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News
A new once-daily oral GLP-1 pill, orforglipron (Foundayo), proved as safe as insulin glargine for heart outcomes in people with type 2 diabetes at high cardiovascular risk, per the phase 3 ACHIEVE-4 trial. It also delivered better blood sugar control and significant weight loss. Full cardiovascular benefit, however, remains to be proven in a future trial.
Orforglipron (Foundayo, Eli Lilly), a once-daily oral non-peptide GLP-1 receptor agonist, met the noninferiority bar against insulin glargine for major adverse cardiovascular events (MACE-4) in adults with type 2 diabetes at elevated cardiovascular risk, according to the phase 3 ACHIEVE-4 trial presented at the EASD 2026 Annual Meeting and simultaneously published in The Lancet. While the trial wasn't powered to prove superiority — and didn't achieve it for MACE-3 — the data showed a favorable trend, with researchers optimistic that cardiovascular benefit will be confirmed in the upcoming ATTAIN-OUTCOMES trial.
Beyond heart safety, orforglipron outperformed insulin glargine on metabolic outcomes, delivering meaningfully better blood sugar control and substantial weight loss over 104 weeks. It also showed a much lower rate of hypoglycemia. The main downside: gastrointestinal side effects were common and drove higher treatment discontinuation.
By the Numbers:
Why it matters: Orforglipron's pill format — no fasting or water restrictions required — could expand access to effective GLP-1 therapy for millions with type 2 diabetes globally, especially where injectable options face barriers.
