Category · 31 entries

Pipeline & In-Development

Compounds in late-stage clinical trials or under FDA review — not yet available as approved medicines.

Clinical Trials

Amycretin

Novo Nordisk's unimolecular GLP-1 + amylin dual agonist — Phase 1b oral data published 2024 showed ~13% weight loss in 12 weeks; SC Phase 1b reported ~22% weight loss at 36 weeks in 2025. Phase 3 programs initiating 2026. Novo's answer to the retatrutide/triple-agonist class.

In Development

Apitegromab

⚠ Monoclonal antibody — not a classical peptide. A Scholar Rock fully human IgG (~150 kDa) selective for pro-/latent myostatin (sparing mature myostatin in other tissues) — SAPPHIRE Phase 3 in spinal muscular atrophy read out positive in October 2024; BLA submission in 2025. Platform validation for myostatin biology beyond the muscle-sparing-in-obesity use case.

In Development

Apraglutide

Ironwood's weekly GLP-2 analog for short-bowel syndrome — STARS Phase 3 positive (2024), NDA submitted to FDA 2025; potentially the first once-weekly SBS therapy and a meaningful improvement over teduglutide's daily dosing.

Clinical Trials

AZD6234

AstraZeneca's long-acting amylin analog — Phase 2 in obesity (2024) — part of AZ's entry into the GLP-1-adjacent obesity space alongside ECC5004; analogous in mechanism to cagrilintide.

Clinical Trials

Bimagrumab

⚠ Monoclonal antibody — not a classical peptide. A first-in-class muscle-sparing antibody (fully human IgG1, ~150 kDa) against activin type II receptors. Combined with semaglutide in the BELIEVE Phase 2b trial (Nature Medicine, March 2026), it produced greater fat loss than semaglutide alone while preserving lean mass. Not approved; Lilly developer. Included here because it's widely discussed alongside peptides in the muscle-sparing and myostatin conversations.

In DevelopmentFull Entry

CagriSema

Novo Nordisk's next-generation obesity injection — NDA filed December 2025, FDA review expected 2026. If approved, it would be the first GLP-1 + amylin fixed-dose combination and a direct competitive response to tirzepatide.

Discontinued

Cotadutide

AstraZeneca's discontinued GLP-1/glucagon dual agonist — shelved in 2023 despite positive Phase 2 data in NASH and obesity, reportedly for commercial rather than safety reasons. Included for pipeline completeness; the mechanism lives on in pemvidutide, survodutide, and the glucagon arm of retatrutide.

Discontinued

Danuglipron

⚠ Not a peptide — small molecule. Pfizer's discontinued oral GLP-1 program — halted April 14, 2025 after a single case of potential drug-induced liver injury in a once-daily dose-optimization study, ending Pfizer's second oral GLP-1 failure in as many years. Included in this peptide encyclopedia because the audience frequently searches for it alongside peptide GLP-1 agonists.

Clinical Trials

ECC5004

AstraZeneca's oral-peptide GLP-1 candidate (in-licensed from China-based Eccogene in 2023) — Phase 2b in obesity and T2DM; a peptide, not a small molecule, distinguishing it from orforglipron and danuglipron despite the oral route.

Clinical Trials

Efpeglenatide

A weekly-to-monthly exendin-4-based GLP-1 agonist with positive Phase 3 cardiovascular outcomes (AMPLITUDE-O, 2021) — Sanofi returned the license to Hanmi in 2020; Hanmi re-partnered with Innovent in 2020 for China development and with Kailera in 2024 for global development.

Not Approved (US)

Eftansomatropin alfa

Genexine and Handok's long-acting growth hormone candidate — approved in South Korea (Declage, 2025) for pediatric growth hormone deficiency; global partnership with Handok for Korean commercialization.

Discontinued

Elsiglutide

Zealand's early GLP-2 analog program (Phase 2 for chemotherapy-induced diarrhea) — superseded by glepaglutide in Zealand's GLP-2 pipeline; retained for pipeline-history completeness.

Clinical Trials

Garetosmab

⚠ Monoclonal antibody — not a classical peptide. A Regeneron anti-activin-A fully human IgG (~150 kDa). Primary development target is fibrodysplasia ossificans progressiva (LUMINA-1 Phase 2); the activin-A mechanism overlaps bimagrumab biology, and the antibody is of cross-reference interest in the muscle-sparing-adjunct discussion.

Clinical Trials

Glepaglutide

Zealand Pharma's long-acting GLP-2 analog for short-bowel syndrome — Phase 3 EASE program completed 2023 with mixed results (primary endpoint not met in EASE-1 under the prespecified analysis, though post-hoc and secondary analyses were positive); regulatory path under review.

