AstraZeneca’s oral GLP-1 elecoglipron delivered up to 11.8% weight loss and 1.9% HbA1c reduction in Phase 2b obesity and diabetes trials, supporting Phase 3 development.
Written By: Sana Khan, BPharm
Reviewed By: Pharmacally Editorial Team
AstraZeneca has reported positive Phase 2b data for elecoglipron, its investigational oral GLP-1 receptor agonist, showing up to 11.8% weight loss in adults with obesity or overweight and a 1.9% reduction in HbA1c in people with type 2 diabetes. Results from the VISTA and SOLSTICE studies were presented at the American Diabetes Association (ADA) 2026 Scientific Sessions and simultaneously published in The Lancet as the company advances the therapy into Phase 3 development.
Differentiated Oral GLP-1 Approach
Elecoglipron is a once-daily oral small-molecule GLP-1 receptor agonist that reduces food intake, promotes weight loss, and improves glucose control. Unlike peptide-based GLP-1 therapies, it does not require food or fasting restrictions and may offer manufacturing and scalability advantages.
VISTA Trial: Obesity Outcomes
The VISTA Phase 2b trial (NCT06579092) enrolled 310 adults with obesity or overweight and at least one weight-related comorbidity. The study met both co-primary endpoints, including body weight reduction and the proportion of participants achieving at least 5% weight loss at 26 weeks.
Participants receiving elecoglipron 75 mg achieved a mean weight reduction of 10.5% at week 26 compared with 0.6% for placebo. Weight loss continued through week 36, reaching 11.8% versus 0.3% for placebo.
Up to 88.8% of patients achieved at least 5% weight loss by week 26, while more than 60% achieved reductions of at least 10% by week 36. Nearly 40% achieved weight loss of 15% or greater. Exploratory analyses also showed improvements in blood pressure and C-reactive protein levels.
SOLSTICE Trial: Diabetes Outcomes
The SOLSTICE Phase 2b trial (NCT06579105) enrolled 404 adults with type 2 diabetes. The study met its primary endpoint, with patients receiving elecoglipron 75 mg achieving a mean HbA1c reduction of 1.9% at 26 weeks compared with 0.2% for placebo.
Glycemic control was notable, with 90% of participants achieving HbA1c below 7% and 85% reaching 6.5% or lower. Elecoglipron also reduced body weight by 7.7% compared with 1.7% for placebo. An exploratory oral semaglutide arm showed smaller reductions in HbA1c and body weight than the highest-dose elecoglipron regimen, though the trial was not powered for direct comparisons.
Safety Profile
Safety findings were consistent with the GLP-1 receptor agonist class. The most common adverse events were gastrointestinal, including nausea, constipation, diarrhea, and vomiting, and were generally mild to moderate in severity.
Treatment discontinuations were infrequent, and investigators reported no liver safety signals across either study. In SOLSTICE, hypoglycemia was uncommon, with no serious adverse events or discontinuations attributed to hypoglycemia.
Strategic Outlook and Phase 3 Program
The Phase 3 program is already underway. The EMBOLD studies will evaluate elecoglipron in obesity or overweight populations with and without type 2 diabetes, while the ELUMINATE program will assess the therapy as monotherapy and in combination with dapagliflozin in type 2 diabetes.
AstraZeneca also plans dedicated cardiovascular and kidney outcomes trials, positioning elecoglipron as a potential therapy across the broader cardiovascular-renal-metabolic disease spectrum beyond weight management alone.
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About the Writer
Sana Jamil Khan (LinkedIn) is a B. Pharm graduate with a strong interest in medical writing and scientific communication. Her work focuses on interpreting clinical research, exploring developments in pharmaceutical science, and presenting complex medical information in a clear and accessible manner. She is particularly interested in topics related to human clinical studies, drug safety observations, and emerging therapeutic research.