GLP-1 Pipeline: What’s Coming

Receptors: GLP-1GIPglucagonamylinNPY2UCN2 −GIP = antagonistStage: filled = reached, dark = currentBeyond weight loss: ✓ benefit ~ early signal ⚠ harm · untested
retatrutide —28.3% mean weight change80 wk · obesity, no T2D · efficacy estimand · raw change
StagePhase 3 complete
TargetsGIPGLP-1glucagon triple agonist
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, type 2 diabetes, knee osteoarthritis, OSA, MASLD, chronic kidney disease (TRANSCEND-CKD), cardiovascular outcomes, chronic low back pain
Efficacy28.3% mean weight loss (~70.3 lb) at 80 wks on 12 mg vs 2.2% placebo (TRIUMPH-1 Phase 3, efficacy estimand); on the treatment-regimen estimand it is 25.0% vs 3.9%. Up to 30.3% at 104 wks in BMI 35+. Harder populations lose less: 22.6% in severe obesity with established cardiovascular disease (TRIUMPH-3) and 20.8% with type 2 diabetes (TRIUMPH-2), both at 80 wks on 12 mg. source
Beyond weight loss
  • ✓ Knee osteoarthritis: 28.7% weight loss and WOMAC knee pain down 75.8% at 12 mg — but placebo fell 40.3%, so roughly half the pain improvement is not attributable to the drug. (TRIUMPH-4, Dec 2025 · source)
  • ✓ Obstructive sleep apnea: Apnea-hypopnea events -60.6% (about 36 fewer events/hr) at 12 mg as a TRIUMPH-1 secondary endpoint (ADA 2026). MASLD and CV-renal still under study (TRANSCEND-CKD). (TRIUMPH-1 (ADA 2026) · source)
  • ⚠ Dysesthesia + UTI (safety): New dose-dependent signal absent in Phase 2: dysesthesia (abnormal/burning skin sensation) in 5.1%/12.3%/12.5% on 4/9/12 mg vs 0.9% placebo (TRIUMPH-1); up to 20.9% at 12 mg in TRIUMPH-4. UTIs elevated (up to 8.8% vs 5.3%). Mostly mild-moderate, usually resolved on treatment; AE discontinuation 11.3% at 12 mg vs 4.9% placebo. In T2D (TRANSCEND-T2D-1) the signal was milder: dysesthesia 2-4% vs 0% placebo, HR +~1 bpm. The two July 2026 trials came in lower at the top dose — 7.3% in TRIUMPH-2 and 6.4% in TRIUMPH-3 vs 0.7% and 1.3% on placebo — so the signal is consistent and dose-related but not as large as TRIUMPH-1 suggested. Discontinuation for side effects was highest in the sickest group: 13.5% at 12 mg in TRIUMPH-3 vs 4.8% placebo. (TRIUMPH-1 (May 2026); TRIUMPH-4 (Dec 2025); TRIUMPH-2 and TRIUMPH-3 topline (Jul 2026) · source)
  • ~ Heart and circulation (signal): TRIUMPH-3 put retatrutide into 1,949 people who already had cardiovascular disease, and nothing alarming surfaced over 80 weeks — but the trial cannot show benefit either, and Lilly says so: cardiovascular events "occurred less frequently than anticipated" in both arms. Pre-specified, retatrutide had 44 broad events (death, heart attack, stroke, heart failure, revascularisation) against 52 on placebo, a hazard ratio of 0.82 with a confidence interval of 0.55 to 1.22 that crosses 1. On the narrower measure — cardiovascular death, heart attack, stroke — there were slightly more on the drug: 27 vs 23, hazard ratio 1.12 (0.64 to 1.96). Both results are compatible with a meaningful benefit and with a modest harm. The friendlier numbers Lilly also reports (0.73 and 0.92) come from an analysis that was not pre-specified. Risk factors did move clearly at the top dose: triglycerides -37.0%, non-HDL cholesterol -16.5%, systolic BP -9.3 mmHg, hsCRP -51.2%. The earlier worry stands unresolved rather than settled: because the glucagon arm can raise heart rate, in TRANSCEND-T2D-1 7 of 403 treated patients had arrhythmias and 3 had major cardiovascular events against none on placebo, and resting pulse rose about 1 bpm. The dedicated cardiovascular-outcomes trial reads out around 2029. (TRIUMPH-3 topline (Jul 2026); TRANSCEND-T2D-1, Lancet 2026 · source)
  • ✓ Type 2 diabetes: TRANSCEND-T2D-1 (Lancet 2026, n=537, 40 wks, monotherapy in early T2D): HbA1c -1.94% (ETD -1.12% vs placebo) and -15.3% weight at 12 mg with no plateau; 82-89% reached HbA1c <7%; up to 64% hit the <=6.5% + >=10%-weight composite. Also improved triglycerides, non-HDL, and systolic BP. TRIUMPH-2 (Jul 2026) confirms this at scale and at 80 weeks: from a baseline HbA1c of 7.7%, reductions of 1.4 to 1.6 points against 0.2 on placebo, alongside 20.8% weight loss at 12 mg. (TRANSCEND-T2D-1, Lancet 2026; TRIUMPH-2 topline (Jul 2026) · source)
Access & priceNot yet available
Key trials
  • TRIUMPH-1 (Ph 3, obesity (no diabetes)) — Full data at ADA 2026 (n=2,339, 80 wks): 28.3% mean weight loss (~70.3 lb) at 12 mg (25.9% at 9 mg, 19.0% at 4 mg), 65.3% reached BMI <30; up to 30.3% (~85 lb) at 104 wks in the BMI ≥ 35 extension. Secondary endpoints at 12 mg: knee-osteoarthritis pain -73.1%, OSA events -60.6%, triglycerides -41%, systolic BP -12.3 mmHg. AE discontinuation 11.3% at 12 mg vs 4.9% placebo. source
