Survodutide

also known as: BI 456906

A once-weekly GLP-1/glucagon co-agonist in late-stage trials for obesity, type 2 diabetes, and MASH.

A synthetic peptide dual agonist at GLP-1 and glucagon receptors, engineered for weekly dosing, with glucagon agonism adding an energy-expenditure component to GLP-1 appetite suppression.

Mechanism of action

Dual agonism at GLP-1 and glucagon receptors. GLP-1 drives insulin release, glucagon suppression during hyperglycemia, gastric emptying delay, and central appetite suppression. Glucagon activation increases hepatic lipolysis, hepatic glucose output during hypoglycemia, and energy expenditure — a combination particularly relevant for liver fat reduction in MASH.

Primary uses

Obesity — Phase 3
Type 2 diabetes — Phase 3
MASH — Phase 3 (Breakthrough Therapy)

Typical dosing

0.6–6.0 mg weekly (subcutaneous)

Phase 2 used 0.6, 2.4, 3.6, and 4.8 mg weekly. Phase 3 dosing TBD.

Regulatory status

Investigational. Developed by Boehringer Ingelheim and Zealand Pharma. In Phase 3 (SYNCHRONIZE program) for obesity and T2DM; Phase 2 completed for MASH (FDA Breakthrough Therapy designation granted 2024).

References

[clinical-trial] le Roux CW, et al. "Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial." Lancet Diabetes Endocrinol, 2024;12:162-173.
[clinical-trial] Sanyal AJ, et al. "A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis." N Engl J Med, 2024;391:311-319.
[clinical-trial] ClinicalTrials.gov NCT06066515 (SYNCHRONIZE-1, Phase 3 obesity trial).

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Mazdutide

A weekly GLP-1/glucagon dual agonist approved in China for obesity (2025); the first OXM-mimetic to reach market.

Semaglutide

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

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.