$VKTX Full thread on upcoming Maintenance Study results
Maintenance study is due this quarter, possibly in September. The significance of these results is substantial, and I will explain why in this thread.
Why this is an important readout: First, this trial will give us our first look at 31‑week weight‑loss data; until now, we’ve only seen results through 13 weeks.
Second, the subcutaneous dose is titrated up to 22.5 mg, offering insight into the impact of higher dosing. We’ll also get new information on switching from subcutaneous to oral, along with early signals on weekly oral dosing.
There’s a lot of data here, including the first look at monthly subcutaneous dosing. In total, we’ll be evaluating four distinct dosing regimens: weekly subcutaneous, monthly subcutaneous, daily oral, and weekly oral.
In summary, maintenance study results will also be important for topline data from the oral maintenance study, which will have read-throughs to the Ph3 program. Opportunity for VK2735 may be greater given it's a more potent dual GLP/GIP agonist and will also couple well with SQ VK2735 for seamless transition between SQ and oral formulations.
Advantage
$VKTX as SQ VK2735 To Oral VK2735 offers a more seamless transition between Formulations. The fact that both the SQ and oral drugs are identical molecules formulated as oral and SQ. This should help mitigate some of the AEs associated with switching patients between different molecules.
Take a look at when patients were switched from SQ Wegovy or SQ tirzepatide to orforglipron, discontinuation rates went up. In the ATTAIN-MAINTAIN study by
$LLY showed that when patients were switched from SQ semaglutide or SQ tirzepatide to orforglipron, D/C rates due to AEs were 4.8% and 7.2%, respectively. Also, patients who switched from Zepbound to orforglipron gained 11 lbs after 52 weeks on orforglipron.
Just a recap on
$LLY Obesity portfolio
1) Retatrutide- Triple agonist, weekly subq injection. Efficacy- Weight at 80 weeks from avg. baseline: Retatrutide 4 mg -19.0%, 9mg -25.9%, 12mg -28.3%, Placebo 2.2%.
Safety- The most common adverse events among participants treated with retatrutide (4 mg, 9 mg, 12 mg, vs. placebo, respectively) were nausea (28.6%, 38.4% and 42.4% vs. 14.8%), diarrhea (25.2%, 34.1% and 32.0% vs. 13.5%), constipation (23.8%, 25.9% and 26.1% vs. 10.9%), vomiting (10.6%, 22.8% and 25.3% vs. 4.8%), and upper respiratory tract infection (14.2%, 12.2% and 13.1% vs. 11.6%). Incidences of dysesthesia occurred in 5.1%, 12.3%, and 12.5% of patients treated with retatrutide 4 mg, 9 mg, and 12 mg, respectively, compared with 0.9% with placebo.
2) Tirzepatide (Zepbound)- LLY's blockbuster drug is a dual GIP and GLP-1 receptor agonist like
$VKTX 2735 which is currently in PH3 and reports data in 2027.
Efficacy- Average weight loss with tirzepatide of 26.6% from study entry over 84 weeks, 20.2% compared at 72 weeks
Safety- See the Chart below.
3)
$LLY oral drug orforglipron, a small non-peptide for obesity
Efficacy- orforglipron showed placebo adjusted weight loss at 72 weeks of:
• -5.4% for 6 mg dosing
• -6.3% for 12 mg dosing
• -9.1% for 36 mg dosing- this is nothing earth shattering weight loss as it had been touted as the next blockbuster drug. In comparison,
$VKTX VK2735 oral drug showed loss of 8.7% at 60mg dose in just 13 weeks. Weight loss of 12.2% at 120mg dose though higher D/C rates and side effects and not likely a viable dose from manufacturing standpoint.
Safety- Higher treatment D/C due to adverse events (10.3% at highest dose vs 2.6% placebo)
Significant gastrointestinal side effects reported (33.7% nausea, 25.4% constipation at highest dose)
Overall discontinuation rate of 24.4% at highest dose indicates tolerability challenges.
The most common adverse events for participants treated with orforglipron (6 mg, 12 mg and 36 mg, respectively) were nausea (28.9%, 35.9% and 33.7%) vs. 10.4% with placebo, constipation (21.7%, 29.8% and 25.4%) vs. 9.3% with placebo, diarrhea (21.0%, 22.8% and 23.1%) vs. 9.6% with placebo, vomiting (13.0%, 21.4% and 24.0%) vs. 3.5% with placebo, and dyspepsia (13.0%, 16.2% and 14.1%) vs. 5.0% with placebo. Treatment discontinuation rates due to adverse events were 5.1% (6 mg), 7.7% (12 mg) and 10.3% (36 mg) for orforglipron vs. 2.6% with placebo. The overall treatment discontinuation rates were 21.9% (6 mg), 22.5% (12 mg) and 24.4% (36 mg) for orforglipron vs. 29.9% with placebo.