  • TRIUMPH-2 (Ph 3, obesity/overweight + type 2 diabetes) — Topline 23 Jul 2026 (NCT05929079, n=1,152 randomised, 80 wks, all three doses vs placebo). Weight -20.8% at 12 mg (-49.6 lb), -19.1% at 9 mg, -12.7% at 4 mg vs -4.0% placebo, from a baseline of 106.4 kg / BMI 38.2 (efficacy estimand). HbA1c fell 1.5 / 1.6 / 1.4 points vs 0.2 on placebo, from a baseline of 7.7%. This is the harder population — people with type 2 diabetes consistently lose less on incretin drugs than people without it — and 20.8% here sits well below the 28.3% of TRIUMPH-1. Dysesthesia 7.3% / 5.6% / 4.5% vs 0.7% placebo; AE discontinuation 7.7% (12 mg) / 11.6% (9 mg) / 3.8% (4 mg) vs 4.9%. Detailed results to be presented and published; not yet peer-reviewed. source
  • TRIUMPH-3 (Ph 3, severe obesity + established cardiovascular disease) — Topline 23 Jul 2026 (NCT05882045, n=1,949 randomised, 80 wks). Severe obesity (BMI ≥ 35) with established cardiovascular disease, with or without type 2 diabetes. Weight -22.6% at 12 mg (-55.8 lb) and -21.6% at 9 mg vs -3.2% placebo, from a baseline of 111.4 kg / BMI 40.4 (efficacy estimand). At the top dose: triglycerides -37.0%, non-HDL cholesterol -16.5%, systolic BP -9.3 mmHg, waist -19.0 cm, hsCRP -51.2%. Cardiovascular events were too few to interpret (see the cardiovascular row below). Dysesthesia 6.4% on both doses vs 1.3% placebo; AE discontinuation 13.5% (12 mg) / 9.8% (9 mg) vs 4.8%. Detailed results to be presented and published; not yet peer-reviewed. source
  • TRANSCEND-T2D-1 (Ph 3, type 2 diabetes) — Lancet 2026 (Bajaj et al., online 6 Jun; NCT06354660). 40-wk once-weekly monotherapy in drug-naive early T2D (n=537; baseline HbA1c 7.9%, BMI 35.8, diabetes 2.5 yr). HbA1c -1.94% at 12 mg vs -0.81% placebo (ETD -1.12%, p<0.0001); weight -15.3% at 12 mg vs -2.6% (no plateau); 82-89% reached HbA1c <7%, up to 64% hit the HbA1c<=6.5% + >=10%-weight composite. GI-predominant AEs; dysesthesia 2-4% (vs 0% placebo); no severe hypoglycaemia; pulse +~1 bpm. source
  • TRIUMPH-4 (Ph 3, obesity/overweight + knee osteoarthritis) — Obesity + knee OA, 68 wks: weight -28.7% at 12 mg / -26.4% at 9 mg vs -2.1% placebo. WOMAC knee-pain -74.3% (12 mg) / -75.8% (9 mg) vs -40.3% placebo, with physical-function subscale -73.7% / -71.8% vs -35.6%. Pain-free at 68 wks: 12.0% (12 mg) / 14.1% (9 mg) vs 4.2% placebo (>1 in 8 on drug). Detailed data presented at ADA 2026; peer-reviewed publication pending. 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 CagriSema20.4% mean weight change68 wk · obesity, no T2D · treatment-policy · raw change
StageFiled (FDA review)
TargetsGLP-1amylin GLP-1 + amylin analogue combination
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, type 2 diabetes
Efficacy20.4% weight loss at 68 wks vs 3.0% placebo (REDEFINE 1, treatment-policy estimand — the figure in the published NEJM paper; 22.7% on the efficacy estimand) — short of the ~25% the Street expected. source
Beyond weight loss
  • ✓ Type 2 diabetes: 13.7% weight loss vs 3.4% placebo in adults with obesity + T2D (REDEFINE 2, treatment-policy estimand as published; 15.7% on the efficacy estimand). (REDEFINE 2, NEJM 2025 · source)
  • ✓ Type 2 diabetes (head-to-head): REIMAGINE 2 (n=2,728, 68 wks): superior to semaglutide 2.4 mg on A1C (-1.91% vs -1.76%) and weight (-14.2% vs -10.2%). (REIMAGINE 2 (ADA 2026) · source)
Access & priceNot yet available
Key trials
  • REDEFINE 1 (Ph 3, obesity (no diabetes)) — 20.4% weight loss at 68 wks vs 3.0% placebo (treatment-policy estimand as published in NEJM; 22.7% on the efficacy estimand). 23% of patients lost 30% or more. source
  • REDEFINE 2 (Ph 3, obesity + T2D) — 13.7% weight loss vs 3.4% placebo in adults with obesity and type 2 diabetes (treatment-policy estimand as published; 15.7% on the efficacy estimand). source
  • REIMAGINE 2 (Ph 3, type 2 diabetes (head-to-head vs semaglutide)) — n=2,728; CagriSema 2.4/2.4 mg superior to semaglutide 2.4 mg at 68 wks: A1C up to -1.91% vs -1.76%, weight -14.2% vs -10.2% (43% lost >=15%, 24% >=20%). Published in Lancet Diab & Endo (7 Jun 2026). source
  • REIMAGINE 1 (Ph 3, type 2 diabetes (monotherapy vs placebo)) — n=180; 40-wk monotherapy in T2D inadequately controlled on diet and exercise, vs placebo. Published in Lancet Diab & Endo (7 Jun 2026). source
  • REIMAGINE 3 (Ph 3, type 2 diabetes (add-on to basal insulin vs placebo)) — n=270; 40-wk add-on to basal insulin in T2D, vs placebo. Published in Lancet (7 Jun 2026). source
Papers
My takeNovo's reavtion to the tirepatide effectiveness, promising, but may be quickly superceded by amycretin.
