Elecoglipron, an oral small molecule GLP-1 receptor agonist in adults with obesity or overweight (VISTA): a multicentre, phase 2, randomised, placebo-controlled clinical trial.

Summary

In a 36-week, multicentre, randomized, double-blind, placebo-controlled, phase 2 trial, once-daily oral elecoglipron achieved clinically meaningful weight reductions in adults with obesity or overweight without diabetes. Safety and tolerability were consistent with the GLP-1 receptor agonist class, supporting progression to phase 3.

Key Findings

• Once-daily oral elecoglipron produced clinically meaningful weight loss over 36 weeks versus placebo.
• Safety and tolerability were consistent with the GLP-1 receptor agonist class.
• A total of 310 participants were randomized; 288 (93%) completed the study and 231 (75%) completed assigned treatment.

Clinical Implications

If confirmed in phase 3, oral GLP-1RA therapy could expand first-line pharmacotherapy options for obesity, improve adherence versus injectables, and facilitate primary care delivery.

Limitations

• Phase 2 sample size and duration limit long-term safety and durability inference
• High female predominance and 25% treatment non-completion may affect generalizability

Future Directions

Proceed to phase 3 trials to assess long-term efficacy, cardiometabolic outcomes, comparative effectiveness versus injectable GLP-1RA, and patient-reported outcomes.