Lilly at EASD 2026: Retatrutide's TRIUMPH-2 Phase 3 Readout, Foundayo's Lancet Cardiovascular Data, and What eloraTZP Signals for the Next Generation of Incretin Combinations

Key takeaways

• Retatrutide's TRIUMPH-2 Phase 3 trial in adults with obesity and type 2 diabetes reported mean body-weight reduction of up to 20.8% (22.5 kg; 49.6 lbs) and A1C reduction of up to 1.6% at 80 weeks, according to Eli Lilly.
• ACHIEVE-4, the largest and longest Phase 3 study of Foundayo (orforglipron) in type 2 diabetes, met its primary cardiovascular non-inferiority objective versus insulin glargine and was simultaneously published in The Lancet on 30 September 2026, per Lilly's press release.
• Phase 2 data for eloraTZP, an investigational combination of the selective amylin receptor agonist eloralintide and tirzepatide, were presented at EASD's amylin symposium.
• All three datasets were presented at the 62nd Annual Meeting of the European Association for the Study of Diabetes (EASD), which runs 28 September to 2 October 2026 at the Allianz MiCo in Milan.

Context: Lilly's cardiometabolic presence at EASD 2026

Eli Lilly, the maker of Zepbound (tirzepatide), Mounjaro (tirzepatide) and Foundayo (orforglipron), presented new data across its cardiometabolic health portfolio at the 62nd Annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy. The meeting took place from 28 September to 2 October 2026 at the Allianz MiCo – Milan Convention Centre, with a scientific programme featuring hundreds of presentations spanning basic and clinical diabetes research.

The three headline datasets — retatrutide TRIUMPH-2, Foundayo ACHIEVE-4, and eloraTZP Phase 2 — collectively map Lilly's incretin strategy across injectable peptide agonists, oral small-molecule GLP-1 receptor agonists, and next-generation combination approaches involving amylin receptor co-agonism. For research-procurement professionals tracking the GLP-1 therapeutics landscape, they mark a notable concentration of Phase 3-level evidence arriving within the same conference window.

Retatrutide: TRIUMPH-2 readout in obesity and type 2 diabetes

Retatrutide is an investigational GIP, GLP-1, and glucagon receptor triple agonist administered by weekly injection. It is distinct from tirzepatide in that it adds glucagon receptor agonism — a pathway theorised to augment energy expenditure — to the dual GIP/GLP-1 mechanism.

TRIUMPH-2 reported that retatrutide produced mean weight loss of up to 49.6 lbs (22.5 kg; 20.8%) and A1C reduction of up to 1.6% at 80 weeks in adults with obesity or overweight and type 2 diabetes. Those figures place it among the most efficacious injectable anti-obesity agents yet to reach Phase 3 readout in the type 2 diabetes population — a group where disease-related metabolic resistance typically blunts weight loss response relative to obesity-only cohorts.

Pivotal results from TRIUMPH-2 showed retatrutide delivered substantial weight loss and A1C improvements in obesity and type 2 diabetes, building on earlier Phase 2 data presented at prior conferences. Lilly has not yet announced a regulatory submission timeline for retatrutide, and the compound remains investigational in all markets. No MHRA or EMA application is on record as of 1 October 2026.

For UK research labs following the GLP-1 peptide reference compound landscape, retatrutide's triple-agonist mechanism — and particularly the pharmacological contribution of the glucagon receptor arm — continues to attract preclinical investigation interest. The TRIUMPH-2 80-week follow-up provides a substantially longer efficacy window than prior Phase 2 data, though peer-reviewed publication details were not available at the time of writing; Lilly characterised the results as company topline data.

Foundayo (orforglipron): ACHIEVE-4 cardiovascular safety and The Lancet publication

Foundayo is a once-daily small molecule (non-peptide) oral glucagon-like peptide-1 receptor agonist that can be taken at any time of day without restrictions on food and water intake. It was discovered by Chugai Pharmaceutical and licensed by Lilly in 2018, and received FDA approval for chronic weight management in April 2026. The ACHIEVE programme covers its type 2 diabetes development.

Detailed results from ACHIEVE-4 were announced on 30 September 2026, presented at EASD in Milan, and simultaneously published in The Lancet. The trial — the largest and longest study of Foundayo in type 2 diabetes to date — demonstrated non-inferior risk of major adverse cardiovascular events (MACE) and improved A1C, weight and other key cardiometabolic measures compared with insulin glargine.

