LONDON — Researchers presented findings Tuesday suggesting that a once-daily oral medication could help patients maintain weight loss after discontinuing injectable obesity treatments, offering a potential bridge therapy for the millions of people worldwide who cannot sustain long-term access to the widely prescribed GLP-1 receptor agonist injections that transformed obesity medicine after 2022. The data were unveiled at the European Congress on Obesity in Vienna and published simultaneously in the peer-reviewed journal Metabolic Medicine and Research.
The pill, a low-dose formulation of the compound retatrutide acetate marketed under the provisional name Slendura, was evaluated in a 52-week randomized controlled trial involving 1,840 adults in seven countries who had previously lost an average of 14.6 percent of their body weight while on injectable semaglutide or tirzepatide therapy. Participants who switched to the daily oral pill after completing their injectable course retained roughly 68 percent of their prior weight loss over the following year, compared with 31 percent retention in the placebo group. The difference was statistically significant at a p-value below 0.001 and was consistent across age groups, sexes, baseline body mass index categories and geographic regions.
The injectable GLP-1 medications that became household names in the years following their obesity approvals have fundamentally changed how clinicians and patients approach weight management, but they carry significant practical limitations that restrict their long-term use in large portions of the population. Monthly costs without insurance coverage can exceed $900, supply constraints have left many patients unable to obtain consistent prescriptions, and a meaningful share of users discontinue therapy due to side effects including nausea, vomiting and gastrointestinal cramping. Studies have consistently shown that most patients regain a substantial proportion of lost weight within 12 months of stopping injectable therapy, a pattern clinicians describe as weight rebound and which undermines the long-term health gains the medications are designed to deliver.
Lead investigator Dr. Sophia Vanthorpe of the University of Antwerp said the pill worked by partially engaging the same hormonal pathways as the injectable medications but at a lower pharmacological intensity calibrated for maintenance rather than active weight loss. “Think of it as a lower gear,” Dr. Vanthorpe said at a press briefing attended by several hundred delegates. “The injections are highly effective during the weight-loss phase, but many patients do not need that level of pharmacological intensity once they have reached a healthier weight. This pill is designed to hold the new equilibrium and prevent the hormonal rebound that drives weight regain.”
The trial reported that the most common side effects associated with Slendura were mild gastrointestinal discomfort, present in approximately 22 percent of participants during the first four weeks and resolving in the majority of cases by week eight, and a modest but sustained reduction in appetite that most subjects described as manageable and not distressing. Serious adverse events occurred at a rate of 3.1 percent in the treatment group versus 2.8 percent in the placebo group, a difference investigators said was not clinically meaningful. Cardiovascular markers including systolic blood pressure and resting heart rate showed no significant change from baseline across the 52-week observation period.
The drug’s developer, Genova Therapeutics, has filed for regulatory approval with the European Medicines Agency and the United States Food and Drug Administration and expects an initial decision within 14 to 18 months if no additional data requests are made. The company said the pill was being manufactured at a cost structure that would allow a substantially lower retail price than injectable alternatives, though specific pricing had not been finalized. Independent analysts at MedCapital Research estimated the pill could be positioned between $180 and $240 per month in the United States market, a range that would make maintenance therapy accessible to a considerably broader patient population than the injections currently serve.
Obesity medicine specialists offered cautious endorsement while emphasizing important caveats. The pill was not designed or approved as a standalone weight-loss agent and would only be prescribed as a follow-on treatment for patients who had completed an injectable weight-loss course. Dr. Felix Okafor of the National Obesity Research Centre in Manchester called the results genuinely promising but urged physicians to guard against framing the pill as a permanent fix for a chronic condition. “Obesity is a long-term metabolic disease that requires long-term management,” he said. “That said, a safe and meaningfully effective maintenance option is something the obesity medicine field has genuinely lacked for years, and this could represent real progress for patients.”