maridebart cafraglutide MariTide16.2% mean weight change52 wk · obesity, no T2D · treatment-policy · raw change
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
Efficacy12.3% to 16.2% weight loss at 52 wks vs 2.5% placebo (Phase 2, obesity without T2D, treatment-policy estimand as published in NEJM). Amgen's earlier topline release quoted ~20% on the efficacy estimand. source
Beyond weight loss
  • ✓ Type 2 diabetes: 8.4% to 12.3% weight loss and HbA1c down 1.2 to 1.6 percentage points in type 2 diabetes (Phase 2, as published in NEJM). (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 —13.0% mean weight change76 wk · obesity, no T2D · treatment-regimen · raw change
StagePhase 3
TargetsglucagonGLP-1 dual agonist
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, MASH (FDA Breakthrough Therapy)
Efficacy13.0% mean weight loss at 76 wks on 6.0 mg vs 5.4% placebo (SYNCHRONIZE-1, treatment-regimen estimand — the primary analysis in the published NEJM paper). Under the efficacy estimand the same trial reads 16.6% vs 3.2%; the two pairs are not interchangeable. 71.9% lost 5% or more vs 46.3% on placebo. source
Beyond weight loss
  • ✓ MASH / liver fibrosis: MASH improved in 47% at 2.4 mg and 62% at 4.8 mg vs 14% on placebo — but 43% at the highest 6.0 mg dose, so the response is not more-is-better. FDA Breakthrough Therapy Designation; the glucagon arm is liver-active. (Phase 2, NEJM 2024 · source)
Access & priceNot yet available
Key trials
  • SYNCHRONIZE-1 (Ph 3, obesity) — 13.0% mean weight loss at 76 wks on 6.0 mg vs 5.4% placebo (treatment-regimen estimand, the published primary), with 71.9% losing 5% or more vs 46.3%. On the efficacy estimand the same trial reads 16.6% vs 3.2%, with 85.1% vs 38.8% losing 5% or more. Published NEJM 7 Jun 2026. source
  • SYNCHRONIZE-2 (Ph 3, obesity with type 2 diabetes) — NCT06066528, 752 people treated across 133 sites in 19 countries, all with type 2 diabetes and a BMI of 27 or above. Weekly survodutide up-titrated to 3.6 mg or 6.0 mg against placebo over 76 weeks, with two primary endpoints: percentage change in body weight and the share of people losing 5% or more. The trial finished in December 2025 and no efficacy results have been released. Only the baseline characteristics have been published (Wharton et al., Diabetes, Obesity and Metabolism, DOI 10.1111/dom.70263). This is the diabetes counterpart to SYNCHRONIZE-1, and weight loss on these drugs is consistently smaller in people with type 2 diabetes. source
  • LIVERAGE (Ph 3, MASH + fibrosis) — MASH/fibrosis Phase 3, NCT06632444, n=1,800, still recruiting — primary completion Dec 2031. LIVERAGE-Cirrhosis (NCT06632457, n=1,590) runs to Jun 2029. Neither is a near-term readout. source
  • SYNCHRONIZE-CVOT (Ph 3, cardiovascular outcomes) — NCT06077864, n=5,531, event-driven CV safety trial. Primary completion 16 Jun 2026. Results not yet published. source
Papers
brenipatide —
StagePhase 3
TargetsGIPGLP-1 agonist (monthly; optimized for neuroscience, not weight loss)
Maker
Routeinjection (monthly)
Indicationsinvestigating alcohol use disorder, major depressive disorder, bipolar disorder, smoking cessation, opioid use disorder, schizophrenia, IBS, asthma
EfficacyNot a weight-loss drug — it targets addiction and psychiatric endpoints. No efficacy data has been published in any indication. The first dedicated body-weight study (NCT07476118, Phase 1b, 150 participants with overweight or obesity) does not complete until Feb 2027, so no weight number can honestly be quoted yet. source
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 (Ph 3, alcohol use disorder) — NCT07219966, n=1,100, recruiting since 15 Oct 2025, primary outcome up to 56 weeks. source
  • RENEW-ALC-2 (Ph 3, alcohol use disorder) — NCT07219953, n=1,100, recruiting since 16 Oct 2025 — a separate registration from ALC-1. source
  • RENEW-MDD-1 (Ph 3, major depressive disorder) — NCT07412756, n=1,000, recruiting since 9 Feb 2026 — a second Phase 3 indication. source
  • Phase 1b body-weight study (Ph 1, overweight / obesity) — NCT07476118, n=150, started 18 Mar 2026, primary completion Feb 2027. The only study measuring body weight. 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.
