Patients with obesity who received maridebart cafraglutide (MariTide; Amgen), a once-monthly obesity medication, demonstrated weight loss of up to 19.9% in a phase 2 trial (NCT05669599).1 Those with obesity and type 2 diabetes showed weight loss of up to 17%.
Maridebart cafraglutide is a long-acting peptide–antibody conjugate that combines glucagon-like peptide-1 (GLP-1) receptor agonism and glucose-dependent insulinotropic polypeptide (GIP) receptor antagonism. The 2 identical GLP-1 peptide analogs conjugated to a single monoclonal antibody antagonist to the GIP receptor result in a 21-day half-life, 3 times longer than the FDA approved longest-acting once-weekly anti-obesity medication, semaglutide. The extended half-life can potentially lead to increased access and adherence for those whose health and access to health care are disproportionately affected by socioeconomic status.2
The mean percent change in body weight from the obesity cohort from baseline to 52 weeks ranged from −12.3% to −16.2% to −16.2%. | Image Credit: ricka_kinamoto – stock.adobe.com
“[Maridebart cafraglutide]’s monthly or less frequent dosing has the potential to improve adherence and long-term weight control, providing the opportunity to optimize health outcomes for people living with obesity, type 2 diabetes, and related conditions,” Jay Bradner, MD, executive vice president of Research and Development at Amgen, said in a press release.3 “[Maridebart cafraglutide] delivered strong efficacy, including sustained weight loss without a plateau in the 52-week phase 2 study and meaningful improvements in cardiometabolic risk factors, representing a defining advance for the obesity field.”
Phase 2 of the trial tested the efficacy, adverse event profile, and safety of maridebart cafraglutide at various doses with and without escalation.1 The study enrolled 592 participants—465 in the obesity cohort and 127 in the obesity-diabetes cohort. The obesity cohort was randomly assigned in a 3:3:3:2:2:2:3 ratio to receive either 52 weeks of maridebart cafraglutide subcutaneously at 140, 280, or 420 mg every 4 weeks without dose escalation; 420 mg every 8 weeks without dose escalation; 420 mg every 4 weeks with either a 4- or 12-week dose escalation; or a placebo. Participants in the obesity-diabetes cohort were randomly assigned in a 1:1:1:1 ratio to receive maridebart cafraglutide over 52 weeks at a dosage of 140, 280, or 420 mg every 4 weeks or a placebo.
The mean percent change in body weight from the obesity cohort from baseline to 52 weeks ranged from −12.3% to −16.2% (95% CI, −15.0 to −9.7) to −16.2% (95% CI, −18.9 to −13.5). The obesity-diabetes cohort mean percent change in body weight ranged from −8.46% (95% CI, −11.0 to −5.7) to −12.3% (95% CI, −15.3 to −9.2).
Those in both cohorts who received maridebart cafraglutide also showed a significant difference in the percentage points of glycated hemoglobin (HbA1c) levels when analyzed using the treatment policy estimand. The obesity cohort had a mean difference of –0.32 (95% CI, –0.5 to –0.2) percentage points measuring glycated hemoglobin levels. Similarly, the obesity-diabetes cohort showed a mean difference of –1.43 (95% CI, –1.9 to –0.7) percentage points in glycated hemoglobin. When analyzed using the efficacy demand, the obesity cohort did not show a significant difference in weight loss; however, the obesity-diabetes cohort did, with –2.03 (95% CI, –2.4 to –1.6) percentage points.
Participants in both cohorts experienced improvement in additional secondary end points, including differences in systolic and diastolic blood pressure, high-sensitivity C-reactive protein (hs-CRP), and select lipid variables. Furthermore, those receiving a dose escalation over 4 or 12 weeks did not show significant differences in primary or secondary end points when compared with those that did not receive dose escalation.
Adverse events occurred in an average of 93.5% of participants across both cohorts. The most common adverse events (AEs) were gastrointestinal, which included mild to moderate nausea, vomiting, constipation, retching, and diarrhea. There was a lower incidence of adverse events in the groups with dose escalation and those starting at a lower dose across both cohorts.
Of the 592 participants in the obesity cohort, 8% in the dose escalation group discontinued the trial due to GI AEs, as opposed to the 12% to 17% in the no–dose escalation groups. Similarly, 6% to 16% of participants in the obesity-diabetes cohort discontinued due to GI-related adverse events. Other predefined adverse events varied in severity, ranging from mild to moderate, and included injection-site rash, reactions, and/or urticaria.
“These results, alongside the phase 1 pharmacokinetics low-dose initiation data, have shaped our phase 3 MARITIME program,” Bradner said.3
References
- Jastreboff AM, Ryan DH, Bays HE, et al. Once-monthly maridebartcafraglutide for the treatment of obesity — a phase 2 trial. New England Journal of Medicine. Published online June 23, 2025. doi:10.1056/nejmoa2504214
- Eberly LA, Yang L, Essien UR, et al. Racial, ethnic, and socioeconomic inequities in glucagon-like peptide-1 receptor agonist use among patients with diabetes in the US. JAMA Health Forum. 2021;2(12): e214182. doi:10.1001/jamahealthforum.2021.4182
- Results from Amgen’s phase 2 obesity study of monthly maritide presented at the American Diabetes Association 85th Scientific Sessions. Amgen. June 23, 2025. Accessed June 25, 2025. https://www.amgen.com/newsroom/press-releases/2025/06/results-from-amgens-phase-2-obesity-study-of-monthly-maritide-presented-at-the-american-diabetes-association-85th-scientific-sessions