🥼One of the most closely-watched obesity assets in the clinic, Lilly’s triple-G agonist retatrutide, read out trial data this week. In patients with obesity and knee osteoarthritis, retatrutide caused them to lose an average of 23.7% of their body weight at around 16 months. The weight loss with the shot is the most profound ever seen in a clinical trial at this extended time period. Read the full report from senior biopharma journalist Elizabeth Cairns here. 

But the side effect profile included a surprising finding of a neurological condition called dysesthesia, in which patients have burning, itching or painful sensations on their skin with no physical stimulus. Dysesthesia occurred in 8.8% and 20.9% of participants treated with retatrutide 9 mg and 12 mg, respectively, while it was seen in just 0.7% of placebo recipients. 

Like other GLP-1 drugs, however, the most common side effects were gastrointestinal: 43% of the high-dose group had nausea, 35% diarrhea and 21.8% constipation, compared to 11%, 13% and 9%, respectively, in the placebo group.

This week’s data were the first of several planned readouts for retatrutide. No fewer than seven additional Phase 3 trials are expected in 2026, including in patients with obesity only, and those with both obesity and type 2 diabetes. Additionally, other drugmakers read out obesity data this week, including Structure Therapeutics and Wave Life Sciences.

The news also came a few days after top Lilly dealmaker Jacob Van Naarden said the company would be “aggressive” in spending its GLP-1 cash. Retatrutide activates the receptors for the hormones GIP, GLP-1 and glucagon, and is the most advanced triple-G agonist in the clinic. 

📊How are biotechs feeling about 2026? After hearing from 77 executives, John Carroll wrote that cautious optimism might be the best way to characterize industry sentiment. One in five execs said they are feeling “much better” about the economics of drug development next year compared to 2025. And roughly half are in the “somewhat better” camp. 

The survey covered a range of topics, including interactions with the FDA, “most favored nation” pricing, the IPO market, dealmaking and more. One of the biggest boosts John saw was in excitement for M&A. About 43% of respondents said they expect a hot M&A arena in 2026, while roughly 42% expect it to be warm and 5% predict it will be “sizzling.”

Challenges certainly remain. A third of respondents rated the flow of investments from venture groups as “fair,” while 26% ranked it “poor.” Just over 40% of respondents also said the state of IPOs and public follow-on markets was “poor” — but that’s still an improvement from the last survey, when the overwhelming majority of execs gave the field a poor rating. About 35% of execs said they are “very” or “extremely” confident in accessing capital for their companies — the highest rate we’ve recorded since the second half of 2021. Click here to see the full results and John’s analysis. 

💵 Investors can’t seem to get enough of biotech stocks, Endpoints’ Kyle LaHucik wrote. From late Tuesday evening into Wednesday morning, a record-setting $3.2 billion in biotech follow-on stock offerings were sold. The raises came on the heels of positive data in obesity, sickle cell disease and leukemia. 

🩸Physicians and biopharma execs from around the world descended on Orlando, FL last weekend for the American Society of Hematology’s annual meeting. Here were some of the highlights:

• Multiple myeloma remains an area of high excitement, but new data from CAR-Ts and bispecifics are raising questions about which treatment should come first. 
• Early in vivo CAR-T results in multiple myeloma also turned heads at ASH, including data from Kelonia. 
• AstraZeneca's dual-targeting CAR-T saw similar response rates in Western patients as it did in China.
• Will a biotech’s pivot away from obesity let it compete with Novartis in leukemia?
• Novartis says an experimental antibody helps prolong control of a rare blood disorder.

🧬 The drug, Waskyra, was approved for a rare immune disease called Wiskott-Aldrich syndrome, a disease that primarily impacts boys and leads to a number of severe symptoms including bleeding, eczema and infections, among others. The gene therapy was developed by Fondazione Telethon, an Italian charity focused on rare disease research. It was previously licensed by Orchard Therapeutics, which stopped work on the treatment in 2022 in an effort to save cash amid layoffs. Tuesday’s FDA approval followed the European Medicines Agency’s recommendation for approval of Waskyra last month. Lei Lei Wu has the full story here.