amycretin (INN: zenagamtide) —22.0% mean weight change36 wk · obesity, no T2D · raw change
StagePhase 3
TargetsamylinGLP-1 receptor agonist (oral & injectable)
Maker
Routeoral / injection
Indicationsinvestigating obesity, type 2 diabetes
Efficacy~22% mean weight loss at 36 wks (Phase 1b/2a, subcutaneous, obesity; up to 24% at the top dose) source
Beyond weight loss
  • ✓ Type 2 diabetes (once-weekly SC): Phase 2 (n=262, 36 wks): A1C -0.9 to -1.7 pp across 0.4-40 mg doses, significant vs placebo across the dose range (The Lancet, 30 Jul 2026). ADA 2026 presentation additionally reported up to 14.6% weight loss and up to 89.1% reaching A1C <7% (not in the Lancet abstract). (Phase 2 T2D SC (The Lancet 2026; ADA 2026) · source)
  • ✓ Type 2 diabetes (once-daily oral): Phase 2 (n=186, 36 wks): once-daily oral 6, 25, and 50 mg cut A1C by 0.9, 1.3, and 1.4 pp, all significant vs placebo; GI adverse events 26-47% by dose vs 23% placebo. Weight loss not reported in the abstract. (Phase 2 T2D oral, The Lancet 2026 · source)
Key trials
  • Phase 2 T2D, once-weekly SC (zenagamtide) (Ph 2, type 2 diabetes (once-weekly injectable)) — n=262 (225 drug / 37 placebo), 36 wks, once-weekly maintenance doses 0.4-40 mg: A1C -0.9 pp at 0.4 mg to -1.7 pp at 40 mg (treatment difference vs placebo -0.77 to -1.56 pp, significant across the dose range; baseline 7.8%). Most adverse events gastrointestinal, mild to moderate; serious AEs in 21/261 (8%) across all groups incl. placebo; no deaths. Weight loss not reported in the abstract — the up-to-14.6% weight loss and up-to-89.1% reaching A1C <7% figures are from the ADA 2026 presentation. Published in The Lancet 30 Jul 2026 (NCT06542874). source
  • Phase 2 T2D, once-daily oral (zenagamtide) (Ph 2, type 2 diabetes (once-daily oral)) — n=186 (54 on 6 mg / 51 on 25 mg / 51 on 50 mg / 30 placebo), 36 wks: A1C -0.9, -1.3, and -1.4 pp from a 7.9-8.1% baseline (treatment difference vs placebo -0.5, -0.99, and -1.09 pp; all significant). GI adverse events in 26%, 41%, and 47% by dose vs 23% on placebo; serious AEs in 7/186 (4%), none on placebo; no deaths. Weight loss not reported in the abstract. Published in The Lancet 30 Jul 2026 (NCT06542874). source
  • AMAZE (Phase 3 obesity programme) (Ph 3, obesity) — AMAZE 1 (NCT07339423, n=1,150) started 24 Feb 2026 and is recruiting, with AMAZE 2, 3, 4, 5, 6 and 12 also recruiting and 7, 8 and 13 registered. Note Novo's separate type 2 diabetes Phase 3 is the one still described as planned for H2 2026 — the obesity programme began months earlier. source
  • HF-POLARIS (Phase 3, heart failure) (Ph 3, heart failure) — NCT07567001, n=5,610, recruiting since 11 May 2026. source
Papers
mazdutide —16.65% mean weight change60 wk · obesity, no T2D · raw change
StageApproved · China
TargetsglucagonGLP-1 dual agonist
Maker
Routeinjection
Indicationsapproved for chronic weight management (China, NMPA, Jun 2025), type 2 diabetes glycaemic control (China, NMPA, Sep 2025); investigating obesity and type 2 diabetes outside China (no US filing)
Efficacy-16.65% mean weight loss at 60 wks on 9 mg (GLORY-2 Phase 3, JAMA, all-treated; 42% lost 20% or more); in GLORY-1 the 6 mg dose gave -14.01% at week 48 on the treatment-policy estimand, or -14.84% on the efficacy estimand. source
Beyond weight loss
  • ✓ Type 2 diabetes (head-to-head): DREAMS-3 (n=349, China, 32 wks): superior to semaglutide 1 mg on glycemia and weight (HbA1c -2.03% vs -1.84%; weight -10.29% vs -6.00%). (DREAMS-3 (ADA 2026) · source)
Key trials
  • GLORY-2 (Ph 3, obesity (China; once-weekly 9 mg)) — n=461 Chinese adults with obesity (16% with T2D), 60 wks: mazdutide 9 mg -16.65% mean body weight vs -1.50% placebo (difference -15.15%). 84% lost >=5%, 70% >=10%, 57% >=15%, 42% >=20%. SBP -9.8 mm Hg, triglycerides -21%, non-HDL -14.6%. GI AEs common (vomiting 53%, nausea 47%); 2.9% discontinued for AEs. Published in JAMA. source
  • DREAMS-3 (Ph 3, type 2 diabetes + obesity (head-to-head vs semaglutide)) — n=349 Chinese adults, early T2D + obesity, 32 wks: mazdutide 6 mg beat semaglutide 1 mg — HbA1c -2.03% vs -1.84%, weight -10.29% vs -6.00%, composite (A1c<7% + >=10% weight) 48% vs 21%. Presented at ADA 2026. source
Papers
VK2735 —14.7% mean weight change13 wk · obesity · raw change
StagePhase 3
TargetsGIPGLP-1 dual agonist (injectable + oral in development)
Maker
Routeinjection (weekly); oral (daily) in development
Indicationsinvestigating obesity, type 2 diabetes
Efficacy~14.7% at 13 wks (Phase 2 VENTURE, subcutaneous); oral VK2735 ~12.2% at 13 wks (VENTURE-Oral) source
aleniglipron (GSBR-1290) —16.3% mean weight change44 wk · obesity · placebo-adjusted
StagePhase 3 (dosing)
TargetsGLP-1 receptor agonist (oral, non-peptide small molecule)
Maker
Routeoral (daily)
Indicationsinvestigating obesity, type 2 diabetes
