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The Best Obesity Drug Is Yet to Come

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Obese patients have seen more choices for treatments over the past year, as new obesity drugs from VIVUS (NASDAQ: VVUS  ) and Arena Pharmaceuticals (NASDAQ: ARNA  ) have launched. A third drug, Orexigen's (NASDAQ: OREX  ) Contrave, looks as if it could be on the market by the middle of next year after a safety study ruled out excessive cardiovascular risk.

The best obesity drug, though, may still be in the pipeline.

Quick weight loss
Privately held Zafgen released phase 2 data this month showing that its obesity drug beloranib was capable of helping patients lose 24 pounds or about 10.8% of their body weight after just 12 weeks on the highest dose of the drug.

By comparison VIVUS', Arena's, and Orexigen's drugs helped patients lose 5.8% to 9.8% of their body weight over one year. Novo Nordisk's (NYSE: NVO  ) Victoza, which is a diabetes drug that also helps patients lose weight, produced similar results.

The placebo-adjusted numbers are even more striking, since over 12 weeks, patients who received placebo in Zafgen's study lost less than 0.4% of their body weight, while over a year, patients in an obesity study typically lose 1% to 3% of their body weight while getting the dummy pill.

Best drug?
The difference between 10.8% for beloranib and 9.8% for VIVUS' Qsymia isn't all that much. The big question is whether patients taking beloranib will continue to lose weight beyond the initial 12 weeks. Zafgen is planning to start a phase 2b trial in the first half of next year. Hopefully it will test patients for longer than three months.

The other major issue is that beloranib is injected, while Qsymia, Arena's Belviq, and Contrave are all taken orally. Like Novo Nordisk's Victoza, which is also injected and will probably be primarily used in patients who need a diabetes drug anyway, the market for beloranib may be limited. Side effects, including nausea and insomnia, will also play a role in exactly who gets beloranib.

If belornaib is prescribed only for the most severely obese patients, there should be plenty of potential market for VIVUS, Arena, and Orexigen.

Time to prepare
After the phase 2b trial, Zafgen is still going to have to run a couple of phase 3 trials and the FDA may want to see year-long data for safety reasons, so patients will have to wait years for beloranib to be available commercially.

Fortunately, that gives the current obesity-drug makers a few years to get their act together; they've gotten off to a slow start so far. VIVUS' obesity drug Qsymia hasn't exactly been flying off the shelves, and Arena Pharmaceuticals' marketing partner Eisai hasn't done much better with their obesity drug Belviq. Orexigen and its marketing partner Takeda get a free pass for Orexigen, but that's only because Contrave isn't on the market yet.

I continue to think there's a potential market for obesity drugs, but the drugmakers are going to have to convince doctors that the benefits justify the side effects and secure insurance coverage so patients can afford to take them.

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Read/Post Comments (19) | Recommend This Article (3)

Comments from our Foolish Readers

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  • Report this Comment On December 01, 2013, at 10:01 AM, marp11 wrote:

    belviq SYM # 11/22-- 6128

    wil be over 10k a week in a month with the

    entire worls coming in

    shorts are panicked

    but keep trying...orelli keep trying

  • Report this Comment On December 01, 2013, at 10:01 AM, marp11 wrote:

    maybe a monday am bash around 8 will help ya brian

    i doubt tho

  • Report this Comment On December 01, 2013, at 10:26 AM, 1yossi1 wrote:

    Many weight loss drug candidates showed great results first 12 weeks but after one year or two patients gained weight (compared to baseline)!

    "The best obesity drug, though, may still be in the pipeline" and it is Lorc/Phen!

    For a very long time you are trying to help ARNA shorts but failed!

    Even 1,000 articles like this one + AF + LK (Credit Suisse) together will NOT cause ARNA longs to sell now since sales reps doubling NOW, DTC TV ads are going to start very soon, and insurance coverage is increasing!

    Lorc/Phen study started already!

  • Report this Comment On December 01, 2013, at 10:28 AM, yermamma wrote:

    NVO would have been a great investment 5 years ago when it was around $50. At around $180, not so good. As noted in the above article, "The other major issue is that beloranib is injected". We have all heard "if it were as easy as taking a pill..." but how many have heard, "it's as easy as taking an injection"? The better bet is still ARNA which not only quadrupled in the last 2 years but, as anyone who can read a chart will tell you, has a date with $7.50 soon and will likely hit at least $12 next year.

  • Report this Comment On December 01, 2013, at 10:32 AM, foolfafa wrote:

    No thanks. Zafgen and Victoza are injection drugs, that along will scare away more than half of the population.

  • Report this Comment On December 01, 2013, at 10:36 AM, foolfafa wrote:

    Here's more information you need to know why Belviq is best. I am just copying and pasting the analysis from yahoo message.

