Petrelintide's Phase 2 Paper Is Out: Weight Loss Levelled Off Above 5 mg. What Else EASD 2026 Showed
Published: October 2, 2026 · 6 min read · By Grey Peptides News Desk · ✓ Sourced
A late-breaker presented on the meeting's final day, read in full in Hansoh Pharma's October 2 release: olatorepatide (HS-20094), a GLP-1/GIP receptor agonist, in LIGHTEN, a phase 3 trial of 604 Chinese adults with a BMI of 28 or more, or 24 to 28 with a weight-related condition. Counting everyone randomised, the treatment-regimen estimand, weight fell 11.8%, 17.0% and 18.7% at 48 weeks on weekly 5, 10 and 15 mg, against 2.5% on placebo; the release's headline 19.3% is the efficacy estimand at 15 mg. Across the three doses, 7.8% reported nausea and 4.9% vomiting, against 2.6% and 2.0% on placebo, and Hansoh reports no stopping for treatment-related adverse events. The results are the company's and have not been published in a journal; the trial's lower BMI thresholds make its figures hard to set beside Western trials. China's drug regulator accepted Hansoh's application for weight management in June 2026, and Regeneron holds the rights outside China. This post is otherwise kept as it was published.
The full phase 2 paper on petrelintide, Zealand Pharma's weekly amylin analogue, was published as the trial was presented at EASD 2026 in Milan. At the trial's primary endpoint, 28 weeks, weight fell 7.9% to 9.8% across five doses against 1.7% on placebo, and the three highest doses performed about the same. Zealand's headline figure, up to 10.7%, is from week 42. Smaller first looks at three other peptides came out of the same meeting.
What the paper reports
ZUPREME-1 enrolled adults without type 2 diabetes who had obesity, or overweight with high blood pressure or abnormal blood lipids, at 32 sites in Poland, Romania and the United States. Of 493 people randomised, 485 received at least one dose: five maintenance doses of once-weekly petrelintide, from 1.0 mg to 9.0 mg, or placebo, for 42 weeks including a dose-escalation period. The trial's primary endpoint was the change in body weight at 28 weeks.
At that point, under the efficacy estimand, weight fell 7.9% on 1.0 mg and on 2.5 mg, 9.8% on 5.0 mg, 9.3% on 7.0 mg and 9.4% on 9.0 mg, against 1.7% on placebo. The paper was published in The Lancet Diabetes & Endocrinology and the trial was presented at the meeting on September 30.
The curve flattens above 5 mg
The striking feature of the 28-week results is not the size of the effect but its shape. Doubling the dose from 2.5 mg to 5.0 mg added about two points; going on to 7.0 mg and 9.0 mg added nothing. A flat top like that is useful to a developer choosing phase 3 doses, and it is also a reminder that more drug is not always more effect.
Zealand's own announcement leads with a different number: weight loss of up to 10.7% at 42 weeks against 1.7% on placebo under the efficacy estimand, which assumes everyone stayed on treatment, and up to 10.2% against 1.4% under the treatment-policy estimand, which counts everyone as randomised. Both figures are real; the week-42 one is a secondary endpoint, and the gap between the two estimands is small, which suggests few people stopped.
Tolerability is the selling point
Amylin analogues are being developed partly because nausea and vomiting limit how many people stay on GLP-1 drugs. Zealand reports that gastrointestinal side effects with petrelintide were generally mild and occurred at rates similar to placebo, and that at the maximally effective dose there was no vomiting and no one stopped because of gastrointestinal effects. It also reports smaller waists, lower hsCRP and triglycerides, and a slightly lower pulse than with placebo. Those are the company's figures; the paper's full safety tables were not read for this post.
The weight loss is smaller than incretin-based drugs have shown in their own trials. Those trials enrolled different people for different lengths of time, so the numbers are not directly comparable, and the case for amylin rests as much on tolerability, and on combinations with GLP-1 drugs, as on weight loss alone.
Also presented in Milan
HRS-4729, an injectable triple agonist of the GLP-1, GIP and glucagon receptors from Hengrui, licensed outside China to Kailera Therapeutics as KAI-4729, had its first-in-human study presented as a late-breaking abstract. Kailera reports that at 12 weeks, 10 people on the highest weekly dose lost a mean of up to 16.0% of their weight and 67.3% of their liver fat. Groups that small, over 12 weeks, are a first look rather than evidence of what the drug will do in larger trials.
Ribupatide (HRS9531), the same companies' GLP-1 and GIP dual agonist, served as that study's active comparator, with 16.7% weight loss in 10 people. A separate study in 51 people found that injecting it into the upper arm or thigh gave drug levels similar to the abdomen. Kailera says Hengrui has filed for approval of ribupatide for weight management in China; it is approved nowhere yet.
ABBV-295, a long-acting amylin analogue from AbbVie, reported detail from its phase 1 multiple-dose study in 60 people: a half-life of about 11 to 12 days, which AbbVie says could support dosing every two weeks or monthly, with weight reduction and good tolerability at every dose tested.
Survodutide's phase 3 SYNCHRONIZE-2 results were also presented at the meeting and published in the New England Journal of Medicine; our October 1 post covers what they showed and what was left out.
EloraTZP, Lilly's amylin agonist eloralintide given alongside tirzepatide, reported phase 2b results in adults with type 2 diabetes at the meeting. Our October 2 post covers what its 23.3% headline assumes, how many people stopped, and why it cannot be ranked against retatrutide.
Where they stand
All four drugs are investigational and approved nowhere. Zealand has started a phase 3 programme for petrelintide on its own, and a combination with a GLP-1 and GIP agonist is planned with Roche. None of them is available outside a clinical trial, and products sold online under these names are not the drugs tested here.
Related on Grey Peptides
The amylin analogue's earlier trials, how amylin works, and its regulatory status, dated at the source. Ribupatide (HRS9531)
The GLP-1 and GIP dual agonist's first trial in people and its registered phase 3 programme. SYNCHRONIZE-2
Survodutide's phase 3 result in type 2 diabetes, also presented at EASD 2026, and the estimand behind its headline. Cagrilintide
The other weekly amylin analogue in late-stage trials, alone and in CagriSema.
The 28-week petrelintide figures are from the paper's abstract, read on PubMed. The 42-week, tolerability and risk-factor figures are Zealand Pharma's, from its September 30 announcement, read in full. Ribupatide and HRS-4729 figures are from Kailera Therapeutics' October 1 announcement, and ABBV-295's from AbbVie's of September 30. Presentations whose primary source was not read are left out.