Lilly says Foundayo beats oral semaglutide in diabetes analysis

Eli Lilly reported findings on September 29, 2026, from an indirect treatment comparison showing that its oral drug Foundayo (orforglipron) at a 17.2 mg dose achieved greater weight loss and better blood sugar control than oral semaglutide 25 mg in adults with type 2 diabetes. The data were presented at the 62nd Annual Meeting of the European Association for the Study of Diabetes in Milan, Italy.

The analysis pooled data from the ACHIEVE-3 and PIONEER PLUS trials. At 52 weeks, patients receiving Foundayo 17.2 mg lost an average of 1.5% more body weight (95% CI -2.7% to -0.2%) and lowered their A1C by 0.3% more (95% CI -0.6% to -0.1%) than those on oral semaglutide 25 mg. Across different statistical methods, Foundayo demonstrated 1.5% to 2.4% greater weight loss and 0.3% to 0.6% greater A1C reduction.

The findings build on Lilly's Phase 3 ACHIEVE-3 study involving 1,698 participants across the United States, Argentina, China, Japan, Mexico, and Puerto Rico. In that head-to-head trial, Foundayo reduced A1C by 1.9% at 9 mg and 2.2% at 17.2 mg, compared to 1.1% with 7 mg and 1.4% with 14 mg of oral semaglutide. Participants on Foundayo lost 14.6 lbs (6.7%) on 9 mg and 19.7 lbs (9.2%) on 17.2 mg, compared with 7.9 lbs (3.7%) on 7 mg and 11.0 lbs (5.3%) on 14 mg of oral semaglutide.

Orforglipron, licensed by Lilly from Chugai Pharmaceutical in 2018, is an oral, once-daily non-peptide GLP-1 receptor agonist with no food or water restrictions. It is FDA-approved for chronic weight management in adults with obesity or certain overweight adults, while its Phase 3 global development program for type 2 diabetes enrolled over 6,000 participants.