EloraTZP Shows Greater Weight Loss, A1C Reduction Than Tirzepatide

Phase 2b results announced by Eli Lilly show the investigational eloralintide-tirzepatide combination (EloraTZP) demonstrated greater weight loss and reduction in A1C when compared with tirzepatide alone, according to a release.¹ In the trial, all 367 adult participants with obesity or overweight and type 2 diabetes (T2D) met their primary and secondary endpoints.

“Obesity and T2D are interconnected, and we are seeing the potential benefit of targeting multiple hormonal pathways to address both,” said Liana K. Billings, MD, director of clinical and genetics research in diabetes and cardiometabolic disease at Endeavor Health, and lead trial author, according to the release. “Across the dose combinations studied with eloralintide and tirzepatide, participants had substantial weight loss alongside meaningful reductions in A1C.”

At 48 weeks, participants receiving the highest dose combination of 9 mg eloralintide and 15 mg tirzepatide achieved an average weight loss of 23.3%, or 54.1 pounds, compared with 14.8%, or 34.4 pounds, for tirzepatide 15 mg alone. In addition, A1C reductions reached up to 2.9% in the combination group versus 2.4% with tirzepatide monotherapy.¹

READ MORE: Integrated Care and the Keys to Successful GLP-1 Therapy

Gastrointestinal adverse events were the most frequent side effects, occurring more often in the combination arms and leading to treatment discontinuation rates between 10.8% and 27%.

Lilly plans to advance a co-formulated version of EloraTZP into phase 3 clinical trials by late 2026 using an optimized dose escalation regimen.¹

“I find EloraTZP’s phase 2b trial results encouraging because they suggest that adding eloralintide, an amylin receptor agonist, to tirzepatide could offer additional weight and glycemic benefits for patients with obesity and type 2 diabetes,” Hailey Choi, PharmD, BCACP, CDCES, associate professor of pharmacy practice at the Massachusetts College of Pharmacy and Health Sciences, told Drug Topics®. “If eventually approved, EloraTZP could provide another treatment option while reinforcing pharmacists’ role in appropriate patient selection, dose titration, gastrointestinal adverse effect management, and reassessing insulin or sulfonylurea doses as glycemic control improves.”

Multi-Hormone Synergy and the Next Frontier in Metabolic Care

EloraTZP represents an emerging class of multi-target therapies designed to engage several distinct physiological pathways simultaneously, specifically pairing incretin receptors with selective amylin receptor agonism. Amylin is a hormone co-secreted with insulin that slows gastric emptying, promotes central satiety, and regulates postprandial glucose metabolism.^1-3

Although traditional glucagon-like peptide-1 (GLP-1) receptor agonists primarily suppress appetite and delay gastric emptying through single-target signaling, combining GLP-1 with glucose-dependent insulinotropic polypeptide (GIP) and amylin offers synergistic metabolic benefits. Endocrinology experts emphasize that the therapeutic focus in obesity management is expanding beyond raw weight loss and toward enhanced tolerability, preservation of lean muscle mass, and better cardiometabolic risk reduction.^2,3

Researchers are actively exploring various multi-hormone configurations, including dual and triple receptor agonists, to establish a broader family of targeted options tailored to unique patient biology.

Integrating Advanced Therapies into Pharmacies’ Clinical Workflows

For community and health-system pharmacists, the rapid evolution of multi-hormone therapeutics transforms daily dispensing into an expanded clinical opportunity. Clinical pharmacy leaders highlight that GLP-1 and combination care should serve as an entry point to connect patients with comprehensive clinical services such as medication synchronization, continuous glucose monitoring support, and side effect management.^4,5

Practical frameworks like the IMPACT protocol encourage pharmacy teams to proactively identify eligible patients, provide structured counseling during dose titration, check in at regular intervals to resolve gastrointestinal discomfort, and track clinical outcomes like A1C and weight changes.⁴

Structured patient communication and detailed documentation in pharmacy management software are essential to demonstrate clinical value to prescribers and payers while keeping patients persistent on therapy.^4,5

“From my perspective as an ambulatory care pharmacist, helping patients navigate affordability, maintain adequate nutrition, and minimize drug adverse events would be essential to translating these promising results into sustained benefits,” continued Choi.

Navigating Shortages, Insurance Hurdles, and Compounded Drug Risks

As patient demand for advanced metabolic therapies continues to surge, pharmacists frequently navigate inventory shortages, prior authorization hurdles, and insurance coverage restrictions. These supply disruptions have driven many consumers toward unapproved compounded versions and unregulated online platforms, raising severe public health concerns regarding product purity, sterility, and nonstandard salt formulations.^5,6

Regulatory authorities and pharmacy associations strongly warn against using non-FDA–approved compounded incretin products, citing risks of dosing errors, variable biodistribution, and adverse reactions.⁶

For the therapies that have been approved, however, pharmacists play a pivotal role in educating patients on the safety hazards of unverified compounded drugs, helping them navigate manufacturer savings assistance programs, and collaborating with prescribers on appropriate therapeutic regimens.^4,6

“These are outcomes that matter to patients,” concluded Billings, according to the release.¹ “We need to continue building on these findings so that, in the future, we can offer patients more treatment options that address both weight and glucose and better reflect the complexity of living with T2D and obesity.”

READ MORE: Diabetes Resource Center

REFERENCES

1. Lilly's EloraTZP (combination of eloralintide and tirzepatide) delivered greater weight loss and A1C reduction vs. tirzepatide 15 mg in adults with obesity and type 2 diabetes. Eli Lilly and Company. News Release. September 30, 2026. Accessed October 22, 2026. https://www.prnewswire.com/news-releases/lillys-eloratzp-combination-of-eloralintide-and-tirzepatide-delivered-greater-weight-loss-and-a1c-reduction-vs-tirzepatide-15-mg-in-adults-with-obesity-and-type-2-diabetes-302894480.html?utm_source=chatgpt.com

2. MacMillan C. Beyond GLP-1s: combination therapy, new hormones reshape obesity treatment. Yale Medicine. August 19, 2026. Accessed October 22, 2026. https://www.yalemedicine.org/news/beyond-glp-1s-combination-therapy-new-hormones-reshape-obesity-treatment

3. Wang X, Lin R, Sun Q, et al. GLP-1-based combination strategies for weight loss: multi-target agents and combination therapies. Pharmacol Res. 2026;230:108331. doi:10.1016/j.phrs.2026.108331

4. Nowosielski B, Pezzino N. FAQ: scaling pharmacy services through GLP-1 care | NCPA 2026. Drug Topics. October 17, 2026. Accessed October 22, 2026. https://www.drugtopics.com/view/scaling-pharmacy-services-through-glp-1-care-ncpa-2026

5. Weight loss medications (GLP-1s): what pharmacies need to know. PioneerRx. September 15, 2026. Accessed October 22, 2026. https://www.pioneerrx.com/blog/weight-loss-medications-glp-1s-what-pharmacies-need-to-know

6. Sood N, Garg R. Global rise of compounded weight-loss medicines: a worrisome trend. J Endocr Soc. 2025;9(8):bvaf084. 2025 Jun 7. doi:10.1210/jendso/bvaf084