MariTide, the First Monthly or Less Frequently Dosed Obesity Treatment, Demonstrated Up to ~20% Average Weight Loss Without a Weight Loss Plateau, and Delivered Significant Cardiometabolic Improvements at 52 Weeks
In People Living With Obesity With Type 2 Diabetes, MariTide Demonstrated Up to ~17% Average Weight Loss and Robust HbA1c Improvements
Dose Escalation With Lower Starting Doses Substantially Improved Gastrointestinal Tolerability, Without Compromising Efficacy
The MARITIME Phase 3 Chronic Weight Management Studies are Actively Enrolling, and Phase 3 Studies in People Living With Atherosclerotic Cardiovascular Disease, Heart Failure and Obstructive Sleep Apnea Will be Initiated in 2025
In the Phase 2 study, MariTide demonstrated up to ~20% average weight loss in people living with obesity without Type 2 diabetes (T2D) compared with 2.6% in the placebo arm, and up to ~17% average weight loss in people living with obesity with T2D, compared with 1.4% in the placebo arm, per the efficacy estimand.1 Weight loss had not plateaued by 52 weeks, indicating the potential for further weight reduction. In addition to meaningful weight loss, MariTide demonstrated a robust and sustained reduction in hemoglobin A1c (HbA1c) of up to 2.2%1 in people living with obesity and T2D. Weight loss with MariTide was also accompanied by improvements across pre-specified cardiometabolic measures, including waist circumference, blood pressure, high-sensitivity C-reactive protein (hs-CRP) and select lipid parameters.
"MariTide delivered strong efficacy, including sustained weight loss without a plateau in the 52-week Phase 2 study and meaningful improvements in cardiometabolic risk factors, representing a defining advance for the obesity field," said
No new safety signals were identified in the Phase 2 study and tolerability was consistent with the GLP-1 class. The most frequently reported adverse events (AEs) were gastrointestinal (GI) related, and most were mild to moderate. The study employed a rigorous daily patient reporting tool known as the MINVR (modified index of nausea/vomiting/retching) to actively solicit the presence of select GI symptoms in addition to standard unsolicited AE reporting. Gastrointestinal events were predominantly limited to initial dosing and less frequent when dose escalation was used without compromising efficacy. Discontinuation rates of MariTide due to GI AEs in the dose escalation arms (up to 7.8%) were lower than non-dose escalation arms.
"In this Phase 2 study, participants living with obesity treated with MariTide had substantial weight reduction at 52 weeks without reaching a weight plateau," said
The Phase 1 PK-LDI study assessed PK and also used the MINVR reporting tool to assess different dose escalation schedules of MariTide. The complete primary analysis showed participants that received 21 mg/70 mg/350 mg had an overall incidence of vomiting of 24.4% and participants that received 35 mg/70 mg/350 mg had an overall incidence of vomiting of 22.5%. There were no discontinuations due to GI AEs at any time during the study.
Data from the Phase 2 and Phase 1 PK-LDI MariTide studies informed the Phase 3 MARITIME program. The recently initiated Phase 3, 72-week chronic weight management studies will evaluate the safety, efficacy and tolerability of MariTide in participants living with obesity or overweight with and without Type 2 diabetes. Participants will be randomized to one of three target doses, each with an initial starting dose of 21 mg, followed by 35 mg and then 70 mg, over a further optimized eight-week dose escalation period.
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About the Phase 2 MariTide Study (NCT05669599)
The trial enrolled 592 adults into two Cohorts. Cohort A enrolled participants living with obesity or overweight without Type 2 diabetes and Cohort B enrolled participants living with obesity or overweight with Type 2 diabetes. In Part 1, participants in Cohort A (n=465) were assigned to one of four monthly fixed dose arms (placebo, 140 mg, 280 mg, or 420 mg) or an 8-week, 420 mg dose arm. There were also two dose escalation arms, with a starting dose of 70 mg and a target dose of 420 mg, given over a 4-week or 12-week dose escalation period. Adults in Cohort B (n=127) were assigned to one of four monthly fixed dose arms (placebo, 140 mg, 280 mg, and 420 mg).
In Cohort A, the mean percent change in weight loss from baseline to Week 52 per the treatment policy estimand2 ranged from 12.3% to 16.2% with MariTide, compared to 2.5% with the placebo arm, and per the efficacy estimand1, ranged from 16.3% to 19.9% with MariTide, compared to 2.6% with the placebo arm. In Cohort B, the mean percent change in weight loss per the treatment policy estimand ranged from 8.4% to 12.3% with MariTide, compared to 1.7% with the placebo arm, and per the efficacy estimand, ranged from 12.1% to 17.0% with MariTide, compared to 1.4% with the placebo arm.