    Type 2 Diabetes Benefits Comparison between Belviq, Contrave and Qsymia

    BELVIQ® Highlights of Prescribing Information - Table 9 on Page 19

    A1C (%) for BELVIQ®

    Baseline = 8.1%

    Change from Baseline at Week 52 = -0.9%

    A1C % BELVIQ Reduction = - 0.9% / 8.1% = - 11.11%

    A1C (%) for BELVIQ® Placebo

    Baseline = 8.0 %

    Change from Baseline = -0.4 %

    A1C % BELVIQ Placebo Reduction = - 0.4% / 8.0% = - 5.00%


    CONTRAVE® Advisory Meeting Briefing Document - Page 77:

    A1C (%) for CONTRAVE®

    Baseline = 8.0%

    Change from Baseline at Week 56 = -0.63%

    A1C % CONTRAVE Reduction = - 0.63% / 8.0% = - 7.88%

    A1C (%) for CONTRAVE® Placebo

    Baseline = 8.0 %

    Change from Baseline = -0.14 %

    A1C % CONTRAVE Placebo Reduction = - 0.14% / 8.0% = - 1.75% **


    QSYMIA® Highlights of Prescribing Information - Page 33

    A1C (%) for QSYMIA ®

    Baseline = 6.8%

    Change from Baseline at Week 52 = -0.4%

    A1C % QSYMIA Reduction = - 0.4% / 6.8% = - 5.88%

    A1C (%) for QSYMIA Placebo

    Baseline = 6.8 %

    Change from Baseline = -0.1 %

    A1C % BELVIQ Placebo Reduction = - 0.1% / 6.8% = - 1.47% ****


    ** -1.75% is a very weak Placebo for CONTRAVE compared to BELVIQ Placebo that had -5.0% A1C % Reduction**


    **** -1.47% is a very weak Placebo for QSYMIA compared to BELVIQ Placebo that had -5.0% A1C % Reduction****

    Considering Belviq Very Strong Placebo Group as a Good Comparator (No wonder why my Endocrinologist was telling me that he thought that the Placebo for Belviq exhibited very high reduction meaning a Very Strong Placebo)

    CONTRAVE® minus BELVIQ® Placebo Comparison

    A1C % additional Reduction = 7.88% (Contrave) - 5.00% (Belviq Placebo) = - 2.88%

    QSYMIA® minus BELVIQ® Placebo Comparison

    A1C % additional Reduction = 5.88% (Qsymia) - 5.0% (Belviq Placebo) = - 0.88%

    BELVIQ® minus BELVIQ® Placebo Comparison

    A1C % additional Reduction = 11.11% (Belviq) - 5.0% (Belviq Placebo) = - 6.11%

    Therefore, as far as the A1C for Type 2 Diabetes is concerned:

    BELVIQ is 2.12 times more effective than CONTRAVE


    BELVIQ is 6.94 times more effective than QSYMIA

  • Report this Comment On December 01, 2013, at 1:24 PM, gazoo99 wrote:


    Time to pack up your toy box and head back to your pals at Wall Street......

    Nobody's wanting to play with you anymore!

  • Report this Comment On December 01, 2013, at 1:28 PM, marp11 wrote:

    poor liddle brian orwelli has failed his masters'

    which hf will have to cave first and start the squeeze.??

    combined with solid company fudamentals

    scary thought for shorts

    hope ya holiday weekenend was a stomach churner,,who knows where ARNA opens monday after those fabulous scrip numbers

  • Report this Comment On December 01, 2013, at 1:29 PM, marp11 wrote:

    december for arna shorts

    the losses are staggering to think about.

  • Report this Comment On December 01, 2013, at 4:43 PM, johnrh1958 wrote:

    12 week clinical does not make an obesity drug. Clearly in the right direction but a long way to go.

  • Report this Comment On December 01, 2013, at 5:39 PM, Riggerwo wrote:

    After Big Pharma has been fined more than $5 Billion in the past decade are we expected to believe that the testing has been done properly and ethically?..or have they been up to their old tricks "laundering" the results, accidentally omitting the bad bits just to get the drug on the market...make many millions of dollars before it is found it kills a small fine..settle a few law suits and then go back to Company HQ to count their many have done in the past....Obesity is a life style problem...we do not need a drug..but Americans are so stupid that they seriously believe taking yet more pills will be better than just simply adopting a better life style...they are that lazy!

  • Report this Comment On December 01, 2013, at 5:53 PM, AreaRich wrote:

    With your obstinance in accepting the overwhelming advantages of Belviq you do your readers a great disservice.

  • Report this Comment On December 01, 2013, at 6:34 PM, foolfafa wrote:

    Riggerwo, many health problems are life style problems and yet there're numerous drugs to treat the conditions: high blood pressure, high cholesterol, heart problems, lung problems. You name it, they have it.

  • Report this Comment On December 02, 2013, at 12:56 AM, kdavis860 wrote:

    Serious competition might come not from a drug, but from a surgery that plugs an artery and starves the part of the stomach that messages the brain saying it's hungry. The surgery isn't new, but the realization that you see about 7% weight loss from decreased appetite, even in people who aren't trying to lose weight, is new.

  • Report this Comment On December 02, 2013, at 7:46 AM, aldehyde wrote:

    hey bushwacker nice attempt but no one cares what you think

  • Report this Comment On December 02, 2013, at 8:21 AM, AreaRich wrote:

    "Orexigen Therapeutics, Inc. Proposed Offering of $100 Million of Convertible Senior Notes"

    They always need tools before dilution

  • Report this Comment On December 02, 2013, at 8:40 AM, marp11 wrote:

    orex vvus broke



  • Report this Comment On December 02, 2013, at 9:50 AM, AreaRich wrote:


    You must be out of the Loop.

    If you are, what good is that. If you aren't, what good are you.

  • Report this Comment On December 09, 2013, at 10:07 PM, SacKingsfan wrote:

    Wait until belviq is combined with phenteramine!

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