Obesity market news — September 29, 2026
Novo Nordisk (NVO), Eli Lilly (LLY): What changed: Novo Nordisk released topline results from two Phase 3 CagriSema trials at 06:24 Eastern time on September 21. Against what: the last head-to-head data, from February, had tirzepatide ahead. In REIMAGINE 5, in adults with type 2 diabetes inadequately controlled on metformin, an SGLT2 inhibitor or both, CagriSema 1.0 mg/1.0 mg produced 12.4 percent weight loss at week 60 against 9.1 percent for tirzepatide 5 mg, with HbA1c reduction of 1.71 percent against 1.67 percent. In REDEFINE 9, CagriSema 1.0 mg/1.0 mg produced 21.0 percent weight loss at week 68 against 2.0 percent for placebo in adults with overweight or obesity. Novo states that CagriSema was well tolerated in both trials with a safety profile consistent with previous studies. The comparator dose is the part to hold on to. Tirzepatide is approved for weight management at doses up to 15 mg; the trial used 5 mg, and the announcement gives no reason for that choice. The February comparison, at higher doses over 84 weeks, ran the other way: 20 percent for CagriSema against 24 percent for tirzepatide. Both results are real. Read together they say CagriSema wins at a low dose in diabetes and loses at a high dose in obesity, which is a narrower claim than the headlines carried. We should have had this in the September 22 edition and did not; it was published the day before, and we covered Novo's Capital Markets Day without it.
Zealand Pharma (ZEAL), Roche: What changed: Zealand Pharma announced the initiation of the registrational Phase 3 ZUPREME programme for petrelintide at 11:00 Eastern time on September 22, in company announcement number 17 of 2026. Against what: the half-year report of August 13 guided this start to the second half of 2026, and this log has carried it as an open commitment since August 31. The programme comprises three trials of once-weekly petrelintide against placebo: ZUPREME-3 in overweight or obesity with at least one weight-related comorbidity and without type 2 diabetes, ZUPREME-4 in overweight or obesity with type 2 diabetes, and ZUPREME-5 in overweight or obesity with established cardiovascular disease, enrolling approximately 7,000 participants in total. The Phase 2 ZYNERGY trial of petrelintide with Roche's enicepatide remains planned for the second half of 2026. One timing note we owe the reader: our September 22 edition said no start had been announced, and it was published that morning, hours before this release. The statement was accurate when written and outdated by the afternoon. This is the second tracked commitment closed on the record in eight days, after Viking's maintenance readout on September 22.
Nanexa, Novo Nordisk (NVO): What changed: Nanexa and Novo Nordisk entered a global licence and collaboration agreement worth up to 1.165 billion euros, announced at 18:24 Central European Summer Time on September 24. Against what: Nanexa's PharmaShell technology had no large-pharma obesity partner. The agreement covers up to five development programmes in obesity, type 2 diabetes and other cardiometabolic diseases, with monthly and quarterly administration as target profiles. Nanexa is eligible for 615 million euros in upfront payment and development and regulatory milestones, with the remainder in sales milestones, plus low single-digit royalties on global net sales; Novo leads global development and commercialisation. PharmaShell applies an ultra-thin inorganic coating to individual drug particles by atomic layer deposition, to control release over time. Nanexa's shares rose more than 150 percent at the Stockholm open on September 25 before easing to around 135 percent. Note what this sits beside: Viking reported on September 22 that monthly and every-other-week maintenance dosing held most of the weight lost. Two companies, three days apart, buying and testing the same idea.
Viking Therapeutics (VKTX), Zealand Pharma (ZEAL), Roche: The watchlist after a quarter in which both open Q3 items closed. Viking's maintenance readout arrived September 22, within its guided quarter. Zealand's Phase 3 start arrived September 22, within its guided half-year. What remains: Viking guided initiation of oral VK2735 Phase 3 to the fourth quarter of 2026, which began this week and has not been announced; Zealand and Roche guided the Phase 2 ZYNERGY combination trial to the second half of 2026, leaving until December. Both are inside their windows and neither is late. The count since we began: four tracked commitments, two closed on the record, two open and current, none quietly rolled forward.
Novo Nordisk (NVO): A pattern worth naming rather than a separate event. Three of the four dated items this week belong to Novo Nordisk: two Phase 3 readouts, a billion-euro licence for long-acting delivery, and, eight days ago, a set of 2030 ambitions that included revenue growth in line with industry peers. A company that tells investors it will grow like its peers and then spends a week buying and reporting is describing where the growth is supposed to come from. Whether it arrives is a 2028 question, not a September one. Disclosure: the author holds shares in Novo Nordisk and Eli Lilly, both named in this edition; the full statement is on the About page.