At the end of Part 1, participants who met eligibility criteria (at least 15% weight loss at Week 52 and still taking investigational product) had the option to enter Part 2 of the study, which is investigating MariTide beyond 52 weeks. In part 2, participants were pooled, then re-randomized based on their Part 1 doses to receive either placebo or a fixed monthly dose of 70 mg, 140 mg or 420 mg, or 420 mg dose every 12 weeks. Part 2 evaluates further weight loss with continued treatment, durable weight loss after discontinuation of MariTide and weight maintenance through less frequent or lower dosing in participants that met the eligibility criteria.
For more detailed information about the study, visit https://clinicaltrials.gov/study/NCT05669599.
To learn more about MARITIME, a Phase 3 program in obesity and obesity-related conditions, visit www.maritimestudy.com.
About Phase 2 Efficacy Estimand and Treatment Policy Estimand (Intent-to-Treat Analysis)
The efficacy estimand represents the efficacy as if treated participants had adhered to MariTide for the entire 52-week study period. The efficacy estimand includes endpoint data so long as study drug is taken. Where endpoint data is missing with early discontinuation, the endpoint results for the patient are estimated using individual patient response and predicted performance after drug discontinuation.
The treatment policy estimand, i.e., intent-to-treat analysis, represents the efficacy of treated participants regardless of adherence to MariTide for the entire 52-week study period and conforms to regulatory guidance for clinical trials. The treatment policy estimand includes all endpoint data, irrespective of whether study drug is taken or not. Where endpoint data is missing with early discontinuation, this approach assumes the endpoint for the study patient approximates that of placebo.
The difference between the results generated by the efficacy estimand and the treatment policy estimand was driven by early discontinuations and a conservatively defined treatment estimand used in the Phase 2 study.
About Phase 1 PK-LDI Study (NCT06976372)
The Phase 1 pharmacokinetics low dose initiation (PK-LDI) study was a Phase 1, randomized, double-blind, multiple-dose, parallel-group study to investigate the PK, safety, and tolerability of multiple dose escalation schemes of MariTide administered subcutaneously (SC) in patients living with obesity or overweight. On Day 1, participants were randomized to receive one of three dosing regimens, either 21 mg, 35 mg, or 70 mg of MariTide SC, followed by a dose of 70 mg on Day 15, followed by a dose of 350 mg on Day 29. The primary endpoints were pharmacokinetics of MariTide including maximum observed concentration (Cmax) and area under the concentration time-curve (AUC). Secondary endpoints included incidence of treatment-emergent adverse events and serious adverse events, and incidence of anti-MariTide antibodies. In addition to standard reporting, GI (AEs) were also ascertained directly from patients with MINVR. The primary analysis included all data for participants through the Day 43 visit. Overall, 121 participants were enrolled and included in the safety population, defined as participants who received at least one dose of MariTide and at least one post-dose safety assessment.
For more detailed information about the study, please visit https://clinicaltrials.gov/study/NCT06976372.
About Obesity
Obesity is a complex biological disease that increases the risk of many other serious diseases and conditions, including Type 2 diabetes, heart failure, kidney disease, sleep apnea, atherosclerotic cardiovascular disease and metabolic dysfunction-associated steatohepatitis. The worldwide prevalence of obesity more than doubled between 1990 and 2022. In the
Obesity is linked to a marked reduction in quality of life and an array of serious medical complications and conditions. Despite the breadth of the disease, the formal recognition of obesity as a chronic disease by the American Medical Association (2013) and the European Health Commission (2021), and medical guidelines recommending pharmacologic treatment in appropriate individuals, only 1%-3% of eligible adults in the
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About MariTide
MariTide is a bispecific glucagon-like peptide 1 (GLP-1) receptor agonist and glucose-dependent insulinotropic polypeptide receptor (GIPR) antagonist being investigated for the treatment of obesity and Type 2 diabetes mellitus. As a pioneering peptide-antibody conjugate molecule with a long half-life and dual mechanism of action, MariTide may allow for greater durability or reduce the likelihood of weight regain after treatment stops.
A primary clinical goal for people living with obesity or overweight is to achieve weight loss, and avoid weight regain thereby improving health. Given the heterogeneity of obesity and the number of people impacted, a variety of approaches will be needed. In addition to MariTide,
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1 The efficacy estimand represents the efficacy as if treated participants had adhered to MariTide for the entire 52-week study period. The efficacy estimand includes endpoint data so long as study drug is taken. Where endpoint data is missing with early discontinuation, the endpoint results for the patient are estimated using individual patient response and predicted performance after drug discontinuation.
2 The treatment policy estimand, i.e., intent-to-treat analysis, represents the efficacy of treated participants regardless of adherence to MariTide for the entire 52-week study period and conforms to regulatory guidance for clinical trials. The treatment policy estimand includes all endpoint data, irrespective of whether study drug is taken or not. Where endpoint data is missing with early discontinuation, this approach assumes the endpoint for the study patient approximates that of placebo.
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