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News
A new once-daily GLP-1 pill called orforglipron (Foundayo) has passed a key cardiovascular safety test, showing it's no worse than insulin glargine for heart outcomes in people with type 2 diabetes. The ACHIEVE-4 trial also found meaningful improvements in blood sugar control, weight, and kidney markers. Full proof of cardiovascular benefit, however, awaits a larger trial expected to wrap up in 2031.
A new oral GLP-1 drug is making a strong case for itself. Orforglipron (Foundayo) — a once-daily pill that, unlike semaglutide, requires no fasting or water restrictions — has demonstrated cardiovascular safety in the phase III ACHIEVE-4 trial, presented at the European Association for the Study of Diabetes meeting and simultaneously published in The Lancet.
The trial compared orforglipron to injectable insulin glargine in nearly 2,750 adults with type 2 diabetes and elevated cardiovascular risk. Orforglipron met the noninferiority threshold for major adverse cardiovascular events (MACE), and also delivered better glycemic control, meaningful weight loss, reduced albuminuria, and slower kidney function decline. GI side effects were far more common with orforglipron (62% vs. 14%), and the trial wasn't powered to prove cardiovascular superiority — that's the job of the ongoing ATTAIN-Outcomes trial, due in 2031.
By the Numbers:
Why it matters: Orforglipron's convenience and shelf-stability could expand access to GLP-1 therapy globally, especially in settings where injectable or refrigerated medications are difficult to manage. Establishing full cardiovascular benefit — as semaglutide has already done — would be a significant milestone for this easier-to-use pill.
