Clinical Trials Pipeline & In-Development

Petrelintide

also known as: ZP8396, Zealand amylin analog

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.

A long-acting amylin analog developed by Zealand Pharma (and co-developed with Roche since a March 2025 exclusive licensing agreement) for once-weekly subcutaneous administration in chronic weight management, notable in the pipeline for its non-incretin mechanism and unusually favorable gastrointestinal tolerability relative to GLP-1-based therapies.

Mechanism of action

Mimics endogenous amylin — a peptide co-secreted with insulin from pancreatic beta cells in response to nutrient intake. Activates amylin receptors (calcitonin receptor + RAMP complexes) in the area postrema and related hindbrain circuits, reducing food intake by increasing satiety and, importantly, appearing to restore leptin sensitivity. The non-GLP-1 mechanism is the source of the markedly better GI tolerability profile observed in trials.

Primary uses

Chronic weight management (Phase 2b completed, Phase 3 pending)
Potential combination partner with GLP-1 agonists (e.g. Roche's CT-388, Phase 2 combination trial planned H1 2026)

Typical dosing

up to 9 mg once weekly (subcutaneous)

ZUPREME-1 tested five target doses up to 9 mg with dose escalation every four weeks.

Regulatory status

Not approved. Zealand Pharma developer, Roche co-development/co-commercialization partner (March 2025 agreement). ZUPREME-1 Phase 2b dose-finding trial (N=493) reported positive topline results March 5, 2026, with up to 10.7% mean body weight reduction at week 42 versus 1.7% for placebo, and no cases of vomiting and no treatment discontinuations from GI adverse events at the maximally effective dose. ZUPREME-2 (obesity/overweight with T2D) topline expected H2 2026. Phase 3 initiation planned for late 2026.

References

[news-release] Zealand Pharma. "Zealand Pharma announces positive Phase 2 results for petrelintide." March 5, 2026.
[news-release] Roche. "Roche announces positive Phase II results for petrelintide." March 5, 2026.
[news-release] Roche. "Roche enters into an exclusive collaboration & licensing agreement with Zealand Pharma to co-develop and co-commercialise petrelintide." March 12, 2025.

Related peptides

Cagrilintide

A once-weekly amylin analog developed primarily as a combination partner for semaglutide (CagriSema), adding amylin-pathway appetite suppression to GLP-1 activity.

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.

Semaglutide

A once-weekly GLP-1 receptor agonist FDA-approved for type 2 diabetes and chronic weight management.

Tirzepatide

A once-weekly GLP-1/GIP dual agonist that produced unprecedented weight loss in SURMOUNT trials — up to ~21% at highest dose.

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.