Oral Wegovy by Novo Nordisk Reduces Cardiovascular Risks in Obesity

Novo Nordisk's oral Wegovy (semaglutide) demonstrated a reduction in cardiovascular risk factors during the Phase III OASIS 4 trial.

The company is using the results to support the drug's approval for obesity treatment, as the research showed significant improvements in risk factors like C-reactive protein and serum triglycerides.

Furthermore, the trial showed improvements in blood sugar control in patients, with reductions seen in glycaemic parameters, including HbA1c, fasting plasma glucose, and fasting serum insulin.

Data presented at Obesity Week 2025 in Atlanta, Georgia, indicated that 71.1% of patients treated with oral Wegovy who had pre-diabetes at the start of the trial achieved normal blood glucose levels by week 64, compared to only 33.3% in the placebo group.

In patients taking Wegovy who achieved a body weight reduction greater than 15%, a 10.1mmHg reduction in systolic and a 4.3mmHg reduction in diastolic blood pressure was observed. This compared to a 4.1mmHg and 1.1mmHg reduction in systolic and diastolic readings, respectively, in patients who achieved less than 15% weight loss.

Significant reductions were also observed in the inflammatory marker C-reactive protein, lipids including non-high-density lipoprotein cholesterol, and triglycerides, indicating improved overall health beyond just weight loss. Health tracking apps like Shotlee can help monitor these vital signs and manage health outcomes.

According to trial investigator Dr. Domenica Rubino, the cardiometabolic post hoc analysis revealed that while the benefits were most noticeable in people who achieved greater than 15% weight loss, notable improvements in glycaemic parameters and cardiovascular risk factors were seen in patients taking oral Wegovy, regardless of the amount of weight lost.

Oral Wegovy, dosed at 25mg, is currently under review by the US Food and Drug Administration (FDA) for approval as an obesity treatment. Rybelsus, an oral version of semaglutide already approved for type 2 diabetes (T2D), starts at a 3mg dose and increases to 7mg, eventually reaching a 14mg maintenance dose.

Novo Nordisk aims to secure FDA approval for the drug in obesity before its primary competitor, Eli Lilly, obtains approval for its own oral candidate, orforglipron. This is possible since Novo Nordisk submitted its application to the agency before Eli Lilly.

Despite this, Novo Nordisk is actively defending its position in the obesity and T2D market through a bidding war with Pfizer for biotech Metsera, a move Pfizer contests. If successful, this acquisition would expand their portfolio with additional injectable and oral glucagon-like peptide-1 receptor agonist (GLP-1RA) candidates.

These developments coincide with Eli Lilly's apparent lead in the metabolic field, as evidenced by significant Q3 sales increases for its GLP-1RA tirzepatide, marketed as Mounjaro and Zepbound for T2D and obesity, respectively. Mounjaro generated $6.5 billion in Q3 2025, a 109% increase from the same period in 2024. Zepbound's growth was even more substantial, at 185% over Q3 2024, generating $3.6 billion.

In contrast, Novo Nordisk adjusted its sales growth forecast to 8% to 11% at constant exchange rates (CER), down from a previous estimate of 8% to 14%, due in part to slower sales of Ozempic and Wegovy.

These shifts occur as pharmaceutical and biotech firms worldwide seek to enter the lucrative obesity market, which GlobalData projects will reach $173.5 billion in 2031 across the seven major markets (7MM: France, Germany, Italy, Japan, Spain, the UK, and the US).