Key Takeaways
- Petrelintide demonstrated 10.7% body weight reduction at the 42-week mark in Phase 2 testing — falling short of the 12–15% analyst projections
- Investment firms such as JPMorgan, Jefferies, UBS, and Barclays characterized the findings as underwhelming
- Cantor Fitzgerald revised its stance on the stock from Overweight to Neutral
- Competing treatments from Eli Lilly (eloralintide) and Novo Nordisk (cagrilintide) appear better positioned in the obesity drug market
- Absence of dose-dependent response among highest dosage cohorts casts doubt on Phase 3 improvement potential
Shares of Zealand Pharma (ZEAL) plummeted over 32% on Friday following the release of Phase 2 clinical trial results for petrelintide, its experimental obesity medication, which underperformed Wall Street projections.
The ZUPREME-1 study, conducted alongside Roche, evaluated petrelintide’s effectiveness in overweight and obese adults without type 2 diabetes. Participants receiving the maximum dosage achieved an average weight reduction of 10.7% by week 42 using an efficacy estimand measurement.
While the study successfully reached its primary objective—demonstrating statistically significant weight decreases at the 28-week mark across all dosage levels compared to placebo—the top-line figure disappointed market participants.
Financial analysts had anticipated weight loss results in the 12% to 15% range to establish meaningful market competitiveness. The 10.7% outcome fell considerably below these benchmarks.
JPMorgan analyst Sophia Graeff Buhl Nielsen characterized the outcome as “falls slightly short of expectations,” though she noted the findings “leaves scope for an attractive mid-teens weight loss profile to be achieved in Phase 3,” particularly if future trials include more female participants, who demonstrated superior responses.
Jefferies highlighted that the results would likely trigger disappointment, noting they missed both the firm’s internal projection of 13% to 15% and buy-side expectations exceeding 15%. Analyst Lucy Codrington compared petrelintide to having “Wegovy-like efficacy, but with placebo-like tolerability,” characterizing it as a “viable” option that’s likely “2nd-best to LLY’s elora for now.”
The drug demonstrated notable strength in its safety profile. The highest-dose cohort reported zero vomiting incidents and minimal gastrointestinal adverse events—what Codrington described as “placebo-like” tolerability. While genuinely positive, this advantage alone proved insufficient to offset efficacy concerns.
Cantor Fitzgerald Shifts to Neutral Stance
Cantor Fitzgerald downgraded Zealand Pharma from Overweight to Neutral, citing insufficient differentiation from competitors. The investment firm noted petrelintide’s placebo-adjusted weight reduction of approximately 9% at 42 weeks resembles Novo Nordisk’s cagrilintide results—and trails significantly behind Eli Lilly’s eloralintide.
Cantor expressed concern regarding the absence of dose-dependent response patterns, suggesting limited evidence that weight loss outcomes will strengthen in later-stage trials. The firm now projects petrelintide will achieve weight reduction in the low-teen percentages, comparable to cagrilintide.
With Eli Lilly already advancing eloralintide through Phase 3 trials and Novo Nordisk progressing cagrilintide monotherapy into Phase 3, Cantor suggested petrelintide faces potential market entry as a third-place competitor with minimal differentiation. This positioning presents significant commercial challenges.
Future Outlook and Considerations
UBS observed the trial results arrived “clearly at the lower end of expectations” and questioned petrelintide’s viability as a standalone treatment. Nevertheless, the bank identified a combination strategy—pairing petrelintide with reduced doses of Roche’s CT-388—as a “still viable option,” leveraging the drug’s favorable tolerability characteristics.
Additionally, minimal differentiation emerged among the highest dosage groups, with weight loss outcomes ranging from 10.2% to 10.7%. JPMorgan suggested this pattern may indicate limited additional benefits from escalating doses.
Comprehensive trial data is scheduled for presentation at a scientific conference in 2026.
The stock traded at $38.22 at the most recent check, representing approximately 51% below its 52-week peak of $112.63.
