GLP-1 Pipeline: What’s Coming

Receptors: GLP-1GIPglucagonamylin −GIP = antagonistStage: filled = reached, dark = currentBeyond weight loss: ✓ benefit ~ early signal ⚠ harm · untested
retatrutide —24% weight loss
StagePhase 3
TargetsGIPGLP-1glucagon triple agonist
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, type 2 diabetes, knee osteoarthritis, OSA, MASLD, chronic kidney disease (TRANSCEND-CKD)
Efficacy~24% mean weight loss at 48 wks (Phase 2) source
Beyond weight loss
  • ✓ Knee osteoarthritis: 28.7% weight loss + WOMAC pain −75.8% (TRIUMPH-4, Dec 2025 · source)
  • ⋯ OSA / MASLD / CV-renal: Under study across the TRIUMPH Phase 3 program (TRIUMPH program)
Access & priceNot yet available
Key trials
  • TRIUMPH-1 (Ph 3, obesity (no diabetes)) — Up to ~30% weight loss; full publication pending. source
  • TRIUMPH-4 (Ph 3, obesity + knee osteoarthritis) — 28.7% weight loss + large WOMAC knee-pain reduction at 68 wks. source
  • TRANSCEND-CKD (Ph 3, chronic kidney disease) — Retatrutide in CKD; rationale/design/baseline published May 2026 (Nephrol Dial Transplant) — beyond-obesity expansion. source
Papers
On DSD
My takeThe favourite of body builders and wellness people everywhere. Seems very strong, so that many folks use it at low doses to minimize side effects. Raises heart rate more than tirzepatide, which worries me, personally.
cagrilintide + semaglutide CagriSema22.7% weight loss
StageFiled (FDA review)
TargetsGLP-1amylin GLP-1 + amylin analogue combination
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, type 2 diabetes
Efficacy22.7% weight loss at 68 wks (REDEFINE 1) — short of the ~25% the Street expected source
Beyond weight loss
  • ✓ Type 2 diabetes: 15.7% weight loss in adults with obesity + T2D (REDEFINE 2) (REDEFINE 2, NEJM 2025 · source)
Access & priceNot yet available
Key trials
  • REDEFINE 1 (Ph 3, obesity (no diabetes)) — 22.7% weight loss at 68 wks; 23% of patients lost ≥30%. source
  • REDEFINE 2 (Ph 3, obesity + T2D) — 15.7% weight loss in adults with obesity and type 2 diabetes. source
Papers
My takeNovo's reavtion to the tirepatide effectiveness, promising, but may be quickly superceded by amycretin.
maridebart cafraglutide MariTide20% weight loss
StagePhase 3
TargetsGLP-1−GIP GLP-1 agonist + GIP receptor antagonist (peptide-antibody conjugate)
Maker
Routeinjection (monthly or less frequent)
Indicationsinvestigating obesity, type 2 diabetes
EfficacyUp to ~20% weight loss at 52 wks (Phase 2, obesity without T2D) source
Beyond weight loss
  • ✓ Type 2 diabetes: ~17% weight loss + HbA1c up to −2.2% in T2D (Phase 2) (Phase 2, NEJM 2025 · source)
Access & priceNot yet available
Key trials
  • MARITIME (Phase 3 program) (Ph 3, obesity) — Phase 3 launched 2026 following Phase 2 NEJM publication. source
Papers
survodutide —16.6% weight loss
StagePhase 3
TargetsglucagonGLP-1 dual agonist
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, MASH (FDA Breakthrough Therapy)
Efficacy16.6% weight loss (SYNCHRONIZE-1); 47-62% MASH improvement (Phase 2) source
Beyond weight loss
  • ✓ MASH / liver fibrosis: MASH improvement in 47-62% vs 14% placebo — FDA Breakthrough Therapy. The glucagon arm is liver-active. (Phase 2, NEJM 2024 · source)
Access & priceNot yet available
Key trials
  • SYNCHRONIZE-1 (Ph 3, obesity) — 16.6% mean weight loss in obesity/overweight. source
  • LIVERAGE (Ph 3, MASH + fibrosis) — MASH/fibrosis Phase 3; readout expected late 2026. source
Papers
brenipatide —
StagePhase 3
TargetsGIPGLP-1 agonist (monthly; optimized for neuroscience, not weight loss)
Maker
Routeinjection (monthly)
Indicationsinvestigating alcohol use disorder, bipolar disorder, smoking cessation
EfficacyNot a weight-loss drug — targets addiction/psychiatric endpoints; weight-loss data limited
Beyond weight loss
  • ⋯ Alcohol use disorder: Purpose-built for addiction (neuro-optimized, monthly); Phase 3 RENEW-ALC (RENEW-ALC (recruiting) · source)
  • ⋯ Bipolar / smoking cessation: Psychiatric & addiction endpoints — the whole point of the molecule, not weight (Phase 2/3 program)
Access & priceNot yet available; earliest approval ~2028
Key trials
  • RENEW-ALC-1 / RENEW-ALC-2 (Ph 3, alcohol use disorder) — Phase 3 in moderate-to-severe AUD / hazardous drinking (~56 wks). source
On DSD
My takeThis is a very exciting compound. Anything that helps people stay sober would have huge societal benefit. The monthly dosing would make sticking to the protocol much easier.

Watch list (earlier stage)

MoleculeMakerTargetsStageWeight lossWhat's next
ribupatide (KAI-9531 / HRS9531)
—		GIPGLP-1Early / watch23.6%KaiNETIC global Phase 3 readouts; China NMPA filing submitted (2026-2027)
amycretin
—		amylinGLP-1Early / watch22%Heading into pivotal trials (2026)
mazdutide
—		glucagonGLP-1Early / watch20.1%Approved in China (2025); no US filing yet (2025)
aleniglipron (GSBR-1290)
—		GLP-1Early / watch16.3%Heading to Phase 3 (oral pill) (2026)
pemvidutide
—		glucagonGLP-1Early / watch15.6%Phase 3 planning; also a positive MASH (liver) trial (2026)
VK2735
—		GIPGLP-1Early / watch14.7%Phase 3 VANQUISH (injectable) underway; oral in Phase 2 (2026)
PF-08653944 (MET-097i)
—		GLP-1Early / watch12.3%VESPER-4/5/6 Phase 3 program planned (Pfizer acquired Metsera ~$10B) (2026)
petrelintide
—		amylinEarly / watch10.7%Advancing to Phase 3; petrelintide + CT-388 combo Phase 2 starting (2026)

Weight loss = peak mean result at the approved (or trial) obesity dose. Diabetes brands and lower doses come in below this; see each drug's card for the per-product breakdown.

The pipeline moves fast. I keep this current.
Every trial readout and FDA decision, tracked. Get the updates in your inbox. Free, no spam.
Subscribe on Substack
Scroll to Top