Re: Oral weight-loss drug candidates
The implied premise of the excellent compilation I’m replying to is that all oral weight-loss drugs are competing against one another; however, I think it is more constructive to consider oral peptide weight-loss drugs and oral small-molecule weight-loss drugs as distinct categories.
Oral peptide drugs have poor bioavailability, and this has several knock-on effects, all of which are negative:
• High inter-patient variability in exposure to the active agent, which makes dosing tricky;
• Strict fasting requirements (so the GI system is lulled into not treating the peptides as food);
• Large doses (to overcome low bioavailability) that drive up the cost of goods.
Bottom line: I expect that oral small-molecule weight-loss drugs will be a blockbuster category, but oral peptide weight-loss drugs will be marginal players, at best.