Novo Nordisk presented data from OASIS 4 at the European Congress on Obesity Day 2 today — the trial that supports the Wegovy pill (oral semaglutide 25 mg) — with two sub-analyses that complete Novo’s “early responder” narrative across both injectable and oral formulations. The headline finding: roughly one in three patients (28.8%) on oral semaglutide 25 mg qualifies as an early responder, and that cohort achieves 21.6% mean weight loss by Week 64.

Combined with yesterday’s STEP UP early-responder data for injectable Wegovy 7.2 mg (27% qualify, 27.7% achieved at Week 72), Novo now has consistent early-responder data across both Wegovy formulations. The oral 21.6% in early responders narrows the efficacy gap between pill and injection meaningfully — and reinforces the case for Wegovy pill as a viable first-line oral GLP-1.

The Early Responder Data

Novo defined an early responder on Wegovy pill as a patient achieving ≥10% weight loss by Week 16, approximately four months of treatment. The proportions qualifying and outcomes:

• Proportion qualifying as early responders: 28.8% of oral semaglutide 25 mg patients.
• Week 16 weight loss in early responders: −13.2% (the data point that defined them).
• Week 64 weight loss in early responders: −21.6% mean weight loss.

The 21.6% Week 64 outcome is the most striking number. Injectable semaglutide 2.4 mg produces approximately 15–17% mean weight loss in the broader trial population. The oral early-responder subgroup reaching 21.6% means that roughly a quarter of patients on Wegovy pill are achieving weight loss superior to the typical injectable mean.

This narrows the strategic gap between oral and injectable in a clinically meaningful way. For the patient who responds well to oral semaglutide, the pill format does not require a meaningful efficacy trade-off versus the injectable.

The Physical Function Sub-Analysis

A separate OASIS 4 sub-analysis examined physical function outcomes specifically in patients with poor baseline mobility. The cohort included patients who at baseline reported limitations in clinical mobility measures — difficulty with bending, standing for extended periods, staying active, and similar physical-function tasks.

Headline result: 77.3% of poor-baseline-mobility patients on oral semaglutide 25 mg achieved clinically meaningful improvements in physical function over the trial duration. The comparable placebo rate: 42.9%. The oral semaglutide arm produced nearly double the rate of clinically meaningful mobility improvement.

This quality-of-life dimension matters for the broader patient case. Weight loss is the primary trial outcome, but the lived impact of obesity therapy is mediated through physical function: whether a patient can return to activities they had stopped because of weight-related mobility limitations. The OASIS 4 physical function data quantifies that dimension.

Professor W. Timothy Garvey (University of Alabama at Birmingham), commenting on the data, highlighted the clinical utility of early-response signals: they let clinicians and patients calibrate dose escalation, set realistic outcome expectations, and identify candidates for alternative therapies if response is suboptimal.

What This Means for the Oral GLP-1 Race

After two days of ECO presentations, the oral GLP-1 competitive landscape is clearer:

Wegovy pill (oral semaglutide 25 mg) continues to dominate the launch curve commercially (1.3 million Q1 prescriptions per Novo’s May 6 earnings) and now demonstrates strong efficacy with 28.8% early-responder rate and 21.6% Week 64 outcome in that subgroup. The pill format does not require maximum efficacy trade-off versus the injectable.

Foundayo (orforglipron) has different positioning. Yesterday’s ATTAIN-MAINTAIN data shows 78–82% maintenance of injectable weight loss after switching to oral orforglipron — a different addressable market. Foundayo is positioned for post-injectable maintenance; Wegovy pill is positioned for de novo oral obesity therapy.

Viking’s VK2735 oral showed Phase 2 data of 12.2% weight loss at 13 weeks, with Phase 3 starting Q4 2026. The compound is the longest-horizon entrant — by the time VK2735 reaches market, the segmentation between Wegovy pill (de novo) and Foundayo (maintenance) will be more entrenched.

The class is segmenting. Wegovy pill is establishing first-line oral. Foundayo is establishing maintenance after injectables. The two products do not compete head-to-head for the same patient — they compete for different therapeutic moments.

What the Trial Doesn’t Tell Us

Three honest scope notes.

The early-responder framing is post-hoc. The trial design defined the early-response threshold (≥10% by Week 16) and then characterized that subgroup’s outcomes. This is appropriate clinical-utility analysis but not equivalent to a prospectively randomized comparison of early responders versus non-responders.

The 28.8% early-responder rate is a population characteristic, not a patient prediction. An individual patient cannot know in advance whether they will be among the 28.8% who qualify. The clinical utility is identification at Week 16, not preselection.

The Week 64 outcome is sub-analysis data, not the primary trial endpoint. The primary OASIS 4 outcomes were the overall efficacy and safety of oral semaglutide 25 mg in the broader trial population, not the early-responder subgroup specifically.

What’s Next

Wegovy pill enters the Medicare GLP-1 Bridge on July 1, 2026 at $50 monthly copay alongside injectable Wegovy and Foundayo. The Bridge program covers all three formulations equally, which means the 65+ patient population about to gain access can choose among injectable, oral, and oral-small-molecule options at the same out-of-pocket cost. The OASIS 4 efficacy data, combined with the elderly subgroup data published May 11, supports the case for Wegovy pill in older adults under the Bridge program.

ECO Days 3 and 4 (May 14–15) continue. Tomorrow’s notable data includes Ascletis ASC47 + semaglutide combination poster (reportedly showing 111.8% greater weight loss and 90% lower vomiting in adjunct therapy) and Viking VENTURE-Oral networking session.

References

1. Wegovy Pill Delivered 21.6% Weight Loss in Early Responders and Doubled Mobility Improvement at ECO2026. Yahoo Finance UK. May 13, 2026. Yahoo Finance UK
2. Novo Nordisk: Wegovy Pill Early Responder + Mobility Data at ECO2026. Finanznachrichten. May 13, 2026. Finanznachrichten