雅思阅读 064 — Oral GLP-1 Pill Outperforms Oral Semaglutide in Head-to-Head Trial
改编自 Scientific American（2026-02，Lauren J. Young）。研究发表于 The Lancet。
🎧 课文朗读音频（约 1 分半）
Reading Passage
A clinical trial for diabetes that pits orforglipron, a once-a-day pill developed by Eli Lilly, against oral semaglutide, made by Novo Nordisk, suggests the former pill may have the edge in reducing blood sugar and body weight.
The results, published in The Lancet, are "very encouraging" for the safety and efficacy of orforglipron in people with type 2 diabetes, says Daniel Drucker, an endocrinologist at the University of Toronto. "More options for people with these challenging diseases will be very helpful, particularly if the new oral tablet medicines are priced reasonably."
Orforglipron acts on glucagon-like peptide 1 (GLP-1) receptors — the same target as the popular injectable diabetes and weight-loss drugs Ozempic, Wegovy, Mounjaro and Zepbound. Oral semaglutide has been on the market to treat type 2 diabetes since 2019. In December 2025, Novo Nordisk's Wegovy pill became the first oral GLP-1 medication approved by the U.S. Food and Drug Administration to treat obesity. Now orforglipron is inching closer to becoming the next oral option.
The new trial enrolled 1,698 people and compared the effects of taking 12-milligram and 36-milligram doses of orforglipron with taking 7 mg and 14 mg of oral semaglutide. After 52 weeks, participants who took 36 mg of orforglipron saw a key blood sugar marker reduce by nearly two per cent, while those who received 14 mg of oral semaglutide saw levels drop by roughly 1.5 per cent.
"I'm hoping that for people with type 2 diabetes, this could really help them be less reliant on insulin," says Rozalina McCoy, an endocrinologist at the University of Maryland School of Medicine. "With insulin, there is risk of weight gain, hypoglycaemia, and there's more treatment burden and need for glucose monitoring."
Orforglipron also surpassed oral semaglutide in terms of weight loss: the 36-milligram dose produced an average of eight per cent body-weight reduction (nearly 9 kilograms), compared with five per cent weight loss (about 5 kilograms) in participants who took 14 mg of oral semaglutide.
Importantly, the trial used doses of oral semaglutide based on those currently approved for diabetes — 7 mg and 14 mg — not the higher 25 mg dose recently approved for obesity. "We know that oral semaglutide can be taken in much higher doses as currently approved for obesity," McCoy says, meaning the comparison may not reflect real-world obesity treatment.
Orforglipron showed higher rates of adverse side effects such as nausea, vomiting and other gastrointestinal issues compared with semaglutide. More people discontinued orforglipron during the trial than those who stopped taking semaglutide, too.
"We can't fully divorce side effects from effectiveness," McCoy says. "It's not that one drug is worse than the others. I think it emphasises the importance of matching treatment to the right patient."
Why a small molecule matters
Both pills target GLP-1 receptors to increase insulin secretion and satiety levels. Oral versions of these drugs need to be given in much higher doses than injectable versions to withstand digestion. How the active protein, or peptide, in drugs such as oral semaglutide is absorbed through the gut can vary among people, causing differences in effectiveness and tolerability.
Orforglipron's active ingredient is a non-peptide small molecule that absorbs more readily in the gut without breaking down in the stomach. "It's always been the dream to have a small-molecule version of a GLP-1 drug, because not only can it be taken orally, but small molecules are a lot easier to produce," McCoy says. "The hope is that when they're easier to produce, they will be much more affordable."
Eli Lilly expects U.S. regulators to decide whether to approve orforglipron for obesity as early as this spring. If approved, it will be available in six doses ranging from 1 mg to 36 mg.
Questions
Questions 1–5: TRUE / FALSE / NOT GIVEN
- Orforglipron and oral semaglutide target different receptors in the body.
- The trial lasted 52 weeks.
- Orforglipron reduced blood sugar more than oral semaglutide at the highest doses tested.
- Oral semaglutide has never been approved to treat obesity.
- More participants dropped out of the semaglutide arm than the orforglipron arm.
Questions 6–10: Choose the correct letter, A, B, C or D.
-
How many people took part in the trial?
- A. 52
- B. 1,698
- C. 7,000
- D. 25
-
At 36 mg, orforglipron reduced body weight by approximately
- A. 5%
- B. 8%
- C. 15%
- D. 2%
-
The comparison may be unfair because
- A. semaglutide doses were lower than those used for approved obesity treatment
- B. orforglipron was given at lower doses
- C. the trial was too short
- D. participants were not diabetic
-
According to McCoy, small-molecule GLP-1 drugs are preferable because they
- A. work faster
- B. have no side effects
- C. are easier and cheaper to manufacture
- D. do not need to be taken daily
-
What concern does McCoy raise about orforglipron?
- A. It may be too expensive.
- B. It causes more side effects and discontinuations.
- C. It does not reduce blood sugar.
- D. It cannot be taken orally.
Questions 11–13: Complete the sentences. Choose NO MORE THAN TWO WORDS.
- The trial was published in the medical journal __________.
- GLP-1 drugs work by increasing insulin secretion and __________ levels.
- Orforglipron's active ingredient is a non-peptide __________ molecule.
Answers
- FALSE (都作用于 GLP-1 受体)
- TRUE
- TRUE
- FALSE (2025 年 12 月 Wegovy 口服版已获批)
- FALSE (orforglipron 组停药率更高)
- B
- B
- A
- C
- B
- The Lancet
- satiety
- small
Glossary
- efficacy /ˈefɪkəsi/ n. 功效
- hypoglycaemia /ˌhaɪpəʊɡlaɪˈsiːmiə/ n. 低血糖
- gastrointestinal /ˌɡæstrəʊɪnˈtestɪnl/ adj. 胃肠的
- satiety /səˈtaɪəti/ n. 饱腹感
- peptide /ˈpeptaɪd/ n. 肽
- molecule /ˈmɒlɪkjuːl/ n. 分子
- receptor /rɪˈseptə/ n. 受体
- dose /dəʊs/ n. 剂量
- adverse /ˈædvɜːs/ adj. 不利的
No comments yet.