Efficacy16.3% placebo-adjusted at 44 wks on 180 mg and 16.0% on 240 mg — the two higher doses ACCESS II was built to test. Absolute change from baseline was -15.3% at 180 mg and -15.0% at 240 mg; the gap is because placebo GAINED 1.1%. The 120 mg reference arm was -14.7% placebo-adjusted. A separate earlier trial, ACCESS, gave 11.3% at 36 wks. source
Key trials
  • ACCESS (Phase 2b) (Ph 2, obesity) — NCT06693843, n=230 randomised, 36 wks. Source of the 11.3% figure; published in Nature Medicine. source
  • ACCESS II (Phase 2b, higher doses) (Ph 2, obesity) — NCT06703021, 44 wks, built to test 180 mg and 240 mg: -16.3% and -16.0% placebo-adjusted, with the 120 mg reference arm at -14.7%. source
Papers
enicepatide (CT-388 / RO7795068) —22.5% mean weight change48 wk · obesity · efficacy estimand · placebo-adjusted
StagePhase 3
TargetsGIPGLP-1 dual agonist (cAMP signal-biased, minimal beta-arrestin recruitment)
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, type 2 diabetes
Efficacy22.5% placebo-adjusted at 48 wks (efficacy estimand; 18.3% treatment-regimen) in Phase 2 CT388-103 at 24 mg, no plateau; 26.1% lost ≥30% source
Key trials
  • CT388-103 (Ph 2, obesity / overweight without T2D (dose-finding)) — n=469, 48 wks, top dose 24 mg weekly: 22.5% placebo-adjusted weight loss (efficacy estimand; 18.3% treatment-regimen), no plateau. Responders at 24 mg: 95.7% ≥5%, 87% ≥10%, 47.8% ≥20%, 26.1% ≥30%; 54% resolved obesity (BMI <30) vs 13% placebo; 73% of pre-diabetic participants reached normoglycemia vs 7.5% placebo. Discontinuation for AEs 5.9% vs 1.3% placebo. Full data at ADA 2026. source
  • CT388-104 (Ph 2, obesity / overweight + type 2 diabetes) — Active, not recruiting (started Nov 2024); efficacy data being presented from the program at ADA 2026. source
  • Phase 3 program (obesity) (Ph 3, obesity) — Two Phase 3 obesity trials recruiting since March 2026 (NCT07351045, NCT07351058). source
  • Phase 3 (China) (Ph 3, obesity) — NCT07670416, recruiting since 3 Jul 2026 — a third Phase 3 alongside NCT07351045 and NCT07351058. source
eloralintide —20.1% mean weight change48 wk · obesity · raw change
StagePhase 3
Targetsamylin selective amylin receptor agonist
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, type 2 diabetes, obstructive sleep apnea, knee osteoarthritis
EfficacyUp to 20.1% at 48 wks (Phase 2, NCT06230523, 263 adults); 9.5%-20.1% across doses vs 0.4% placebo, max -21.3 kg at 9 mg. Selective amylin agonist, no GLP-1. source
Key trials
  • Phase 2 (NCT06230523) (Ph 2, obesity/overweight, no type 2 diabetes) — 263 adults; up to 20.1% weight loss at 48 wks vs 0.4% placebo (efficacy estimand); max -21.3 kg at 9 mg. GI/fatigue AEs mild-to-moderate, lower with slower dose escalation. source
  • ENLIGHTEN (Phase 3 programme) (Ph 3, obesity, type 2 diabetes, OSA, knee osteoarthritis) — Five trials recruiting: ENLIGHTEN-1 NCT07321886, -2 NCT07282600, -3 NCT07369011 (obstructive sleep apnea), -4 NCT07353931 (knee osteoarthritis) and -6 NCT07392190. source
Papers
MET-233i (renamed PF-08653945) —8.4% mean weight change5 wk · obesity · placebo-adjusted
StagePhase 2
Targetsamylin ultra-long-acting amylin analog (monthly)
Maker
Routeinjection (monthly)
Indicationsinvestigating obesity
EfficacyUp to 8.4% placebo-subtracted after five WEEKLY 1.2 mg doses at day 36 (Phase 1, 80 adults). The ~19-day half-life is what supports a future monthly product — it is not how this result was produced. Pfizer renamed the molecule PF-08653945 after acquiring Metsera; its GLP-1 partner MET-097i is now berobenatide (PF-08653944). source
Key trials
  • SOLIS-1 (Phase 2b) (Ph 2, obesity) — NCT07575932, n=872, recruiting since 11 May 2026, testing PF-08653945 with PF-08653944 (berobenatide). source
berobenatide (MET-097i / PF-08653944) —14.1% mean weight change28 wk · obesity · placebo-adjusted
StagePhase 3
TargetsGLP-1 ultra-long-acting GLP-1 receptor agonist
Maker
Routeinjection (monthly potential)
Indicationsinvestigating obesity, type 2 diabetes
EfficacyUp to 14.1% placebo-adjusted at 28 wks on weekly 1.2 mg (VESPER-1) and 12.3% placebo-adjusted monthly (VESPER-3). A separate 32-week extension reached ~15.9% on the highest weekly dose — that one is an absolute figure, not placebo-adjusted, so it is not the same measure as the two above. source
Key trials
  • VESPER-1 (Ph 2, obesity / overweight (weekly dosing)) — Up to 14.1% placebo-adjusted weight loss at 28 wks (1.2 mg once-weekly); individual responses up to 26.5%. Full data at ADA 2026. source
  • VESPER-2 (Ph 2, obesity + type 2 diabetes (weekly dosing)) — 28-wk data in adults with overweight/obesity and T2D presented at ADA 2026; dose-level percentages pending full presentation. source
  • VESPER-3 (Ph 2, obesity / overweight) — 12.3% placebo-adjusted weight loss at 28 wks with monthly dosing. source
