What’s Next for Weight Loss Drugs? A Look at EloraTZP, Trevogrumab, and CBL-154

Trevogrumab Aims to Minimize Muscle Loss

Trevogrumab isn’t a weight loss medication per se, but it’s designed to be given alongside semaglutide (the active ingredient in Wegovy and Ozempic) to minimize muscle loss, a common concern with weight loss medications.

Trevogrumab is a monoclonal antibody, a type of medication that targets a specific protein in the body. Here it blocks myostatin, a protein closely linked to muscle mass loss.

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The latest trial used MRI scans to measure the thigh muscles of more than 1,000 patients who took semaglutide (Wegovy and Ozempic) or semaglutide and trevogrumab. After 52 weeks, patients who got a 75 milligram (mg) dose of trevogrumab in addition to semaglutide preserved more than 70 percent of their muscle mass loss compared with those who took semaglutide alone.

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In the first part of the trial, those who took semaglutide lost 6.7 percent of their lean muscle mass over 26 weeks. But participants who took semaglutide and 75 mg of trevogrumab lost only 3.3 percent of ⁠their muscle mass.

Participants who stopped semaglutide but continued taking trevogrumab saw their muscle mass return to where it was before they started semaglutide.

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“Muscle loss is always a concern in any kind of weight loss process,” Dr. Ali says. “Anything that can help to reduce muscle loss is going to be an improvement.” Not only can muscle preserve strength, but more muscle burns more calories at rest, he points out.

On the other hand, Dr. Siegel notes, it’s not yet clear if less muscle mass loss translates to more strength and mobility in patients.

CBL-514 Kills Fat Cells to Prevent Weight Regain

Many weight loss medications target specific hormone receptors in the body to reduce hunger and slow digestion. But CBL-514 takes a novel approach by killing fat cells, a process known as apoptosis of adipocytes, with the goal of making it easier for people who’ve lost weight to keep it off.

While medications like semaglutide and tirzepatide can help people lose weight, they don’t target fat alone, Ali points out.

A phase 2 clinical trial result randomized 40 patients with obesity to receive a course of injections of CBL-514 or a placebo into their lower abdomen every three weeks for up to 12 weeks. The number of injections were reduced as the participants’ fat thickness decreased. The researchers conducted MRI scans to measure fat tissue at the start of the study, and 4, 8, and 12 weeks after the final treatment.

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CBL-514 reduced the layer of fat just below the skin (known as subcutaneous adipose tissue) by 150 milliliters (mL) in nearly 70 percent of participants by the eight-week follow-up. By comparison, none of those who received the placebo reached this marker.

What Doctors Have to Say About New Weight Loss Drugs in Development

As more weight loss drugs make their way through the research pipeline and become available, doctors are hoping that patients will benefit from lower costs and greater choice.

“More options should help to reduce prices for medication, which would ideally increase access through more insurance plans,” says Siegel.

Additional medications also allow providers to better tailor treatment to the patient, according to Ali. “No single medication is effective for everybody,” he says. “Having different options available is important.”