landscape

GLP-1 and Incretin Landscape: From Ozempic to Triple Agonists

A strategic overview of approved and pipeline incretin-based peptide therapeutics.

Published Aug 15, 2024 · Updated Aug 15, 2024 · Last reviewed Aug 15, 2024

Direct answer

The incretin landscape is dominated by approved GLP-1 and dual GIP/GLP-1 agents, with triple agonists and oral small molecules entering late-stage development.

Key takeaways

  • Semaglutide and tirzepatide have set efficacy and commercial benchmarks.
  • Retatrutide and cagrisema are the next potential blockbusters in phase 3.
  • Oral small molecules could expand access but face tolerability and adherence questions.

The GLP-1 receptor agonist class has transformed type 2 diabetes and obesity care. Semaglutide, marketed as Ozempic and Wegovy, demonstrated up to 15% weight loss in STEP 1 and cardiovascular benefit in SELECT. Tirzepatide's dual GIP/GLP-1 mechanism raised the bar further, with SURMOUNT-1 showing mean weight loss above 20%. Retatrutide adds glucagon receptor agonism and has reported up to 24% weight loss in phase 2. Cagrisema combines semaglutide with the amylin analogue cagrilintide and is in the REDEFINE phase 3 program. Oral entrants—including orforglipron, danuglipron, and GSBR-1290—aim to remove injection barriers but must match efficacy and safety profiles. Discontinued assets such as lotiglipron highlight liver safety risks for oral GLP-1 small molecules.

About this report

Author
Dr. Sarah Chen, Senior Biopharma Analyst
Scientific reviewer
Dr. Michael Patel, Healthcare Equity Research Director

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