  • VESPER-4 + Phase 3 programme (Ph 3, obesity) — VESPER-4 (NCT07311850, n=3,501) has been recruiting since 19 Dec 2025, with NCT07400653 (n=999, Feb 2026) and NCT07595549 (n=954, Jun 2026) following. source
  • Q2 2026 earnings call (company statement, not a trial) (Ph 3, obesity) — Pfizer CSO Chris Boshoff said an internal analysis "suggests berobenatide can deliver weight loss comparable to tirzepatide and potentially better than semaglutide." This is a sponsor cross-trial comparison, not a head-to-head trial, and no head-to-head against either drug has been run. Treat as a company claim until VESPER-4 and the wider Phase 3 programme report. source
ribupatide (KAI-9531 / HRS9531) —23.6% mean weight change36 wk · obesity · efficacy estimand · raw change
StagePhase 3
TargetsGIPGLP-1 dual agonist (Kailera also has a separate triple agonist)
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity, type 2 diabetes
Efficacy23.6% weight loss at 36 wks (Phase 2, 8 mg); 19.2% in China Phase 3 (6 mg, 48 wks) source
Key trials
  • KaiNETIC (global Phase 3) (Ph 3, obesity) — Global Phase 3 program; China Phase 3 (HRS9531-301) showed 19.2% at 6 mg / 48 wks. source
  • KaiNETIC-2 and further Phase 3s (Ph 3, obesity, knee osteoarthritis) — KaiNETIC-2 (NCT07284901, n=1,156) recruiting since 12 Jan 2026, plus a Phase 3 in obesity with knee osteoarthritis (NCT07709910, n=382) from Jul 2026. source
efpeglenatide —9.8% mean weight change40 wk · obesity, no T2D · raw change
StageFiled · Korea
TargetsGLP-1 long-acting GLP-1 receptor agonist (exendin-4 based, Lapscovery platform)
Maker
Routeinjection
Indicationsinvestigating obesity, type 2 diabetes
Efficacy~9.8% mean weight loss at 40 wks (Phase 3 topline, non-diabetic adults, 2025) source
Beyond weight loss
  • ✓ Cardiovascular: Fewer major cardiovascular events (3-point MACE) vs placebo in high-risk T2D (AMPLITUDE-O, NEJM 2021 (n=4,076) · source)
  • ✓ Kidney: Slower decline in kidney function / less albuminuria progression (AMPLITUDE-O, NEJM 2021 · source)
Access & priceNot yet available (Korea filing first)
Key trials
  • AMPLITUDE-O (Ph 3, type 2 diabetes, high CV/renal risk) — Cut major cardiovascular events and slowed kidney decline vs placebo in 4,076 patients; the basis for its CV/renal differentiation. source
  • Phase 3 obesity (Korea) (Ph 3, obesity (no diabetes)) — ~9.8% mean weight loss at 40 wks (n=448); full publication pending. source
Papers
My takeThe cardiovascular and kidney outcomes pedigree is real (AMPLITUDE-O), but the obesity efficacy is modest next to tirzepatide and retatrutide, and it's a Korea-first launch with no US filing yet. Worth watching as the value and access play, not the weight-loss leader.
elecoglipron (AZD5004 / ECC5004) —10.5% mean weight change26 wk · obesity, no T2D · raw change
StagePhase 3
TargetsGLP-1 receptor agonist (oral, small molecule)
Maker
Routeoral (daily, no food/water restriction)
Indicationsinvestigating obesity, type 2 diabetes
Efficacy10.5% mean weight loss at 26 wks and 11.8% at 36 wks on 75 mg (VISTA Phase 2b, n=310, obesity without diabetes) vs 0.6% placebo. In type 2 diabetes (SOLSTICE, n=406) HbA1c fell 1.88 points on the 75 mg every-two-week escalation arm vs 0.15 on placebo. SOLSTICE also included an oral semaglutide 14 mg arm that fell 1.28 points — but that arm was open-label and exploratory, and the trial was not powered to compare the two drugs, so it is not a head-to-head result. source
Beyond weight loss
  • · Everything else: Early-stage oral GLP-1; CV/OSA/other effects untested. The orforglipron competitor in the oral-GLP-1 race. (no data yet)
Access & priceNot yet available
Key trials
  • VISTA (Phase 2b, obesity) (Ph 2, obesity without diabetes) — n=310, 36 wks. 75 mg weekly titration: -10.5% at wk 26 vs -0.6% placebo, -11.8% at wk 36; 5 mg -2.6%. 40.4-88.8% lost 5% or more vs 15.6% on placebo. source
  • SOLSTICE (Phase 2b, type 2 diabetes) (Ph 2, type 2 diabetes) — n=406. HbA1c -1.88 on the 75 mg every-two-week escalation arm vs -0.15 placebo; weight down to -7.7%. An oral semaglutide 14 mg arm fell -1.28, but it was open-label and exploratory and the trial was not powered for that comparison. source
  • Embold + Eluminate (Phase 3 programme) (Ph 3, obesity / type 2 diabetes) — Six Phase 3 trials registered, five already recruiting: Embold master protocol NCT07667803 (n=4,500, started 29 Jun 2026), Eluminate-4 NCT07662135 (n=900), plus NCT07662109 (n=2,000), NCT07662213 (n=1,200) and NCT07662044 (n=800), all from 6 Jul 2026. The sixth, Eluminate-3 (NCT07664553), is registered but not yet recruiting. source
Papers
HRS-7535 / KAI-7535 (oral) —11.1% mean weight change50 wk · obesity · efficacy estimand · raw change
StagePhase 3
TargetsGLP-1 oral small-molecule GLP-1 receptor agonist
Maker
Routeoral (once daily)
Indicationsinvestigating obesity, type 2 diabetes
Efficacy11.1% weight loss at 50 wks (China Phase 3 HARBOR-1, 180 mg; 10.9% at 44 wks vs 2.5% placebo, efficacy estimand). Steep GI: vomiting up to 68.6%, nausea ~70%. source
