Amgen presented new data underscoring both the promise and the challenges of treating obesity and type 2 diabetes with GLP-1 receptor–based therapies.
The data was presented at the 2025 meeting of the European Association for the Study of Diabetes (EASD), taking place in Vienna from 15 – 19 September 2025.
The company’s presence centered on real-world evidence showing that patients often struggle to remain on dual glucagon-like peptide-1 (GLP-1) medications outside of clinical trial settings. Amgen also spotlighted its investigational obesity therapy, MariTide (maridebart cafraglutide), which is advancing through late-stage development and is designed to address some of those same challenges.
Real-World Adherence
A large retrospective analysis of insurance claims and electronic medical records, presented at EASD, evaluated more than 794,000 patients with type 2 diabetes who initiated GLP-1 therapy between 2010 and 2023. The results pointed to a substantial gap between trial efficacy and everyday use.
According to the study, adherence at 12 months was 52%, while persistence, defined as continuous use without a treatment gap of at least 60 days, was 42%. Nearly 58% of patients discontinued therapy within a year, with 72% of those discontinuations occurring in the first six months.
Lead investigator Dr. Jaime Almandoz of UT Southwestern Medical Center noted in an interview with the Drug and Device World: “Real-world adherence and persistence are lower than in clinical trials, as evident among the 794,702 patients evaluated in this study who demonstrated 52% adherence and 42% persistence at 12 months.”
The analysis also found that a third of patients who discontinued eventually restarted therapy, particularly those with higher baseline body mass index (BMI). This suggests that while adherence remains a major hurdle, many patients still return to treatment after interruptions.
“The chronic weight management journey involves frequent discontinuation and reinitiation,” Dr. Almandoz said.
Addressing Barriers to Long-Term Therapy
Dr. Almandoz emphasized that adherence challenges reflect a combination of clinical, behavioral, and systemic factors.
“Improving health outcomes is complex and requires a multifaceted approach: patient education about the chronic nature of type 2 diabetes and the importance of continuous therapy, personalized regimens that match patient preferences, system-level support such as reducing insurance barriers, and ongoing engagement through digital health tools and behavioral interventions,” he said.
Such strategies aim to make it easier for patients to stay on treatment long enough to see the benefits demonstrated in trials, including sustained weight loss and cardiometabolic improvements.
Asked about the characteristics of an “ideal” obesity therapy, Dr. Almandoz pointed to durability, tolerability, and ease of use. “An ideal therapy would combine high efficacy with durability, minimal side effects, and flexible administration options (oral, injectable, or long-acting). It should not only reduce weight but also reduce cardiometabolic risk and enhance day-to-day quality of life,” he said.
Amgen’s Lead Obesity Candidate, MariTide
Amgen’s most advanced program in obesity, MariTide, is designed to address some of these issues. The therapy combines GLP-1 receptor agonism with GIP receptor antagonism in an antibody–peptide conjugate. Unlike most marketed incretin therapies, which require weekly injections, MariTide is dosed monthly or less frequently.
In a Phase II study (NCT05669599), MariTide produced up to 20% mean weight loss at 52 weeks in people without diabetes and around 17% in people with type 2 diabetes. HbA1c reductions of up to 2.2 percentage points were observed in the latter group. Other benefits included reductions in waist circumference, blood pressure, and inflammatory markers. Importantly, weight loss had not plateaued at one year.
However, gastrointestinal side effects such as nausea and vomiting were common, as seen with other GLP-1 therapies. Amgen has tested dose-escalation regimens to reduce these events, and discontinuation rates due to GI issues were lower with gradual titration than with higher fixed starting doses.
For Dr. Almandoz, therapies like MariTide illustrate how innovation can align with real-world needs: “Scientific innovation is critical to expanding our treatment toolkit, but its success ultimately depends on how therapies perform in the realities of clinical practice. For example, long-acting or multi-targeted agents like MariTide could help address adherence challenges we see with current GLP-1 therapies.”
Amgen has signaled that its obesity pipeline includes both injectable and oral approaches, spanning incretin and non-incretin mechanisms. While MariTide is the company’s most advanced candidate, Amgen has disclosed additional programs at earlier stages.
One such candidate, AMG 513, has faced regulatory delays, with development placed on hold earlier this year. The company has also suggested that small-molecule and oral therapies are under exploration, though few details have been made public.
The Broader Obesity Landscape
The global market for obesity therapies has expanded rapidly in recent years, fueled by the success of Novo Nordisk’s Wegovy (semaglutide) and Eli Lilly’s Zepbound (tirzepatide). Novo Nordisk’s weight loss drugs, Wegovy and Saxenda (liraglutide), raked in DKK65.1 billion ($9 billion) in sales in 2024. However, it has received stiff competition from Eli Lilly’s dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist Zepbound (tirzepatide), which generated $4.9 billion in sales in 2024.
This competitive environment has also spurred a wave of deals. In March, Roche entered a $5.3 billion co-development deal with Zealand Pharma for an obesity candidate, and AbbVie licensed Gubra’s obesity drug for $2.2 billion. More recently, Novo Nordisk partnered with Septerna in a $2.2 billion collaboration to develop oral small molecules for obesity and cardiometabolic diseases.
Looking Ahead
Experts agree that the field is moving toward more tailored and durable treatments. As Dr. Almandoz put it: “The obesity treatment landscape is evolving towards next-generation therapies that offer more personalized and effective solutions. Next-generation treatments, including biologics and gene therapies, hold promise for targeting underlying genetic and metabolic factors, providing more tailored and long-lasting results.”
Digital health and data analytics may also play a role in supporting adherence and personalizing treatment. “Advancements in digital health and data analytics are likely to complement these therapies by supporting personalized treatment plans and improving patient adherence,” Dr. Almandoz noted.
In his own practice, Dr. Almandoz has already observed the shift toward more effective regimens: “Many of my patients who had only modest responses to earlier agents are now achieving meaningful weight loss and cardiometabolic improvements with dual incretin therapies. These experiences underscore how targeting multiple pathways and delivery modalities can facilitate more meaningful results.”
