EASD Milan 2026: Three Datasets That Reframe the Next Wave of Peptide-Based Obesity Treatments

Key takeaways

• Hansoh Pharma's dual-biased GLP-1/GIP agonist olatorepatide achieved 19.3% mean body-weight loss at Week 48 in a Phase 3 trial, with notably low rates of gastrointestinal adverse events, according to a late-breaking abstract presented at EASD on 2 October 2026.
• Novo Nordisk's OCTANE real-world analysis found that patients who switched from injectable semaglutide or tirzepatide to once-daily oral semaglutide lost an average of 4.1% of body weight within three months, though the study's retrospective, self-reported design limits causal inference.
• Regeneron's Phase 2 COURAGE trial, now in press at The Lancet, showed that adding trevogrumab (anti-GDF8/anti-myostatin) to semaglutide reduced lean-mass loss by approximately 50% and preserved over 70% of muscle volume in an MRI substudy, positioning the combination as a candidate next step in obesity pharmacology.
• All three datasets emerged from the same five-day Milan meeting and collectively illustrate how the GLP-1 peptide landscape is diversifying across molecule design, formulation strategy, and combination therapy.

Olatorepatide (HS-20094): Phase 3 data reach EASD as a late-breaking abstract

Hansoh Pharmaceutical Group's olatorepatide was presented as a late-breaking abstract oral presentation at EASD on 2 October 2026, reporting full results from the LIGHTEN Phase 3 study conducted in Chinese adults with overweight or obesity. The compound is described by Hansoh as a dual-biased GLP-1/GIP receptor agonist — a class that, like tirzepatide, targets two incretin hormone pathways simultaneously but differs in its receptor-signalling bias profile.

The LIGHTEN study randomised 604 adults across 33 clinical sites to once-weekly subcutaneous injections of olatorepatide at 5 mg, 10 mg, or 15 mg, or placebo, over 48 weeks. Eligible participants had a BMI of 28 kg/m² or above, or a BMI of 24–28 kg/m² with at least one weight-related comorbidity. The study met both co-primary endpoints: percentage change in body weight from baseline at Week 48, and the proportion of participants achieving at least 5% weight loss.

At the top dose, participants achieved a mean body-weight reduction of 19.3%, with waist-circumference reduction of 16.0 cm in the 15 mg group versus 3.6 cm in the placebo group (P < 0.0001). The weight-loss curve showed a continued downward trend at Week 48, without reaching a plateau, suggesting that longer treatment duration may yield further weight-loss benefits.

The tolerability profile attracted comment. The incidence of nausea was 7.8% and vomiting 4.9% — rates that compare favourably with published figures for existing approved incretin agents. The overall safety profile was similar to incretin-based therapies approved for weight management, and no participants discontinued treatment due to olatorepatide-related adverse events.

Olatorepatide also demonstrated improvements in broader metabolic parameters including blood pressure, lipid profiles, HbA1c, insulin resistance (HOMA-IR), urine albumin-to-creatinine ratio, and uric acid.

The geopolitical and commercial context is relevant for researchers tracking supply chains. Regeneron Pharmaceuticals licensed olatorepatide from Hansoh and announced plans to initiate a global Phase 3 registrational programme later in 2026. Data presented in Milan on 2 October represent the first full Phase 3 readout from the Chinese cohort, and Regeneron confirmed on the same day that a Phase 3 trial run by Hansoh had met its endpoints and that it remains on track to begin a global programme. UK and European research teams wishing to acquire olatorepatide for mechanistic work should note that no regulatory submission has been made in any Western jurisdiction; the compound remains investigational outside China.

OCTANE: Real-world evidence for the oral semaglutide switch — and its limitations

Novo Nordisk presented the OCTANE study on 30 September 2026 as a late-breaking abstract at EASD, making it among the first analyses to examine outcomes specifically in patients transitioning from injectable GLP-1 therapy to the oral Wegovy formulation.

OCTANE was a retrospective cohort analysis evaluating weight change, treatment adherence, and patient satisfaction three months after switching from injectable semaglutide or tirzepatide to once-daily oral semaglutide, drawn from the Ro telehealth platform. The final sample comprised 194 patients with a mean baseline weight of 100.5 kg and a mean BMI of 34.5 kg/m².

