For many people considering a GLP-1 medication, a daily pill may sound more appealing than an injection. Researchers are now studying whether a new oral medication could eventually provide another convenient option for people with type 2 diabetes or obesity.
Elecoglipron, an experimental once-daily GLP-1 pill, lowered blood sugar and body weight in two randomized clinical trials. The studies were sponsored by AstraZeneca, the pharmaceutical company developing the drug, and published in The Lancet. Elecoglipron is not approved by the Food and Drug Administration. It’s moving into larger phase 3 trials, which will provide more information about its longer-term effectiveness and safety.
The medication belongs to a growing group of small-molecule GLP-1 receptor agonists. Unlike many existing GLP-1 medications, these drugs are designed to be taken as tablets rather than injected. Elecoglipron can also be taken without restrictions involving food or fluids, which could make it easier for some people to fit into their daily routines.
In the SOLSTICE trial, researchers studied elecoglipron in adults with type 2 diabetes across nine countries, including the United States. Participants were randomly assigned to receive a placebo, oral semaglutide or one of several elecoglipron doses and dose-escalation schedules. The oral semaglutide group was included as an exploratory comparison. The study was not designed to determine whether elecoglipron works better than existing GLP-1 medications.
After 26 weeks, people receiving the highest dose of elecoglipron experienced an average 1.9 percentage-point reduction in HbA1c, compared with a 0.2-point reduction among those receiving a placebo. HbA1c is a measure of average blood sugar over the previous two to three months.
At that dose, 90% of participants reached an HbA1c level below 7%, a common treatment target for many adults with diabetes. Participants also lost an average of 7.7% of their body weight, compared with 1.7% in the placebo group.
“Our study’s findings underscore the expanding potential of oral GLP-1 receptor agonists for people with type 2 diabetes,” said study author Vanita Aroda, M.D., director of diabetes clinical research in the Division of Endocrinology, Diabetes & Hypertension at Mass General Brigham.
A separate trial, known as VISTA, examined elecoglipron in 310 adults with obesity or overweight and at least one weight-related health condition. Participants did not have diabetes. All received standardized guidance on diet and physical activity in addition to the medication or placebo.
At the highest dose, participants lost an average of 10.5% of their body weight after 26 weeks, compared with 0.6% among those receiving a placebo. Average weight loss reached 11.8% after 36 weeks, compared with 0.3% in the placebo group.
Researchers did not observe a clear weight-loss plateau by the end of the trial. That may be encouraging, but it also means longer studies are needed to determine how much additional weight loss might occur, whether the results last over time and how the medication compares with other available treatments.
Elecoglipron is not the first oral GLP-1 medication. Oral semaglutide is already available for type 2 diabetes, although it must be taken on an empty stomach with restrictions on food and water for 30 minutes afterward. The FDA also approved Foundayo, the brand name for orforglipron, in April 2026 for adults with obesity or adults with overweight and at least one related health condition. Like elecoglipron, Foundayo is a once-daily small-molecule GLP-1 pill that does not need to be taken on an empty stomach.
That context matters. Elecoglipron is not introducing an entirely new category of treatment. Its potential significance is that it could eventually add another option in a rapidly evolving field, increasing the range of medications available to patients and clinicians.
A pill does not eliminate the trade-offs associated with GLP-1 medications. The most common side effects in the elecoglipron trials involved the digestive system. Among participants receiving the highest dose in the diabetes trial, 37% experienced nausea, 29% experienced constipation, 21% experienced diarrhea and 18% experienced vomiting. In the obesity trial, 55% experienced nausea, 41% experienced constipation, 35% experienced diarrhea and 29% experienced vomiting.
The side effects were generally mild to moderate, according to AstraZeneca, and relatively few participants stopped treatment because of them. Researchers did not observe liver safety signals. Low blood sugar was uncommon in the diabetes trial.
Those findings are reassuring for this stage of development, but phase 2 trials are smaller and shorter than the studies required to determine whether a medication should become widely available. AstraZeneca plans to study elecoglipron in larger phase 3 trials involving people with obesity, overweight and type 2 diabetes. Additional studies will examine longer-term cardiovascular and kidney outcomes.
The early results suggest that oral GLP-1 medications could become an increasingly important part of diabetes and obesity care. For patients, the most meaningful development may not be a single pill. It may be the growing possibility of choosing among several treatments with different benefits, side effects and dosing routines.
AstraZeneca sponsored the SOLSTICE and VISTA trials and is developing elecoglipron. Aroda disclosed institutional contracts with AstraZeneca and several other pharmaceutical companies, as well as consulting fees from multiple organizations.