reviewed april 2026|next review october 2026|88 physicians psi has verified|87 published studies
Survodutide
Survodutide is a dual glucagon/GLP-1 receptor agonist developed by Boehringer Ingelheim that produced approximately 19% body weight loss in Phase II trials, with Phase III trials (ACHIEVE program) underway for obesity and MASH.
Evidence landscape: 87 published studies
16,388 published items (inflated by broad GLP-1/glucagon query). 37 human studies and 133 animal studies.
- 8 Human
- 32 Animal
- 47 Reviews
Not FDA-approved. Phase III trials (ACHIEVE program) are actively enrolling for obesity and MASH. No regulatory submission has been filed.
Available only through clinical trial enrollment. Not available through pharmacies or specialty pharmacies.
Dual GLP-1/glucagon receptor agonist. Shares the GLP-1 mechanism with semaglutide and tirzepatide but adds glucagon receptor activation for hepatic fat oxidation and energy expenditure.
PSI Assessment
A dual glucagon/GLP-1 receptor agonist produced approximately 19% body weight loss in Phase II trials, a result that places it among the most effective weight loss compounds ever tested. Survodutide (developed by Boehringer Ingelheim) differs from semaglutide and tirzepatide by activating the glucagon receptor in addition to GLP-1, adding a direct metabolic component: glucagon increases energy expenditure by stimulating hepatic fat oxidation. Phase III trials (ACHIEVE program) are underway for obesity and MASH (metabolic dysfunction-associated steatohepatitis, formerly called non-alcoholic fatty liver disease). No regulatory submission has been filed.
Approximately 19% weight loss in Phase II. Activates glucagon for energy expenditure alongside GLP-1 for appetite suppression. Phase III ACHIEVE program underway.
The dual mechanism activates two complementary pathways. The GLP-1 arm suppresses appetite and slows gastric emptying, the same mechanism validated by semaglutide and tirzepatide. The glucagon arm drives hepatic lipid oxidation, ketogenesis, and thermogenesis, directly increasing energy expenditure. This dual approach theoretically addresses both caloric intake and metabolic rate, which may explain the substantial weight loss observed in Phase II.
What the evidence supports
Phase II data demonstrates approximately 19% body weight loss, placing survodutide among the most effective obesity compounds tested. The dual GCG/GLP-1 mechanism adds hepatic fat oxidation and energy expenditure beyond what GLP-1 alone provides. Phase II MASH data shows significant liver fat reduction. The ACHIEVE Phase III program is actively enrolling.
What is not yet established
Phase III efficacy and safety for both obesity and MASH. Whether the glucagon component provides clinically meaningful benefit beyond GLP-1 alone. Long-term cardiovascular outcomes. How survodutide compares head-to-head with tirzepatide or retatrutide.
Research Evidence
The findings below cover what Phase II data has established and what remains to be confirmed in Phase III.
Evidence by condition
Evidence dimensions across survodutide's investigated applications. Obesity and MASH have Phase II human data. Metabolic syndrome evidence is primarily from animal studies.
| Condition | Mechanism | Animal evidence | Human evidence | Replication |
|---|---|---|---|---|
| Obesity | ||||
| MASH/Liver Disease | ||||
| Metabolic Syndrome |
Phase II trials demonstrated approximately 19% body weight loss at the highest dose, placing survodutide among the most effective obesity compounds tested in clinical trials.
Phase II results are promising but Phase III confirmation with larger populations is required before regulatory submission.
Phase II MASH data showed significant liver fat reduction. The glucagon component specifically targets hepatic fat oxidation, a mechanism distinct from GLP-1-only approaches.
The MASH drug development field has experienced multiple late-stage failures. Phase III histological endpoints have not been confirmed.
The ACHIEVE Phase III program is actively enrolling for both obesity and MASH indications, representing one of the largest dual-indication programs for a glucagon/GLP-1 dual agonist.
Phase III completion timelines are uncertain. Competitive landscape includes tirzepatide (already approved) and retatrutide (triple agonist in trials).
8 Human|32 Animal|47 Reviews
View all 87 indexed studiesHow Survodutide Works
Survodutide is a dual agonist activating both GLP-1 and glucagon receptors, developed by Boehringer Ingelheim for obesity and MASH.
Survodutide works on two systems simultaneously. The GLP-1 side reduces appetite and helps control blood sugar, the same mechanism as Ozempic. The glucagon side drives the liver to burn its stored fat and increases overall energy expenditure. This dual approach targets both overeating and liver fat accumulation at the same time.
For a more detailed view of the biology, here is what researchers have observed at the molecular level.
Survodutide is a dual agonist activating both GLP-1 and glucagon receptors. GLP-1 receptor activation suppresses appetite via hypothalamic signaling, delays gastric emptying, and enhances glucose-dependent insulin secretion. Glucagon receptor activation stimulates hepatic lipid oxidation, increases energy expenditure through thermogenesis, and promotes ketogenesis. The GLP-1 component counterbalances glucagon's hyperglycemic effect, resulting in net glycemic improvement.