Adults who stayed on treatment for three months lost an average of 4.1% of body weight, or approximately 4.0 kg, compared with their baseline weight (P < 0.001). The proportion of participants classified as clinically obese — BMI ≥30 kg/m² — fell from 87.1% at baseline to 65.5% at three months. Among participants with available self-report data, 82.4% reported at least one treatment improvement, including better-fitting clothing and healthier eating habits.

These figures should be interpreted carefully. Novo itself acknowledged that real-world studies evaluate associations and cannot determine causality, and that self-reported data may be biased with results potentially not applicable to the broader population. The 194-person sample is modest, participants were not required to have lost weight on the injectable prior to switching, and the three-month window is short relative to the chronic-disease timescale typically used to evaluate weight-loss interventions. Separately, the OASIS 4 trial — the randomised controlled study supporting oral semaglutide's label — produced a 13.6% average weight loss at the 25 mg maintenance dose, providing a cleaner benchmark for researchers comparing injectable and oral formulation profiles.

For laboratory procurement teams, the OCTANE data are primarily relevant as market signal: they indicate that real-world adoption of oral semaglutide is under active investigation by Novo, and that the company is building a real-world evidence infrastructure through telehealth partnerships that may eventually generate larger cohort data.

COURAGE: Trevogrumab and the lean-mass problem in GLP-1 therapy

A distinct but increasingly discussed challenge in GLP-1 peptide research is the loss of lean mass accompanying rapid weight reduction. With the explosive adoption of GLP-1 weight-loss drugs, there has been growing concern about significant muscle loss accompanying rapidly shed pounds. Studies indicate that patients on semaglutide monotherapy lose approximately 30% of their total weight in the form of lean muscle mass.

Regeneron's Phase 2 COURAGE trial addressed this directly. The trial evaluated trevogrumab, an anti-GDF8/anti-myostatin monoclonal antibody, in combination with semaglutide in adults with obesity. Results were presented at EASD and simultaneously accepted for publication in The Lancet.

In the COURAGE trial, patients taking semaglutide alone lost 6.7% of their lean muscle mass over 26 weeks, whereas those who also took 75 mg of trevogrumab lost only 3.3% — a reduction of roughly 50%. In a predefined MRI substudy measuring skeletal muscle volume directly, trevogrumab at 75 mg preserved over 70% of thigh muscle mass loss associated with semaglutide treatment. A pre-specified subgroup analysis found that patients meeting the low lean-mass definition for sarcopenia derived greater lean-mass preservation from trevogrumab.

Building on these findings, Regeneron is planning to initiate a Phase 2 trial evaluating trevogrumab in combination with GLP-1 receptor agonist-based therapies specifically in older adults with obesity and decreased muscle mass and/or strength. Trevogrumab is not a peptide in the classical sense — it is a monoclonal antibody targeting the GDF8/myostatin pathway — but its relevance to research teams working on GLP-1 peptide pharmacology is direct: it tests whether the muscle-composition consequences of GLP-1-induced weight loss are pharmacologically correctable.

What these datasets mean in aggregate

The three EASD datasets do not tell a single story, but taken together they illustrate where the peptide-based obesity field is heading. Olatorepatide represents the continuing emergence of Chinese-origin GLP-1/GIP dual agonists with a global licensing model; OCTANE signals Novo's strategy of building real-world data to support oral formulation uptake alongside its injectable franchise; and COURAGE surfaces a mechanistic question — muscle preservation — that is likely to influence the design of future combination programmes regardless of which GLP-1 backbone is used.

For UK research-procurement professionals, none of these compounds is presently available through licensed domestic channels. Olatorepatide and trevogrumab remain investigational, and the oral semaglutide formulation (Wegovy pill) does not yet hold a Medicines and Healthcare products Regulatory Agency (MHRA) licence for the UK market as of the date of this briefing. Researchers requiring reference standards or characterised peptide analogues for mechanistic assay work should ensure that any material is obtained through compliant channels with a full Certificate of Analysis, appropriate purity documentation by HPLC, and mass-spectrometry confirmation of identity.