Novo and Lilly:Novo Nordisk and Eli Lilly are using the European Association for the Study of Diabetes (EASD) meeting in Milan to present new evidence on their leading GLP-1 medicines, with data spanning diabetes control, weight loss and cardiovascular outcomes.
The competing presentations come as the two companies continue to battle for share of the rapidly expanding diabetes and obesity drug markets. Novo is presenting new findings on semaglutide products including Ozempic and Wegovy, while Lilly is highlighting data on Mounjaro, Zepbound and its oral GLP-1 Foundayo.
- Novo Nordisk presented real-world data comparing Ozempic with Eli Lilly’s Mounjaro in adults with type 2 diabetes.
- The analysis found a 6% lower risk of major cardiovascular events among patients who increased their Ozempic dose from 1 mg to 2 mg compared with those who switched to Mounjaro.
- Lilly presented an indirect comparison suggesting Foundayo produced greater weight loss and A1C reductions than Novo’s 25 mg oral semaglutide in people with type 2 diabetes.
- Lilly is also presenting Phase 3 data for investigational retatrutide, a triple GIP, GLP-1 and glucagon receptor agonist.
- The competing datasets illustrate how the companies are increasingly differentiating their products through cardiovascular outcomes, oral formulations and next-generation medicines.
Novo Highlights Ozempic Cardiovascular Data
One of Novo’s headline presentations at EASD centers on real-world evidence comparing semaglutide with tirzepatide.
The analysis included 636,525 adults with type 2 diabetes and examined patients who either increased their Ozempic dose from 1 mg to 2 mg or switched to Lilly’s Mounjaro. Patients who escalated Ozempic were associated with a statistically significant 6% reduction in major adverse cardiovascular events compared with those who switched to Mounjaro.
The findings add to Novo’s effort to emphasize cardiovascular outcomes as a differentiating feature of semaglutide.
However, the data are observational real-world evidence rather than results from a randomized head-to-head clinical trial. That distinction is important when comparing outcomes between the two medicines because differences between patient populations and treatment decisions can affect results.
Lilly Counters With Oral GLP-1 Data
Lilly is taking aim at Novo’s emerging oral semaglutide franchise with data on Foundayo, the company’s oral GLP-1 medicine.
An indirect analysis of two late-stage studies found that Foundayo at a 17.2 mg dose produced between 1.5 and 2.4 percentage points more weight loss than Novo’s 25 mg oral semaglutide. Lilly’s analysis also found an additional 0.3 to 0.6 percentage-point reduction in A1C.
The comparison was not based on a direct head-to-head clinical trial. Instead, Lilly drew the comparison from separate studies involving the two medicines.
Novo’s 25 mg oral semaglutide is also at a different regulatory stage depending on the indication and market. In the U.S., a regulatory decision on its use in type 2 diabetes is expected later in 2026.
Oral GLP-1s Create a New Competitive Battleground
The emergence of oral GLP-1 treatments is adding another dimension to the competition between the companies.
Novo launched its Wegovy pill earlier this year, giving the company an oral version of its established semaglutide obesity franchise. Lilly has launched Foundayo, creating a direct competitive alternative in the growing oral obesity market.
The companies are now competing not only on weight reduction but also on factors such as dosing, convenience, blood-sugar control and the evidence supporting broader cardiometabolic benefits.
Prescription data cited by Fierce Pharma show that both oral products have continued to gain traction, although their commercial trajectories remain substantially different in scale.
Lilly Brings Retatrutide Into the Spotlight
Lilly’s EASD program extends beyond Foundayo and currently marketed tirzepatide products.
The company is presenting Phase 3 results for retatrutide, an investigational once-weekly medicine that activates GIP, GLP-1 and glucagon receptors.
In the TRIUMPH-2 study, adults with obesity or overweight and type 2 diabetes experienced average weight loss of up to 20.8%, or 22.5 kilograms, after 80 weeks, while A1C fell by as much as 1.6 percentage points depending on the dose.
Retatrutide represents a potential next step in Lilly’s obesity pipeline, adding a third hormonal pathway to the GIP and GLP-1 activity already used by tirzepatide.
Novo Advances Its Next-Generation Pipeline
Novo is also using the Milan meeting to showcase medicines beyond semaglutide.
The company’s EASD program includes data on CagriSema, its combination of semaglutide and the investigational amylin analogue cagrilintide, as well as early data involving the next-generation amylin candidate zenagamtide.