Key trials
  • HARBOR-1 (China Phase 3, obesity) (Ph 3, obesity) — 180 mg: -10.9% at 44 wks / -11.1% at 50 wks; 120 mg: -9.5%; placebo -2.5% (efficacy estimand; treatment-policy -9.8%/-8.0% vs -2.4%). Nausea ~70%, vomiting 66.7-68.6%, diarrhea ~36% (vs placebo 16.2/4.5/15.3%); discontinuation 3.1-4.1% vs 2.7% placebo; no liver safety signal. source
  • OUTSTAND-2 (China Phase 3, type 2 diabetes) (Ph 3, type 2 diabetes) — HbA1c -1.58%/-1.50%/-1.68% at 32 wks (30/60/90 mg) vs -1.28% dapagliflozin 10 mg; no liver signal, no Grade 3 hypoglycemia. source
  • Global Phase 2 (obesity) (Ph 2, obesity) — Initiated Apr 2026 with a lower 15 mg start dose and gentler titration to blunt GI intolerability; data expected 2027. This is the Western-relevant program (the Phase 3 above is China-only). source
BI 3034701 —
StagePhase 2
TargetsGLP-1GIPNPY2 triple receptor agonist
Maker
Routeinjection (long-acting peptide; dosing interval not disclosed)
Indicationsinvestigating obesity, overweight
EfficacyNo efficacy data disclosed — none at all. Phase 1 (125 participants, completed Oct 2025) yielded only a "generally favorable safety and tolerability profile." No weight-loss figures, preclinical or clinical, have been released. source
Beyond weight loss
  • · The NPY2 pathway itself: First multi-receptor obesity agonist to include NPY2 (neuropeptide Y receptor type 2). NPY2 acts as a brake on NPY hunger signaling and slows gastric emptying — in theory blunting the body's defense against fat loss. But every standalone NPY2 agonist so far has failed: BI's own BI 1820237 was discontinued after GI adverse events, and Novo's PYY1875 (NN9748) died in Phase 2 because it "was not well tolerated." The GIP arm here is likely the tolerability play, since GIP is anti-emetic and both GLP-1 and NPY2 drive nausea and vomiting. (mechanistic rationale only; no human efficacy data for this molecule · source)
Access & priceNot yet available
Key trials
  • NCT06352437 (Phase 1 SAD/MAD) (Ph 1, healthy adults + overweight/obesity) — 125 participants; started 10 Jun 2024, completed 7 Oct 2025. BI cites a "generally favorable safety and tolerability profile" as the basis for advancing. No results posted, no efficacy disclosed. source
  • NCT07662122 (Phase 2) (Ph 2, obesity / overweight) — 300 participants; dose-finding weight-loss study. Started 30 Jun 2026, announced 16 Jul 2026. Primary completion 4 Aug 2027 — that is when the first real efficacy read arrives. source
  • NCT07693231 + NCT07708493 (Phase 1 support) (Ph 1, Japanese cohort tolerability; pharmacokinetics) — 48-participant Japanese SAD/MAD and an 8-participant PK study, both starting late Jul 2026. Standard groundwork for a global program. source

Watch list (earlier stage)

MoleculeMakerTargetsStageMean weight changeWhat's next
pemvidutide
—		glucagonGLP-1Phase 2 complete15.6%48 wk · obesity · raw changePERFORMA Phase 3 planned; no Phase 3 registered yet (2026-H2)
petrelintide
—		amylinPhase 2 complete10.7%42 wk · obesity · raw changeRegistrational Phase 3 initiation (monotherapy) expected H2 2026 per Zealand's H1 report — watch ClinicalTrials.gov for the NCT; ZUPREME-2 (NCT06926842) and the ZYNERGY combo trial (NCT07589686, est. start 30 Sep 2026) are the nearer data points
ABBV-295 (GUB014295)
—		amylinPhase 17.75%12 wk · mean BMI under 30, 88% men · raw changeAdvancing toward Phase 2 (2026)
AZD6234
—		amylinPhase 2 complete—AZD9550 + AZD6234 combination readout (2026-H2)
HM17321 (LA-UCN2)
—		Hanmi Pharmaceutical / Genentech (Roche)UCN2Phase 1—Phase 1 completion (NCT07219589); Genentech assumes development from Phase 2
PF-08642534 (YP05002)
—		Pfizer (licensed from YaoPharma)GLP-1Pre-Phase 3—First efficacy data (TBD)

These percentages are not a league table. Each is the highest-dose mean result at the approved (or trial) obesity dose, but the conditions differ — read the small print under each number. Trials vary in length (5 to 80 weeks) and in population (with or without type 2 diabetes), and the result is calculated in more than one way. Raw change is the change from baseline; placebo-adjusted subtracts the placebo group. Beyond that, sponsors report an idealised estimate of what happens if you stay on the drug — Lilly calls it the efficacy estimand, Novo the trial-product estimand — and a second figure that includes people who stopped or switched, labelled treatment-regimen or treatment-policy depending on the trial. The first will usually read higher than the second. Those two labels are not strictly interchangeable; each trial defines its own, so treat them as a family rather than one thing. Two drugs are only comparable when duration, population and calculation method all match. Diabetes brands and lower doses come in below the figure shown; see each drug's card for the per-product breakdown.

