Lilly’s triple agonist retatrutide drives up to 28.7% weight loss and pain relief in Phase 3 TRIUMPH-4

Eli Lilly and Company’s investigational triple hormone receptor agonist retatrutide delivered substantial weight loss and meaningful relief from osteoarthritis pain in the Phase 3 TRIUMPH-4 trial, the company reported today. Retatrutide met all co-primary and key secondary endpoints at 68 weeks, underscoring its potential as a next-generation therapy for obesity with comorbid knee osteoarthritis.

In the global, randomized, double-blind study, adults with obesity or overweight (84% with a baseline BMI ≥35 kg/m²) and knee osteoarthritis received once-weekly retatrutide at 9 mg or 12 mg or placebo, alongside diet and physical activity. At the highest dose, average body weight reduction reached 28.7%, or approximately 71.2 lb, compared with minimal change in the placebo group. At the same time, retatrutide reduced WOMAC pain scores by up to 75.8% and improved physical function, with more than 1 in 8 patients reporting no knee pain at 68 weeks.

Retatrutide’s mechanism activates three hormone receptors — GLP-1, GIP and glucagon — distinguishing it from current dual- or single-agonist approaches and potentially enhancing weight-loss efficacy versus existing treatments.

Secondary analyses showed reductions in cardiovascular risk markers including non-HDL cholesterol, triglycerides and high-sensitivity C-reactive protein (hsCRP), and a systolic blood pressure reduction of about 14 mmHg at the highest dose.

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Adverse events aligned with profiles seen for incretin-based therapies, most commonly gastrointestinal events such as nausea, diarrhea and constipation, and decreased appetite; discontinuation rates due to adverse events were similar across treatment and placebo arms.

Lilly said seven additional Phase 3 studies of retatrutide — including in obesity and type 2 diabetes — are expected to complete in 2026, with detailed TRIUMPH-4 data slated for medical meeting presentation and peer-review publication.

What this means

Retatrutide is the most advanced of the triple agonists in clinical development for obesity, with recent results representing among the most pronounced weight-loss outcomes seen in late-stage obesity research to date, potentially positioning it ahead of current GLP-1 and dual-agonist competitors. Further, its dual impact on weight and osteoarthritis pain could broaden clinical utility beyond pure weight management. Phase 2 results were recently published in The New England Journal of Medicine and Nature Medicine, highlighting the significant clinical impact and ongoing research momentum.