The cardiovascular signal warrants careful reading. In ACHIEVE-4, Foundayo demonstrated non-inferiority versus insulin glargine, with a 16% lower risk of MACE-4 events (HR: 0.84; 95.0% CI: 0.59 to 1.20) and a 23% lower risk of MACE-3 events (HR: 0.77; 95.0% CI: 0.52 to 1.13), in adults with type 2 diabetes and obesity or overweight at increased cardiovascular risk. Both confidence intervals cross 1.0, meaning the directional signal is present but formal superiority has not been established; the trial was powered for non-inferiority, not superiority.

In pre-planned analyses, Foundayo showed a 53% lower risk of cardiovascular death and a 57% lower risk of all-cause death versus insulin glargine, suggesting the potential for more comprehensive health benefits. These are exploratory findings from pre-planned secondary analyses and should be interpreted accordingly, particularly given the confidence interval breadth at these event rates.

Analyses from ACHIEVE-2 and ACHIEVE-3 also showed that Foundayo 17.2 mg helped adults with type 2 diabetes reach their A1C target and body weight loss goals faster than dapagliflozin and oral semaglutide 7 mg and 14 mg.

Separately, Lilly announced results from an analysis showing that Foundayo 17.2 mg was associated with significantly greater weight loss and better blood sugar control than oral semaglutide 25 mg in adults with type 2 diabetes. The findings were based on an indirect treatment comparison drawing on data from ACHIEVE-3 and PIONEER PLUS, presented at EASD in Milan. Indirect treatment comparisons carry methodological limitations relative to head-to-head randomised trials, and Lilly has not announced a direct head-to-head study versus oral semaglutide.

For UK procurement teams, Foundayo is not yet licensed by the MHRA or EMA for type 2 diabetes (the April 2026 approval was FDA, for weight management only); the ACHIEVE data package will form the basis of any future regulatory submissions in those jurisdictions.

eloraTZP: Phase 2 data for a tirzepatide-amylin combination

The EASD-sponsored symposium on amylins in diabetes featured Phase 2 results for eloraTZP, an investigational combination of eloralintide and tirzepatide, in adults with obesity or overweight and type 2 diabetes. Eloralintide is a selective amylin receptor agonist; its combination with tirzepatide adds a third hormonal signalling axis — amylin, which modulates gastric emptying, glucagon suppression, and satiety — to tirzepatide's GIP/GLP-1 dual agonism.

In addition to chronic weight management, orforglipron is being studied as a potential treatment for type 2 diabetes, obstructive sleep apnea, osteoarthritis knee pain, hypertension, peripheral artery disease and stress urinary incontinence, illustrating the broader therapeutic ambition Lilly is placing across its incretin portfolio. eloraTZP sits at an earlier stage; the Phase 2 results presented at EASD represent its first substantive clinical data package.

The amylin co-agonism approach echoes the broader industry interest in multi-receptor combinations. Novo Nordisk has pursued cagrilintide (amylin analogue) in combination with semaglutide as CagriSema, while eloraTZP pairs a different amylin-pathway agent with tirzepatide's dual GIP/GLP-1 mechanism. Full Phase 2 efficacy and safety data for eloraTZP had not been published in a peer-reviewed journal at the time of writing; conference abstracts are the primary source.

Implications for the research landscape

The three EASD datasets collectively illustrate the compression of the clinical development timeline in the GLP-1 and multi-agonist space. Retatrutide's 80-week TRIUMPH-2 data — if they survive regulatory scrutiny — would establish the most extended high-quality Phase 3 efficacy window available for a triple agonist in this population. The Foundayo ACHIEVE-4 Lancet publication gives that programme a peer-reviewed cardiovascular safety dossier ahead of anticipated EMA and MHRA type 2 diabetes filings.

For UK research procurement professionals, the practical implications in the near term are modest: none of these three agents is currently licensed in the UK for the indications studied at EASD, and MHRA submissions will require separate evaluation. However, the TRIUMPH-2 retatrutide data in particular will inform how research labs calibrate their reference compound sourcing for triple-agonist mechanistic work over the coming 12–18 months, as the compound moves closer to potential regulatory filing.

BSR Intelligence monitors the GLP-1 therapeutics pipeline on behalf of UK research-procurement professionals. Data cited from company press releases and conference abstracts have not all been subject to independent peer review at the time of publication; readers should consult primary sources for full statistical disclosures.