Partly, and the trial does not answer the question most people are asking. It compared a tablet against nothing, not against staying on the injection.
What the trial did
Participants had already been treated with tirzepatide or semaglutide in an earlier trial [1]. They were then randomized to a daily orforglipron tablet or placebo for 52 weeks. Cohort 1 followed tirzepatide and had 205 people. Cohort 2 followed semaglutide and had 171.
| Prior injectable | Kept on the tablet | Kept on placebo | Difference |
|---|---|---|---|
| Tirzepatide | 74.7% | 49.2% | 25.5 points (95% CI 14.5 to 36.5) |
| Semaglutide | 79.3% | 37.6% | 41.7 points (95% CI 24.4 to 59.0) |
The comparison the trial did not run
The authors name it themselves. There was no arm that continued the injectable.
So the trial shows a tablet beats nothing. It does not show a tablet matches the injection you were already on. Those are different claims, and only the first is supported.
The authors also state the second limit: the trial ran one year. What happens in year two is untested.
What the placebo arms did
Placebo held 49.2% of the earlier loss in cohort 1. In cohort 2 it held 37.6%.
So roughly half the loss persisted with no drug at all after tirzepatide. That is the baseline the tablet has to beat. It also explains why the two cohorts differ so much. The tablet added 25.5 points after tirzepatide and 41.7 after semaglutide, because the placebo floors were not the same. The withdrawal evidence behind those floors is in what happens when you stop tirzepatide.
A different tablet, a different question
Orforglipron is not oral semaglutide. They are separate molecules and the trials ask separate questions.
Oral semaglutide 25 mg was tested from a standing start rather than as maintenance [2]. Over 64 weeks weight fell 13.6% against 2.2% on placebo, a difference of 11.4 points with an interval from 13.9 to 9.0. Gastrointestinal adverse events ran 74.0% against 42.2%.
That is what a tablet does when it is the treatment. ATTAIN-MAINTAIN asks what a tablet does after the treatment. The approval status of the oral route is in the oral one is approved now. What it costs is in the fifty-milligram dose.
Neither trial priced anything. Orforglipron is not approved and not sold.