Eli Lilly used the American Diabetes Association’s annual meeting to announce that its investigational triple agonist retatrutide can treat the conditions obesity drives, beyond the excess weight itself. Detailed Phase 3 results from the TRIUMPH-1 program showed the once-weekly GIP, GLP-1 and glucagon agonist cut moderate-to-severe obstructive sleep apnea severity by up to 60.6% and knee osteoarthritis pain by up to 73.1%. Meanwhile, a companion diabetes trial, TRANSCEND-T2D-1, published in The Lancet, reported A1C reductions of up to 2.0%.
The weight-loss figure that made headlines, an average 28.3% at the top dose, landed in a topline release back in May. TRIUMPH-1 ran as a master protocol: an 80-week, randomized, double-blind, placebo-controlled study in 2,339 adults with obesity or overweight and without diabetes. Lilly enrolled two nested basket trials featuring participants who also had knee osteoarthritis or moderate-to-severe sleep apnea. Folding the comorbidities into one registrational study turns each positive basket into a potential label expansion off a single molecule, the same indication-stacking logic behind the franchise that has already made Lilly the most valuable drug company in the world.
That franchise has redrawn the industry’s revenue map in two years. In Drug Discovery & Development’s Pharma 50, Lilly closed FY2025 at $65.18 billion in revenue, up 44.7% year over year, the steepest growth on the list. Novo Nordisk, its closest rival in metabolic disease, grew 10.9% to $46.71 billion. As recently as FY2024 the two sat less than $3 billion apart.
Novo has struggled to regain momentum in recent months. In February it guided to a 5% to 13% decline in 2026 sales and profit, its first revenue contraction in modern history. Weeks later its next-generation drug CagriSema failed to match Zepbound’s weight loss in the head-to-head REDEFINE 4 trial. Its market value has fallen roughly 75% from a 2024 peak that briefly made it Europe’s most valuable company. Meanwhile, Lilly became the first pharmaceutical company to cross $1 trillion and trades near $1.01 trillion today, worth about six times its former rival.
Filed Under: Metabolic disease/endicrinology
