Elecoglipron is an experimental daily GLP-1 tablet. AstraZeneca is developing it for obesity and type 2 diabetes. It is not approved anywhere, and no seller offers it. In a 26-week obesity trial, body weight fell by 2.6% to 10.5% depending on dose [2]. Placebo lost 0.6%.
It is one of several oral GLP-1 drugs in trials. How it compares with the others in development is in which GLP-1 pills are in development. This page is about elecoglipron alone.
What kind of drug it is
Elecoglipron is a small molecule, not a peptide. Semaglutide and tirzepatide are peptides. Elecoglipron is taken once a day with no food or fluid restrictions [1].
It began as ECC5004, also coded AZD5004. The first human study tested single doses of 1 to 300 mg in healthy volunteers [3]. It then gave daily doses of 5 to 50 mg for 28 days to people with type 2 diabetes. There were no serious adverse events. Glucose and body weight fell with dose.
Manufacturing cost is part of a wider argument about price. It is set out in what semaglutide costs to make.
The obesity trial: VISTA
VISTA randomized 310 adults with obesity, or overweight plus a weight-related condition[2]. None had diabetes. Mean BMI was 38.2. Treatment ran 36 weeks, and the main readout came at week 26.
Weight fell 2.6% on 5 mg. It fell 10.5% on 75 mg with weekly dose steps. Placebo lost 0.6%. Across doses, 40.4% to 88.8% of people lost at least 5%. On placebo it was 15.6%.
Across doses, 84% to 98% reported an adverse event. On placebo it was 84%. Nausea, constipation, diarrhea, headache and vomiting were most common. Of 310 people, 231 completed their assigned treatment.
The diabetes trial: SOLSTICE
SOLSTICE gave 404 adults with type 2 diabetes elecoglipron, placebo, or oral semaglutide[1]. It had eight groups and ran 26 weeks. The main outcome was HbA1c, not weight.
HbA1c fell 0.91 points on 5 mg. It fell 1.88 points on 75 mg with two-weekly dose steps. Placebo fell 0.15. Adverse events ran from 63% to 87% by dose. Placebo was 63%.
Oral semaglutide 14 mg was an open-label arm. Every elecoglipron dose was masked. So the trial is not a blinded head-to-head against semaglutide.
When it could be available, and at what price
Nobody can say yet. Both trials were phase 2, and both sets of authors call for phase 3[1] [2]. No price exists. Oral semaglutide is already sold in tablet form. Whether that costs more than the injection is covered in whether the GLP-1 pill is cheaper. What the injections cost a month is in GLP-1 cost per month.