Clinical Trials

GMA106

Gmax Biopharm's GLP-1 / FGF21 dual-activity candidate — Phase 2 in obesity and MASH; pairs GLP-1 appetite suppression with FGF21's metabolic and hepatic steatosis effects.

Clinical Trials

HM15136

Hanmi's once-weekly glucagon analog being developed for congenital hyperinsulinism (CHI) — a rare paediatric indication in which chronic glucagon receptor agonism is used to counteract life-threatening hypoglycemia.

Clinical Trials

HM15275

Hanmi's triple-agonist GLP-1/GIP/glucagon candidate, mechanistically analogous to retatrutide — Phase 2 in obesity with a monthly-dosing ambition enabled by Hanmi's LAPSCOVERY platform.

Clinical Trials

HRS-9531

Hengrui's once-weekly GLP-1/GIP dual agonist in Phase 3 in China for obesity, with Kailera Therapeutics holding global ex-China rights since 2024; the structurally closest Chinese competitor to tirzepatide.

In Development

Insulin efsitora alfa

Lilly's once-weekly basal insulin candidate — Phase 3 QWINT program completed 2024 in T1DM and T2DM; NDA submission 2025. Competes head-to-head with Novo's insulin icodec, using Fc fusion rather than albumin binding to achieve the weekly profile.

Clinical Trials

KN056

Alphamab's GLP-1 / glucagon dual agonist — an early-clinical Chinese entry in the GLP-1/glucagon mechanism space pioneered by cotadutide and now represented by pemvidutide and survodutide.

Discontinued

Langlenatide

Hanmi's original long-acting exendin-4 conjugate, superseded by efpeglenatide (the optimized successor) after early clinical work; effectively a program predecessor rather than an independent pipeline candidate.

Clinical Trials

Maridebart cafraglutide

Amgen's once-monthly obesity injection — Phase 3 MARITIME program underway, ~20% weight loss at 52 weeks in Phase 2 (NEJM 2025), approximately 21-day half-life enabling monthly or less frequent dosing.

Clinical Trials

PB-718

PegBio's dual GLP-1 / GLP-2 agonist — an unusual combination targeting both the incretin axis and intestinal mucosal trophic signaling; Phase 2 in T2DM and NAFLD.

Clinical Trials

Pemvidutide

Altimmune's GLP-1 / glucagon co-agonist — received FDA Breakthrough Therapy Designation for MASH in January 2026 after positive IMPACT Phase 2b antifibrotic data, with Phase 3 initiation planned for 2026.

Clinical Trials

Petrelintide

Zealand Pharma's amylin monotherapy — ZUPREME-1 Phase 2b hit its endpoints in March 2026 with up to 10.7% weight loss at 42 weeks and "placebo-like" GI tolerability. Roche-partnered since 2025; Phase 3 planned for late 2026.

Clinical Trials

Relamorelin

Motus Therapeutics' (formerly Rhythm, then Allergan) ghrelin agonist pentapeptide — Phase 2b results in diabetic gastroparesis were positive, Phase 3 development paused following Allergan's divestiture; status ambiguous as of 2026.

Discontinued

Tabimorelin

Novo Nordisk's discontinued oral GH secretagogue — evaluated in Phase 2 for adult GH deficiency in the late 1990s and early 2000s; discontinued for commercial/strategic reasons. Relevant today as a historical archetype alongside MK-677 and capromorelin.

Clinical Trials

Taldefgrobep alfa

A Biohaven (ex-BMS) myostatin-binding adnectin-Fc fusion — RESILIENT Phase 3 trial in spinal muscular atrophy missed its primary endpoint (December 2024); further development pivoted toward obesity and sarcopenia indications.

Discontinued

Taspoglutide

A once-weekly GLP-1 RA co-developed by Ipsen and Roche — Phase 3 halted in 2010 after unacceptably high rates of injection-site reactions and hypersensitivity (including systemic allergic reactions), making it the most prominent immunogenicity-driven failure in the GLP-1 class.

Clinical Trials

Trevogrumab

⚠ Monoclonal antibody — not a classical peptide. A Regeneron anti-myostatin fully human IgG (~150 kDa) being tested as a muscle-sparing adjunct to GLP-1 therapy — CONVERGE combination program with semaglutide in obesity; earlier sarcopenia programs were deprioritized in favor of the obesity opportunity. Included here because it's widely discussed alongside peptides in muscle-sparing conversations.

Clinical Trials

VK2735

Viking's emerging dual GLP-1/GIP agonist — Phase 2 SC data in obesity reported up to ~14.7% placebo-adjusted weight loss at 13 weeks (VENTURE, 2024), with an oral-tablet Phase 2 program initiated 2024; the principal clinical challenger to tirzepatide's mechanism outside the Lilly / Novo axis.

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