During the earnings call, AstraZeneca's CEO revealed that the company currently has over 100 ongoing Phase III trials, with data from more than 20 late-stage studies expected to read out this year. Among these, the CEO was particularly effusive about the company's weight-loss candidate, elecoglipron. "All I can say is, our product is highly competitive."

From a mechanistic standpoint, elecoglipron is a small-molecule GLP-1 agonist. Unlike peptide-based GLP-1 drugs, small-molecule drugs have shorter chemical synthesis pathways, lower production costs, and offer greater chemical structural compatibility for developing combinations with other targets.

AstraZeneca acquired this asset in November 2023 through an exclusive licensing agreement with Eccogene. The deal included an upfront payment of $185 million, with total milestone payments exceeding $2 billion.

At the time, AstraZeneca found itself in an awkward position within the metabolic disease field. Its internally developed GLP-1 program had been terminated due to efficacy failing to meet expectations, leaving its weight-loss pipeline nearly empty. Eccogene's candidate had just completed a Phase I trial, with data demonstrating good oral bioavailability, a half-life supporting once-daily dosing, and a lower rate of gastrointestinal adverse events compared to semaglutide.

This transaction was not the most expensive among collaborations between multinational pharmaceutical companies and Chinese biotech firms that year, but it became a landmark move signaling AstraZeneca's re-entry into the weight-loss drug arena.

Twenty-six months later, elecoglipron has crossed the threshold into Phase III development. Two Phase II trials have been conducted, covering populations with obesity/overweight and type 2 diabetes:

• The VISTA study: Enrolled 310 patients with obesity or overweight, with a 36-week treatment period evaluating changes in body weight.

• The SOLSTICE study: Enrolled 406 patients with type 2 diabetes, featuring dual control groups (placebo and semaglutide), evaluating changes in HbA1c and body weight.

Both studies were completed by the end of 2025, with all primary endpoints successfully met. The detailed data will be unveiled at the American Diabetes Association (ADA) Scientific Sessions in June.

We have every reason to be highly anticipatory. After all, as Soriot stated: "If we didn't believe in this product ourselves, we wouldn't have advanced it into Phase III, nor would we be unlocking all these valuable investments for monotherapy, combination, and cardiovascular outcomes trials."

“As the weight management market matures, we are developing new products designed to easily improve adherence,” Soriot explained. “For instance, shifting from weekly to monthly injections, while also developing products that enhance the quality of weight loss—meaning more fat loss and less muscle loss.”

From 2025 through early 2026, the company assembled a metabolic pipeline covering diverse mechanisms and varying dosing frequencies through a series of external collaborations.

In January 2026, AstraZeneca entered into an exclusive licensing agreement with CSPC Pharmaceutical Group, paying a $1.2 billion upfront payment to secure the global rights (ex-Greater China) to CSPC’s portfolio of once-monthly injectable weight-loss products. The total milestone payments could approach $18.5 billion. The core asset, SYH2082, is a long-acting GLP-1R/GIPR dual agonist that has completed preclinical development and is poised to enter Phase I trials.

Prior to this, in June 2025, AstraZeneca had already signed another licensing deal with CSPC, paying a $110 million upfront payment to leverage the latter's AI-driven drug discovery platform to develop oral drug candidates.

Internal R&D programs are also advancing. The long-acting amylin receptor agonist, AZD6234, has entered Phase II, with data expected in the first half of 2026. Concurrently, data from the Phase II study evaluating the combination therapy of AZD6234 with the GLP-1/glucagon dual agonist, AZD9550, is anticipated in the second half of this year.

By that time, much of this data will be placed side-by-side in comparative tables with competing assets from Novo Nordisk and Eli Lilly.

Last December, Novo Nordisk became the first company to launch an oral GLP-1 weight-loss drug with the introduction of oral Wegovy. Meanwhile, Eli Lilly's oral GLP-1 candidate, orforglipron, is reportedly expected to receive a regulatory decision in the second quarter of this year.

Furthermore, according to Evaluate's "Top 10 Most Anticipated Drugs of 2026" list, if CagriSema is launched this year, its annual sales could surpass $17 billion within six years. As a point of reference, last year's top-ranked drug was Vertex Pharmaceuticals' latest cystic fibrosis medication, Alyftrek, for which Evaluate estimated 2030 sales at $8.3 billion.

