Can amylin weight-loss drugs compete in a world of GLP-1s?

For the past 7 years, pharmaceuticals that work as glucagon-like peptide 1 (GLP-1) receptor agonists have dominated the weight-loss and diabetes markets. These drugs, currently sold by Novo Nordisk and Eli Lilly and Company, have raked in hundreds of billions of dollars in sales. For a while, the GLP-1s were available only as injectables, then this year, pills, too, made it to the market. But GLP-1s are far from perfect. Their undesirable qualities include side effects such as nausea and muscle loss. And the industry titans know well that being complacent is not the name of the game.In the quest to bring new generations of weight-loss and diabetes drugs to market, Novo Nordisk, Lilly, and several other companies, big and small, have set their sights on targets other than GLP-1. Among them is amylin, a hormone whose analogs were once seen as promising candidates to become weight-loss and antidiabetic medicines. Those molecules were shelved for many years but are now being dusted off.The peptides and small molecules under development elicit weight loss by mimicking amylin, a naturally occurring hormone that plays a role in glucose regulation. And while some companies, such as Lilly, are testing their analogs as stand-alone therapies, others, including Novo Nordisk, are combining them with GLP-1s.Wall Street analysts were particularly excited about amylin candidates for their promise in areas where GLP-1s fall short. Yet as clinical trial results begin to pour in, investor excitement seems to be ebbing. Executives from companies developing the candidates, however, say the