AstraZeneca’s GLP-1 pill, elecoglipron, significantly reduced weight and blood sugar levels in two mid-stage studies, according to data presented at the 2026 annual conference of the American Diabetes Association on June 9. However, the results did not sufficiently outperform a key competitor from Structure Therapeutics.
The Phase 2b VISTA study found that patients with overweight or obesity taking elecoglipron saw an average decrease in body weight of 10.5% at 25 weeks compared to a 0.6% reduction for those on placebo. Weight reduction continued through week 36, reaching an average loss of 11.8%, while placebo was recorded at 0.3%. BMO Capital Markets described these findings as “promising efficacy,” but also called them “relatively underwhelming” when compared to Structure’s aleniglipron.
Structure’s aleniglipron showed a placebo-adjusted weight loss of 15.3% at week 36 when dosing was escalated from 120 mg to 240 mg during the same period. The lower dose of aleniglipron resulted in an average reduction of 11.3%. Both drugs are orally available small-molecule agonists targeting GLP-1 receptors; however, there has not yet been a direct head-to-head study between them, and cross-trial comparisons remain inconclusive.
BMO said AstraZeneca might have a slight edge regarding safety, noting lower rates of nausea and adverse events leading to treatment discontinuation for elecoglipron than its competitor. “While rates of nausea and [adverse events] leading to treatment discontinuation are slightly lower, we do not see this difference as particularly meaningful,” BMO analysts wrote.
At the same conference, AstraZeneca also presented data from its Phase 2b SOLSTICE study testing elecoglipron in patients with type 2 diabetes. The drug led to a drop in HbA1c—a marker for blood sugar levels—of about 1.9% at week 26 versus baseline, compared with a drop of just 0.2% among placebo recipients.
BMO said that elecoglipron’s HbA1c results "appear slightly improved" over Eli Lilly’s orforglipron (recently approved as Foundayo for obesity), but added that this advantage is unlikely to affect Lilly's market position due to its established lead.