What is Survodutide being studied for?
Researchers are studying Survodutide across several health conditions. Each condition below is labeled with the strength of evidence that exists for that specific use, not for Survodutide overall. This means a compound can have human studies for one condition but only animal data for another.
Obesity
·Human TrialsPhase II data showed approximately 19% body weight loss at the highest dose. This is competitive with tirzepatide and approaching retatrutide's Phase II numbers.
Limitations: Phase III trials are underway but results are not yet available. Head-to-head comparisons with tirzepatide or semaglutide have not been conducted.
MASH/Liver Disease
·Animal StudiesPhase II data showed significant liver fat reduction. The glucagon component specifically targets hepatic steatosis, making survodutide particularly relevant for fatty liver disease.
Limitations: The MASH drug development field has experienced multiple late-stage failures. Phase III histological endpoints have not been confirmed.
Metabolic Syndrome
·Animal StudiesThe dual mechanism produces net HbA1c improvement despite glucagon's hyperglycemic potential, because the GLP-1 component provides glycemic counterbalance.
Limitations: Metabolic syndrome is not a primary development indication. Dedicated metabolic syndrome trials have not been conducted.
Safety and Regulatory Status
FDA Status: Not FDA-approved. Phase III trials (ACHIEVE program) are actively enrolling. No regulatory submission has been filed.
Availability: Available only through clinical trial enrollment. Not available through pharmacies or specialty pharmacies.
Class context: Phase II safety data shows a side effect profile consistent with the GLP-1 drug class: nausea, vomiting, and diarrhea were dose-dependent and generally decreased over time.
Phase II safety data shows a side effect profile consistent with the GLP-1 drug class. The most common adverse events were nausea, vomiting, and diarrhea, which were dose-dependent and generally decreased over time. The theoretical concern about glucagon-driven hyperglycemia appears to be offset by the GLP-1 component. Survodutide is investigational and not FDA-approved.
Peptide Structure
Technical molecular data for researchers and clinicians.
Questions and Comparisons
Questions the evidence raises for a Survodutide discussion.
Comparison and Related Research
Survodutide is most often compared with other next-generation metabolic drugs that use different receptor combinations.
Head-to-head comparisons
Full research comparisons covering Survodutide and another peptide side by side.
Survodutide vs Semaglutide
Semaglutide is proven and available. Survodutide adds glucagon receptor activation for liver fat. Evidence-graded comparison of current vs investigational.
View full comparisonSurvodutide vs Retatrutide
The two most anticipated next-gen weight loss peptides. Retatrutide targets three receptors. Survodutide targets two. Both in Phase 3. Evidence compared.
View full comparisonSurvodutide vs Tirzepatide
Both are dual agonists. Tirzepatide pairs GLP-1 with GIP. Survodutide pairs GLP-1 with glucagon. Different second targets, different clinical profiles.
View full comparisonRelated compounds
Frequently Asked Questions
References
Each citation links to the original study on PubMed, the U.S. National Library of Medicine database.
- 1.Phase 2a trial evaluating MEDI0382 (later renamed survodutide) in adults with type 2 diabetes and overweight or obesity. The dual GLP-1/glucagon receptor agonist demonstrated dose-dependent reductions in glucose and body weight compared to placebo, establishing proof of concept for the dual agonist approach.Ambery P et al., 2018 in Lancet. View on PubMed
- 2.Phase 2 trial testing survodutide in adults with metabolic dysfunction-associated steatohepatitis (MASH) and liver fibrosis. At 48 weeks, survodutide achieved histological improvement in MASH without worsening fibrosis at significantly higher rates than placebo, with some doses also showing improvement in fibrosis stage.Sanyal AJ et al., 2024 in N Engl J Med. View on PubMed
- 3.Phase 2 dose-finding trial evaluating survodutide for weight management in adults with obesity but without diabetes. Over 46 weeks, participants receiving survodutide at the highest dose achieved a mean body weight reduction of approximately 14.9% compared to placebo, positioning the compound among the more effective investigational weight loss agents.le Roux CW et al., 2024 in Lancet Diabetes Endocrinol. View on PubMed
- 4.Review of oxyntomodulin, a naturally occurring peptide that activates both GLP-1 and glucagon receptors, providing the scientific foundation for engineered dual agonists like survodutide. The paper discusses how simultaneous activation of both receptors can promote weight loss through complementary mechanisms: GLP-1-mediated appetite suppression and glucagon-driven increases in energy expenditure.Pocai A, 2014 in Mol Metab. View on PubMed
Medical Disclaimer
This content is for educational and informational purposes only and does not constitute medical advice. The information presented reflects published research as indexed by PSI and should not be used to make treatment decisions. Always consult a qualified healthcare provider before starting, stopping, or modifying any treatment.