Elecoglipron, a GLP-1 tablet, lowers blood glucose and bodyweight in phase 2b trial

Phase 2b SOLSTICE trial results have shown that the investigational oral glucagon-like peptide-1 receptor agonist elecoglipron significantly reduced glycated haemoglobin and bodyweight in people with type 2 diabetes

An investigational oral glucagon-like peptide-1 (GLP-1) receptor agonist has significantly reduced blood glucose and bodyweight in people with type 2 diabetes (T2DM), according to phase 2b clinical trial results presented at the American Diabetes Association’s Scientific Sessions.

The medicine – elecoglipron – was assessed in SOLSTICE, which was a randomised, placebo-controlled trial sponsored by AstraZeneca. The findings suggest that oral GLP-1 receptor agonists could help to widen access to therapies that reduce blood sugar and support weight loss in a market currently dominated by once-weekly injection pens.

GLP-1 receptor agonists are a major class of metabolic medicines used to treat T2DM and – in some formulations – obesity. They mimic or enhance the activity of GLP-1, a gut hormone that helps to stimulate insulin release, reduce glucagon secretion, slow gastric emptying and influence appetite. These effects can lower serum blood glucose and reduce bodyweight, both of which are central treatment goals for many people with T2DM.

Most medicines in this class have been delivered by subcutaneous injection. Semaglutide, for example, has also been approved for T2DM in tablet form but this oral peptide formulation must be taken on an empty stomach first thing in the morning, with food and water restricted for 30 minutes afterwards.

Elecoglipron has been developed as an oral treatment for T2DM. The SOLSTICE trial enrolled 406 participants across nine countries, randomly assigning them to treatment groups. The trial assessed different starting doses, dose-escalation schedules and maintenance doses to evaluate the medicine’s effect on glucose control, bodyweight, safety and tolerability.

After 26 weeks, researchers found that all dose concentrations of elecoglipron reduced glucose levels significantly more than placebo. For participants who received the medicine, up to 89.6 per cent achieved a glycated haemoglobin – HbA1c – level of seven per cent (53 mmol/mol). HbA1c reflects average blood glucose levels over the previous two to three months and seven per cent is a standard treatment target for many adults with diabetes. By comparison, 24.9 per cent of participants in the placebo group reached that threshold.

The study also found that up to 72.3 per cent of participants in the elecoglipron groups achieved at least five per cent bodyweight reduction, compared with 20.2 per cent of those who received placebo. The researchers reported that safety and tolerability were similar to those seen with other GLP-1 medicines at this stage of development.

“Our study’s findings underscore the expanding potential of oral GLP-1 receptor agonists for people with type 2 diabetes,” said Dr Vanita Aroda, director of diabetes clinical research in the division of endocrinology, diabetes and hypertension in the Mass General Brigham Department of Medicine, Boston, USA.

“To date, GLP-1 therapies have largely been limited to injectable or oral peptide formulations, each with inherent delivery and dosing constraints. Clinical trials like SOLSTICE can help us evaluate oral medications that may be just as effective for patients with diabetes while overcoming these limitations,” she added.

Dr Aroda was also the principal investigator of REIMAGINE 1, a randomised controlled trial that evaluated CagriSema, a novel combination therapy that combines the amylin receptor agonist cagrilintide with injectable semaglutide. Those results, presented at the American Diabetes Association meeting, in June 2026, were also positive, with up to 87 per cent of participants reaching the target HbA1c level of seven per cent.

“At the centre of every one of our clinical trials is the goal of improving outcomes for patients,” Aroda said.

“The studies being presented at this year’s meeting highlight how essential carefully designed trials are for evaluating new therapies, refining existing approaches, and ensuring that advances in science translate into safer, more effective care for people living with diabetes,” she concluded.

The results support further clinical development of elecoglipron and add to the wider evidence base for oral metabolic medicines that could reduce reliance on injections. For people with T2DM, an effective oral GLP-1 receptor agonist could offer a simpler treatment option, subject to later-stage trials confirming durable benefits, practicality and safety.

For further reading please visit: 10.1016/S0140-6736(26)00802-0