While the current obesity treatment market has a high level of unmet need, the therapeutic landscape could be transformed by a highly innovative and diverse pipeline that includes 248 products in active development, according to business intelligence provider GBI Research.

The company’s latest report states that despite the current market’s clinical and regulatory challenges, the obesity pipeline is robust and contains a high level of diversity in both molecule types and molecular targets, with 39 per cent of the pipeline products with disclosed molecular targets classified as first-in-class.

Angel Wong, senior analyst for GBI Research, says that while most pipeline products target gut hormone receptors, the remainder target a wide range of processes thought to be dysregulated in obesity, such as angiogenesis, insulin signaling, inflammation, fat absorption, lipid synthesis, and metabolism.

Wong comments, “The high level of innovation and diversity in molecular target in development is encouraging, with a number of these not only showing close alignment to the disease pathophysiology but also addressing multiple mechanisms underpinning the development of obesity. As obesity is a multifactorial disease, targeting multiple systems may potentially avoid compensatory mechanisms that lead to weight regain and achieve sustainable weight loss over the long term.”

The analyst adds that small molecules, accounting for 66 per cent of the overall pipeline, are the dominant molecule type in all stages of development for obesity treatment. Biologic therapeutics, consisting largely of peptides, proteins, antibodies and vaccines, also feature prominently.

GBI Research’s report also states that the long-term treatment options for obesity remain sparse, including the dietary fat absorption inhibitor Xenical (orlistat), and appetite suppressants such as Qsymia (phentermine and topiramate extended release), Belviq (lorcaserin hydrochloride), and the two new market entrants Contrave (naltrexone and bupropion) and Saxenda (liraglutide rDNA origin).

Wong continues, “Prescription of these treatments is generally limited, primarily due to concerns over their long-term safety, with the past decade seeing a number of drug withdrawals in the market as a result of serious cardiovascular risks and psychiatric adverse reactions.”

“The uptake of anti-obesity drugs has also been hindered by their modest efficacy in inducing sustained body weight reduction. All of these factors are driving efforts to address the significant unmet need for effective obesity therapeutics with favorable safety profiles,” the analyst concludes.