CagriSema is a once-weekly injectable combination therapy, composed of semaglutide 2.4 mg and the long-acting amylin analog, cagrilintide 2.4 mg. Late last year, an NDA was submitted to the FDA for weight management in adults with overweight or obesity who have at least one weight-related comorbidity.

Two 68-week clinical studies demonstrated an average weight reduction of 22.7% in patients without diabetes and 15.7% in patients with type 2 diabetes. Although these results fell short of the market's anticipated >25% efficacy, triggering stock price declines on two occasions, Novo Nordisk's CEO emphasized that the degree of weight loss is still superior to all currently marketed drugs and that the therapy is well-tolerated. The company is also exploring higher-dose combinations and dose escalation regimens.

Eli Lilly is countering with its oral small-molecule GLP-1 drug, orforglipron. Unlike the peptide-based oral Wegovy, orforglipron, as a small molecule, offers potential advantages in large-scale manufacturing and cost control.

Beyond capturing the global market and needle-averse populations, orforglipron has also demonstrated potential in the post-injection maintenance setting. Switch therapy trials showed that patients transitioning from Wegovy to orforglipron maintained nearly all of their weight loss, while those switching from Zepbound experienced slight weight regain. However, both outcomes were significantly superior to placebo, highlighting orforglipron's clear potential for maintenance therapy following injectable treatment.

Analysts are generally optimistic about its prospects. Leerink Partners projects orforglipron sales could reach $16 billion by 2028. Evaluate offers a more conservative forecast, estimating approximately $11.8 billion by 2032.

While AstraZeneca's obesity pipeline is advancing rapidly, substantial revenue contribution from this area is not expected until beyond 2030.

In the interim, AstraZeneca must navigate a challenging transition period. The patent for its cardiovascular drug Brilinta (ticagrelor) has expired. Biosimilars for its rare disease drug Soliris (eculizumab) and generics for its blockbuster diabetes drug Farxiga (dapagliflozin) are progressively entering the market. Furthermore, the "Most Favored Nation" agreement reached with the U.S. government last October will also impact revenue this year.

As established products face mounting pressure, new products must step up.

Soriot stated that the company currently has 16重磅药物 (blockbuster drugs) with annual sales exceeding $1 billion each. His goal is to increase this number to 25 by 2030. This implies AstraZeneca needs to identify 9 new重磅药物 within the next five years.

One of the most closely watched candidates currently is baxdrostat, an investigational drug for treatment-resistant hypertension. It has demonstrated strong performance in late-stage clinical data and a regulatory decision is expected in the second quarter of this year. Regarding competitors, Mineralys Therapeutics' drug targeting the same mechanism holds a slight data advantage, and the company itself is often viewed as a potential acquisition target.

In the oncology segment, the oral breast cancer drug camizestrant is generating high expectations. This selective estrogen receptor degrader (SERD) has validated its efficacy in the first-line setting and is expected to launch in the first half of this year. However, Roche's same-mechanism drug, giredestrant, is also aggressively pursuing the market.

Last month, Roche publicly stated that giredestrant could become the most profitable product in the company's history. While the target patient populations for the two drugs differ, their clinical usage scenarios post-launch will be difficult to completely separate. Currently, Roche's product enjoys greater market buzz.

These two potential重磅药物 alone are far from sufficient to fill the gap left by declining legacy products. For AstraZeneca to add 9重磅药物 within five years, no one can claim it will be easy, and no one can yet assert it is impossible.

During the earnings call, analysts' focus did not remain solely on commercial performance. Instead, considerable attention was directed toward the company's clinical pipeline. The external world is keen to know whether this British pharmaceutical company can replicate the high success rate it achieved in Phase III trials last year.

AstraZeneca internally regards 2026 as a "year dense with catalysts," with multiple key data readouts anticipated, including:

• Datroway (co-developed with Daiichi Sankyo): The Avanzar study in first-line non-small cell lung cancer.

• Camizestrant (oral SERD): The Serena-4 study in first-line HR-positive breast cancer.

• Wainua (co-developed with Ionis): The CardioTTRansform study in transthyretin amyloid cardiomyopathy.

• Efzimfotase alfa: Three Phase III trials in hypophosphatasia, a rare metabolic bone disease.

• Tozorakimab (IL-33 inhibitor): Three Phase III studies in chronic obstructive pulmonary disease.