pemvidutide —15.6% mean weight change48 wk · obesity · raw change
StagePhase 2 complete
TargetsglucagonGLP-1 dual agonist
Maker
Routeinjection
Indicationsinvestigating obesity, MASH, alcohol use disorder
Efficacy15.6% mean weight loss at 48 wks (Phase 2 MOMENTUM, 2.4 mg) source
Beyond weight loss
  • ✓ MASH / liver: FDA Breakthrough Therapy Designation granted for MASH. The IMPACT Phase 2b 48-week data showed ELF and liver-stiffness improvements versus placebo, and among patients with elevated baseline values, the 1.8 mg dose cut triglycerides 23.7% and total cholesterol 15.4%. (Phase 2b IMPACT, EASL 2026 · source)
Key trials
  • MOMENTUM (Phase 2, obesity) (Ph 2, obesity) — 15.6% mean weight loss at 48 wks on 2.4 mg — still the newest obesity figure. source
  • IMPACT (Phase 2b, MASH) (Ph 2, MASH) — 48-week data at EASL 2026: ELF and liver-stiffness improvements vs placebo. Among patients with elevated baseline values, 1.8 mg cut triglycerides 23.7% and total cholesterol 15.4% — those lipid figures are a subgroup, not the whole trial. FDA Breakthrough Therapy Designation granted. source
  • RECLAIM (Phase 2, alcohol use disorder) (Ph 2, alcohol use disorder) — NCT06987513, n=100. source
petrelintide —10.7% mean weight change42 wk · obesity · raw change
StagePhase 2 complete
Targetsamylin long-acting amylin analog
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity
EfficacyUp to 10.7% mean weight loss at 42 wks vs 1.7% placebo (ZUPREME-1 Phase 2, amylin analog). Zealand's H1 2026 report (13 Aug 2026) reiterates that Zealand and Roche 'expect to initiate registrational Phase 3 trials with petrelintide monotherapy' in H2 2026 — a decision, not a start: no Phase 3 trial is registered on ClinicalTrials.gov as of 16 Aug 2026. source
ABBV-295 (GUB014295) —7.75% mean weight change12 wk · mean BMI under 30, 88% men · raw change
StagePhase 1
Targetsamylin long-acting amylin analog
Maker
Routeinjection (weekly, every-other-week and monthly in trials)
Indicationsinvestigating obesity
Efficacy7.75% to 9.79% weight loss at 12 wks vs -0.26% placebo (Phase 1 multiple-ascending-dose, 76 adults) — but read the population before comparing it to anything else here: mean BMI was under 30, so these were not adults with obesity, and 88.3% of participants were men. Well tolerated, no serious adverse events. AbbVie's first obesity asset. source
AZD6234 —
StagePhase 2 complete
Targetsamylin long-acting amylin (AMY3R) agonist
Maker
Routeinjection (weekly)
Indicationsinvestigating obesity
EfficacyPhase 2 complete, no efficacy data released. APRICUS (NCT06595238, n=262) reached primary completion 3 Dec 2025 and ASCEND (NCT06862791, n=377) on 11 May 2026, and neither has posted results. AstraZeneca now points the AZD9550 + AZD6234 combination readout to H2 2026. source
Key trials
  • APRICUS (Ph 2, obesity) — NCT06595238, n=262. Actual primary completion 3 Dec 2025. No results posted. source
  • ASCEND (AZD9550 + AZD6234 combination) (Ph 2, obesity) — NCT06862791, n=377. Actual primary completion 11 May 2026. No results posted. source
  • ARAY (Ph 2, obesity) — NCT06851858. source
PF-08642534 (YP05002) —
StagePre-Phase 3
TargetsGLP-1 oral small-molecule GLP-1 receptor agonist
MakerPfizer (licensed from YaoPharma)
Routeoral
Indicationsinvestigating obesity
EfficacyNo efficacy data published yet.
Key trials
  • Pfizer obesity pipeline (post-clearout) (Ph 1, obesity) — Licensed from China's YaoPharma for $150M upfront. After Pfizer discontinued MET-224o on 2026-08-04, this is the company's only remaining oral GLP-1. Pfizer had planned to test its GIPR antagonist PF-07976016 in combination with it; that antagonist was discontinued the same day. source
HM17321 (LA-UCN2) —
StagePhase 1
TargetsUCN2 long-acting urocortin-2 (UCN2) analog — selective CRF2 receptor agonist; non-incretin
MakerHanmi Pharmaceutical / Genentech (Roche)
Routeinjection (subcutaneous)
Indicationsinvestigating obesity
EfficacyPhase 1 only — no human efficacy data yet. The pitch is body composition, not just weight: a CRF2-pathway peptide aimed at losing fat while preserving lean mass, positioned as a possible partner drug for incretins. Genentech (Roche) licensed it worldwide except South Korea in August 2026 — $190M upfront, up to ~$2.3B with milestones — and takes over development from Phase 2. A $2.3B bet on a first-in-class mechanism is validation, but every efficacy claim so far is preclinical. source
Key trials
  • Phase 1 SAD/MAD (Ph 1, obesity) — NCT07219589. Single and multiple ascending doses, SC injection, healthy volunteers + adults with obesity; safety/tolerability/PK/PD. FDA IND cleared Nov 2025. source
The pipeline moves fast. I keep this current.
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