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For millions of people managing obesity or type 2 diabetes, GLP-1 medications have fundamentally changed what treatment looks like. Drugs like semaglutide, sold as Ozempic and Wegovy, and tirzepatide, marketed as Mounjaro and Zepbound, now deliver weight loss results once only achievable through surgery. Weekly injections have become routine for many patients. However, asking people to inject themselves 52 times a year is proving unsustainable for a large share of users.
Indeed, real-world data tells a sobering story. Nearly 65 percent of people using GLP-1 drugs for weight management stop within a year. Similarly, among patients with type 2 diabetes, the dropout rate sits close to 47 percent. As a result, researchers have begun rethinking drug delivery entirely. The goal is to stretch dosing from once a week to once a month, or even once every three months.
Moreover, the case for less frequent dosing goes well beyond convenience. Weekly injections cause drug concentrations to spike, then fall before the next dose arrives. Those peaks are closely linked to nausea and gastrointestinal side effects, which rank among the most common reasons patients quit early. Consequently, a slow-release depot formulation could keep drug levels more stable, reducing side effects while maintaining consistent appetite suppression and blood sugar control.
Nevertheless, achieving sustained release is technically difficult. Peptide drugs are chemically fragile, and at body temperature, polymer-based delivery systems expose them to breakdown through deamidation, oxidation, and aggregation. Furthermore, a larger single dose does not solve the problem. It creates a harmful concentration spike upfront, followed by inadequate drug levels later in the cycle.
Meanwhile, the most clinically advanced candidate is maridebart cafraglutide, or MariTide, developed by Amgen. This drug uses a monoclonal antibody scaffold that extends its half-life to around two weeks, making monthly dosing feasible. Notably, it also targets the GIP receptor while activating the GLP-1 receptor, offering a dual mechanism of action that sets it apart from existing weekly therapies.
In view of this dual approach, Phase II trial results have been encouraging. Participants without diabetes lost roughly 12 to 16 percent of body weight over 52 weeks. Those with type 2 diabetes achieved 8 to 12 percent weight reduction and recorded a 1.3 percent drop in HbA1c, a meaningful gain in long-term blood sugar control. Additionally, a gradual dose-escalation approach over 8 to 12 weeks cut early side effects significantly. Phase III trials are now underway.
Meanwhile, other companies are taking a different route altogether. Rather than redesigning the drug molecule, they are building smarter delivery systems around existing compounds. For instance, Nanexa AB, a Swedish biotechnology firm, developed a platform called PharmaShell. It coats microparticles of established GLP-1 analogs like semaglutide with an ultra-thin inorganic layer that controls dissolution and absorption, sustaining drug release for up to three months. Because it relies on molecules with known safety profiles, regulators may require less new safety data compared to a novel compound.
Likewise, Camurus has developed a subcutaneous gel system using its FluidCrystal technology. The gel forms under the skin after injection and steadily releases semaglutide over a month. Early data suggest this monthly formulation may even outperform the weekly version on weight loss outcomes. Nonetheless, formal FDA regulatory review still lies ahead for both platforms.
Thus, none of these systems has received FDA approval yet, and Phase III trial results will ultimately shape how this field develops. Still, the direction is clear. Monthly regimens fit naturally into how patients manage chronic conditions, aligning with prescription refill cycles and routine clinic visits. Therefore, for healthcare systems, better adherence could mean fewer complications from obesity and diabetes, and lower long-term costs. Science is advancing. Regulatory decisions and patient uptake will determine what comes next.
