20 weeks, pointing to a synergistic effect between the two pathways.
How are companies like Novo Nordisk and AstraZeneca advancing amylin-based obesity therapies?
Novo Nordisk’s innovation engine is leading the charge through amycretin, a dual amylin and GLP-1 receptor agonist. At the 2025 American Diabetes Association (ADA) meeting, the Danish drugmaker presented Phase 1b/2a results showing up to 24.3% weight loss in high-dose injectable cohorts and 13.1% in oral dosing arms. The company’s ability to deliver this efficacy in an oral format signals a major shift in patient accessibility, especially among those who avoid injectable therapies due to needle aversion or compliance challenges.
AstraZeneca is developing AZD6234, a once-weekly subcutaneous amylin analog that completed Phase 1 trials with promising tolerability and early weight loss signals. Institutional sentiment is cautiously optimistic as the program progresses into Phase 2, with analysts noting its potential as a differentiated monotherapy or combo partner. Notably, preclinical data suggested that AZD6234 may reduce visceral fat while preserving lean mass, an emerging metric of interest for regulatory and reimbursement bodies.
AbbVie, meanwhile, has licensed GUB014295 from Danish biotech Gubra. The agreement, valued at up to USD 430 million with USD 70 million upfront, positions AbbVie within the amylin race. The asset is currently in Phase 1 testing, and the American biopharma major is expected to disclose further data in early 2026.
Roche Holding AG made headlines after committing up to USD 5.3 billion in milestones to co-develop petrelintide (ZP8396) with Zealand Pharma. As part of its broader metabolic innovation roadmap, Roche aims to pair the amylin analog with CT-388, a GLP-1/GCGR dual agonist, for potential dual and triple hormone co-formulations.
What are the clinical differences between amylin analogs and GLP‑1 receptor agonists in weight loss performance?
While GLP-1 receptor agonists such as semaglutide and tirzepatide have shown 15% to 20% weight loss in pivotal trials, they often encounter tolerability issues like nausea and plateauing efficacy beyond six months. Amylin analogs offer a distinct mechanism with the potential to reduce hunger without reducing resting metabolic rate—possibly preventing the so-called “weight-loss ceiling.”
Monotherapy with cagrilintide has demonstrated 6–10.8% weight loss, while dual agonists such as amycretin are trending toward 20–24% in early trials. Importantly, experts highlight that amylin-based therapies may preserve lean muscle mass better than GLP-1s, offering a unique clinical advantage for aging populations or patients with sarcopenic obesity.
AZD6234, for example, is being evaluated not just for weight loss but also for its ability to selectively target fat over muscle, a key concern with GLP-1-only drugs. Novo Nordisk’s amycretin, particularly in its oral form, could emerge as a best-in-class option for patients seeking effective weight loss without injections or muscle catabolism.
Why are analysts and pharma investors paying closer attention to amylin drug development now?
Institutional investors are increasingly viewing amylin agonism as the next logical step in metabolic drug evolution. Analysts note that semaglutide and tirzepatide have validated the market’s willingness to pay for weight loss solutions that deliver double-digit reductions. However, concerns remain about long-term adherence, injection fatigue, and muscle preservation—all areas where amylin could play a complementary role.
Roche’s licensing of petrelintide and AbbVie’s entry into the space signal strategic moves to build diversified pipelines beyond GLP-1. Analysts believe that first movers in the amylin space could secure label extensions, exclusivity periods, and reimbursement advantages—particularly in payer markets emphasizing metabolic resilience and muscle preservation.
Novo Nordisk’s decision to prioritize both oral and injectable formats of amycretin also indicates confidence in the commercial scalability of amylin-based approaches, particularly in high-growth markets like the U.S., Japan, and parts of Europe.
Can amylin-based drugs overcome historical barriers in formulation and patient tolerability to become mainstream obesity treatments?
The major drawback of earlier amylin analogs, such as pramlintide, was their requirement for multiple daily injections and associated gastrointestinal side effects. Today’s analogs, however, are engineered for once-weekly delivery and appear to be significantly better tolerated. For instance, AZD6234’s Phase 1 data showed no serious adverse events, while cagrilintide has achieved high patient retention in ongoing trials.
Companies are also exploring co-formulations that allow fixed dosing of amylin and GLP-1 in a single auto-injector. This strategy could significantly improve adherence and expand utility among patients who are not reaching target outcomes on GLP-1 monotherapy alone.
With oral amycretin progressing toward Phase 3 trials, there is also hope that the amylin class can enter the mainstream through pill-based delivery—further easing barriers to long-term use and broad patient adoption.
What is the future outlook for amylin drugs in obesity care and how does it fit into multi-hormone therapy strategies?
Between late 2025 and 2027, the amylin landscape will likely see multiple clinical readouts and strategic deals. Amycretin’s oral and injectable formulations could reach Phase 3 by early 2026. AZD6234 is expected to report interim Phase 2 data by mid-2025, and AbbVie’s GUB014295 will likely conclude early-stage trials by the following year.
Pharmaceutical companies are also considering triplet combinations—adding glucagon or GIP pathways to GLP-1 and amylin backbones—to drive even greater efficacy. The trend is clear: multi-hormonal regulation of energy balance, satiety, and fat metabolism is fast becoming the gold standard for treating obesity as a chronic metabolic disease rather than a cosmetic issue.
If successful, these agents could redefine value-based care models and secure long-term formulary positions across public and private healthcare systems.
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