Novo said its presentations cover appetite regulation, eating behavior, body composition, liver fat and other aspects of cardiometabolic disease. The company has scheduled 44 abstracts spanning semaglutide, CagriSema and zenagamtide.
The broader pipeline reflects an industry shift toward combinations and multiple biological pathways as companies seek additional ways to improve weight loss and metabolic outcomes.
Mounjaro Data Add Another Dimension
Lilly is also presenting additional evidence on Mounjaro, its tirzepatide product for type 2 diabetes.
Data from the SURPASS-CVOT program compare tirzepatide with dulaglutide in adults with type 2 diabetes and established cardiovascular disease. Lilly reported that tirzepatide demonstrated non-inferiority on the study’s primary cardiovascular endpoint and produced greater reductions in A1C and body weight.
The findings give Lilly another opportunity to emphasize the broader clinical profile of tirzepatide as the company competes against semaglutide-based therapies.
Competition Is Expanding Beyond Current Products
The EASD presentations show that the competition between Novo and Lilly is increasingly moving beyond Ozempic, Wegovy, Mounjaro and Zepbound.
Both companies are developing oral treatments and next-generation medicines intended to improve efficacy or address additional aspects of metabolic disease.
Lilly’s retatrutide combines three hormonal pathways, while Novo is advancing CagriSema and amylin-based therapies. The companies are also collecting evidence on cardiovascular, kidney and liver outcomes that could influence how these medicines are positioned in clinical practice.
EASD Provides a Snapshot of the Next Phase of the GLP-1 Market
The 62nd EASD annual meeting is taking place in Milan from Sept. 28 through Oct. 2, bringing together new clinical and real-world evidence across diabetes and obesity therapies.
The competing Novo and Lilly presentations demonstrate how the GLP-1 market is evolving from a contest between two established injectable franchises into a broader competition involving oral medicines, multiple mechanisms and evidence for outcomes beyond blood-sugar control and weight loss.
For Novo and Lilly, the data presented in Milan provide additional evidence for their respective products while also setting the stage for the next generation of treatments now moving through development.
Novo and Lilly presented new GLP-1 research at the 62nd Annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan, held from September 28 to October 2, 2026. The meeting featured data covering type 2 diabetes, obesity, cardiovascular outcomes and newer oral and injectable treatments.
Novo and Lilly used the meeting to share different datasets covering their respective cardiometabolic portfolios. Novo presented findings involving semaglutide, CagriSema and zenagamtide, while Lilly highlighted Foundayo (orforglipron), retatrutide and eloraTZP.
Novo and Lilly Focus on Oral GLP-1 Treatments
A major area of interest for Novo and Lilly is the development of oral GLP-1 medicines. Lilly presented data for Foundayo, its oral GLP-1 treatment, including results from the Phase 3 ACHIEVE-4 study in adults with type 2 diabetes and overweight or obesity at increased cardiovascular risk. The company reported sustained A1C and weight improvements alongside cardiovascular safety results.
Novo and Lilly Focus on Oral GLP-1 Treatments
A major area of interest for Novo and Lilly is the development of oral GLP-1 medicines. Lilly presented data for Foundayo, its oral GLP-1 treatment, including results from the Phase 3 ACHIEVE-4 study in adults with type 2 diabetes and overweight or obesity at increased cardiovascular risk. The company reported sustained A1C and weight improvements alongside cardiovascular safety results.
Novo also presented new information on its oral semaglutide program. The company’s EASD materials included real-world evidence involving its semaglutide portfolio and additional research examining cardiometabolic outcomes.
Novo and Lilly Present Cardiovascular Data
Cardiovascular outcomes were another important part of the Novo and Lilly presentations. Novo shared real-world evidence comparing adults with type 2 diabetes who increased semaglutide to 2.0 mg with those who switched to tirzepatide. The analysis was presented at EASD 2026.
Lilly’s ACHIEVE-4 results examined Foundayo against insulin glargine and reported non-inferiority for major adverse cardiovascular events, along with improvements in A1C and body weight. These findings were announced alongside the EASD meeting.
Novo and Lilly Continue GLP-1 Competition
The latest data demonstrate how Novo and Lilly are expanding research beyond established injectable medicines. Both companies are developing additional approaches intended to address diabetes, obesity and broader cardiometabolic health.
Importantly, some comparisons presented around the meeting were based on separate studies rather than direct head-to-head trials. For example, Lilly’s comparison of Foundayo with Novo’s oral semaglutide relied on data from different studies, so the results should not be interpreted as equivalent to a randomized head-to-head comparison.
