Survodutide vs mazdutide

Side by side

Survodutide High and mazdutide High belong to the same new class: dual agonists at the GLP-1 and glucagon receptors. GLP-1 activity reduces appetite and improves insulin release; glucagon activity increases energy expenditure and acts on fat in the liver. Mazdutide is built on oxyntomodulin, a natural gut hormone that does both. The table is read from our encyclopedia entries.

Survodutide's results

In a phase 2 dose-finding trial in adults with obesity and without diabetes (309 treated with survodutide and 77 with placebo ¹), weight fell by 6.2% at 0.6 mg, 12.5% at 2.4 mg, 13.2% at 3.6 mg and 14.9% at 4.8 mg after 46 weeks, against 2.8% on placebo, in the analysis by planned treatment ¹. In the first phase 3 trial, SYNCHRONIZE-1, adults with obesity or overweight and no diabetes lost 16.6% at 76 weeks against 3.2% on placebo, by the efficacy estimand, and up to 85.1% lost at least 5% ². In people with type 2 diabetes, the SYNCHRONIZE-2 paper reported smaller losses, 8.2% and 9.8% on the two doses by the treatment-regimen estimand against 3.9% on placebo, at 76 weeks ³, as is usual for weight drugs in diabetes. Its phase 2 programme also included a trial against semaglutide in 413 adults with type 2 diabetes ⁴ and a trial in 293 adults with MASH and liver fibrosis ⁵, reflecting the interest in its glucagon component for the liver.

Mazdutide's results

GLORY-1 randomized 610 Chinese adults with obesity or overweight, with an average weight of 87.2 kg and BMI of 31.1, to mazdutide 4 mg, 6 mg or placebo ⁶. At 32 weeks weight had fallen 10.09% and 12.55% on the two doses, against a 0.45% gain on placebo; at 48 weeks the losses were 11.00% and 14.01%, against a 0.30% gain ⁶. Side effects led 1.5% and 0.5% to stop the drug, against 1.0% on placebo ⁶.

Side effects

Both drugs cause the gastrointestinal effects typical of the GLP-1 class, but the trials report them differently. In survodutide's phase 2 trial, adverse events occurred in 91% of people on the drug against 75% on placebo, mostly gastrointestinal (75% against 42%) ¹, at doses escalated quickly by today's standards. In GLORY-1, side effects led 1.5% and 0.5% of people on the two mazdutide doses to stop, against 1.0% on placebo ⁶. One trial counts all side effects and the other counts only those that ended treatment, so the figures cannot be set against each other.

Why the numbers cannot be ranked

It is tempting to set 16.6% against 14.0% and call survodutide the stronger drug. The trials do not allow it. GLORY-1 enrolled Chinese adults with a lower average BMI and ran for 48 weeks; SYNCHRONIZE-1 was larger, more international and ran for 76 weeks; and the headline figures use different estimands, one counting everyone assigned to treatment and the other only people who stayed on it. Longer trials and on-treatment analyses both produce larger numbers. Only a head-to-head trial, which has not been run, would settle which is stronger.

What the trials do show is that both drugs produce weight loss in the range of the leading GLP-1 drugs, with the glucagon component adding effects on the liver that interest researchers in fatty liver disease. Our semaglutide vs liraglutide page shows what a genuine head-to-head comparison looks like.

Status as of October 2, 2026

Mazdutide is approved in China by the National Medical Products Administration and is not approved in the US; survodutide is in clinical trials and not approved anywhere, according to our entries as of October 2, 2026. Our SYNCHRONIZE-1 report and the SYNCHRONIZE-2 report follow survodutide's phase 3 programme.

Frequently asked questions

Which works better, survodutide or mazdutide?

No trial has compared them. Their separate trials differ in population, length and analysis, so the headline numbers (16.6% for survodutide, 14.0% for mazdutide 6 mg) cannot be ranked.

Is mazdutide approved?

In China, yes, by the National Medical Products Administration. As of October 2, 2026 it is not approved in the US.

How do they differ from semaglutide?

Both add glucagon-receptor activity to the GLP-1 activity that semaglutide has alone, which raises energy use and acts on liver fat.

Related on Grey Peptides

• Semaglutide vs liraglutide
• The obesity drug pipeline
• Compare any three entries

Sources

1. le Roux, C. W., Steen, O., Lucas, K. J., et al. (2024). Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. Lancet Diabetes Endocrinol, 12(3), 162-173. PMID: 38330987
2. Grey Peptides Wire. SYNCHRONIZE-1: survodutide phase 3 in obesity (/news/synchronize-1-survodutide-phase3-obesity/), April 29, 2026, with its sources; read October 2, 2026.
3. Wharton, S., le, R., Startseva, E., et al. (2026). Survodutide Once Weekly in Adults with Obesity and Type 2 Diabetes. N Engl J Med. PMID: 42820639
4. Blüher, M., Rosenstock, J., Hoefler, J., et al. (2024). Dose-response effects on HbA(1c) and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial. Diabetologia, 67(3), 470-482. PMID: 38095657
5. Sanyal, A. J., Bedossa, P., Fraessdorf, M., et al. (2024). A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. N Engl J Med, 391(4), 311-319. PMID: 38847460
6. Ji, L., Jiang, H., Bi, Y., et al. (2025). Once-Weekly Mazdutide in Chinese Adults with Obesity or Overweight. N Engl J Med, 392(22), 2215-2225. PMID: 40421736

Educational information, not medical advice. Each dose in this guide names its source, an approved label or a published study. None is a recommendation for you. An unapproved compound has no established safe or effective human dose, and products sold for “research use only” are not made or tested for people. Talk to a doctor before acting on anything on this site, including before you start, stop or change any medicine or dose.