Key Highlights
- Petrelintide’s Phase 2 study results revealed 10.7% weight reduction at 42 weeks — falling short of the 12–15% analyst projections
- Several major investment banks including JPMorgan, Jefferies, UBS, and Barclays characterized the findings as underwhelming
- Cantor Fitzgerald revised its rating to Neutral from Overweight following the data release
- Competing candidates eloralintide from Eli Lilly and cagrilintide from Novo Nordisk demonstrate superior performance profiles
- Absence of dose-response pattern among highest dose cohorts creates uncertainty about Phase 3 improvement potential
Zealand Pharma (ZEAL) experienced a sharp decline exceeding 32% on Friday following the release of Phase 2 clinical trial results for petrelintide, its obesity treatment candidate, which underperformed Wall Street projections.
The ZUPREME-1 study, conducted alongside partner Roche, evaluated petrelintide in participants classified as overweight or obese who did not have type 2 diabetes. The maximum dosage group achieved an average body weight reduction of 10.7% at the 42-week mark using an efficacy estimand analysis.
The study successfully achieved its primary endpoint, demonstrating statistically significant weight reductions at 28 weeks across every dose cohort compared to placebo. However, the topline efficacy figure failed to satisfy market participants.
Financial analysts had projected weight loss ranging from approximately 12% to 15% as necessary to demonstrate competitive viability. The observed 10.7% outcome fell considerably below that threshold.
JPMorgan analyst Sophia Graeff Buhl Nielsen characterized the outcome as “falls slightly short of expectations,” while noting the data still “leaves scope for an attractive mid-teens weight loss profile to be achieved in Phase 3,” particularly with increased enrollment of female participants — who demonstrated superior response rates.
Jefferies identified the result as likely to cause disappointment, noting it underperformed both its internal projection of 13% to 15% and buy-side expectations exceeding 15%. Analyst Lucy Codrington described petrelintide as having “Wegovy-like efficacy, but with placebo-like tolerability,” characterizing it as “viable” while probably “2nd-best to LLY’s elora for now.”
The drug demonstrated strong performance in the tolerability domain. The highest-dose cohort reported zero vomiting incidents and minimal gastrointestinal adverse effects — a profile Codrington termed “placebo-like.” This represents a meaningful advantage, though it proved insufficient to offset efficacy concerns.
Cantor Fitzgerald Revises Rating to Neutral
Cantor Fitzgerald lowered its assessment of Zealand Pharma to Neutral from Overweight, citing insufficient differentiation from competitors. The firm noted petrelintide’s placebo-adjusted weight reduction of approximately 9% at 42 weeks aligns with Novo Nordisk’s cagrilintide — while trailing meaningfully behind Eli Lilly’s eloralintide.
Cantor highlighted the absence of a dose response as problematic, indicating no clear evidence supports improved weight loss outcomes in subsequent development phases. The firm now projects petrelintide will achieve weight loss in the low teens, comparable to cagrilintide.
With Eli Lilly already advancing eloralintide through Phase 3 and Novo Nordisk progressing cagrilintide monotherapy into Phase 3, Cantor suggested petrelintide faces a potential third-to-market scenario with minimal competitive advantages. This positioning presents significant commercial challenges.
Future Considerations
UBS observed the trial results arrived “clearly at the lower end of expectations” and questioned petrelintide’s prospects as a standalone treatment. The bank identified a combination strategy — pairing petrelintide with a reduced dose of Roche’s CT-388 — as a “still viable option,” given the drug’s favorable tolerability characteristics.
Minimal differentiation emerged between the highest dose cohorts, with weight loss measurements spanning 10.2% to 10.7%. JPMorgan suggested this pattern may indicate limited additional benefit from dose escalation.
Comprehensive trial findings are scheduled for presentation at a scientific conference during 2026.
Shares traded at $38.22 at the most recent check, representing approximately 51% below the 52-week peak of $112.63.
