Survodutide
An investigational dual glucagon/GLP-1 receptor agonist developed by Boehringer Ingelheim and Zealand Pharma. Not FDA-approved. Phase 2 trials showed up to 14.9% weight loss at 46 weeks and significant MASH resolution — Phase 3 SYNCHRONIZE program is underway.
What is Survodutide?
Survodutide is an investigational dual glucagon receptor (GCGR) and GLP-1 receptor (GLP-1R) agonist co-developed by Boehringer Ingelheim and Zealand Pharma. It is derived from the natural gut hormone oxyntomodulin and activates both the glucagon and GLP-1 receptors. It is not FDA-approved and is currently in Phase 3 clinical development (the SYNCHRONIZE program). Phase 2 trials showed up to 14.9% mean weight loss at 46 weeks (up to 18.7% in completers at the highest dose), and a separate Phase 2 NEJM trial demonstrated MASH resolution in up to 62% of patients with liver fibrosis. Three Phase 3 trials — SYNCHRONIZE-1 (obesity without T2D), SYNCHRONIZE-2 (obesity with T2D), and SYNCHRONIZE-CVOT (cardiovascular outcomes) — are underway, with results expected in 2026-2027 and potential FDA approval in 2027-2028.
Why People Talk About It
Dual-target weight loss via glucagon + GLP-1 (up to ~19% in completers)
EmergingMASH/liver fibrosis resolution (62% in Phase 2)
EmergingGlucagon component may boost energy expenditure beyond GLP-1-only drugs
EmergingHow It Works
Survodutide activates two hormone receptors simultaneously: GLP-1 receptors reduce appetite and slow gastric emptying, while glucagon receptors tell your liver to burn more fat and increase overall energy expenditure. This two-pronged approach produces both weight loss and direct liver fat reduction.
Common Questions
Safety Information
Common Side Effects
Cautions
- • Not yet FDA-approved
- • Phase 3 data still pending
- • Gastrointestinal side effects led to discontinuation in ~25% of participants in Phase 2
- • Glucagon component may affect blood sugar regulation differently than GLP-1-only drugs
- • Long-term safety unknown
What We Don't Know
Phase 3 efficacy and safety results, cardiovascular outcomes, long-term tolerability, and optimal dosing are still being determined. The higher GI discontinuation rate relative to some GLP-1-only drugs needs monitoring in Phase 3.
Published Research
11 studiesBaseline characteristics in the SYNCHRONIZE-2 randomized phase 3 trial of survodutide, a glucagon receptor/GLP-1 receptor dual agonist, for obesity in people with type 2 diabetes
Survodutide for treatment of obesity: Baseline characteristics of participants in a randomized, double-blind, placebo-controlled, phase 3 trial (SYNCHRONIZE-1)
Efficacy and safety of survodutide on glycemic control and weight loss in adults: A systematic review and meta-analysis
Meta-analysis of 6 RCTs (n=1,272) confirming survodutide significantly reduces HbA1c, fasting glucagon, and body weight compared to placebo, with higher doses (>2.4mg/week) and longer treatment (>16 weeks) producing greater effects.
Subgroup analysis by sex and baseline BMI in people with a BMI ≥27 kg/m2 in the phase 2 trial of survodutide, a glucagon/GLP-1 receptor dual agonist
Survodutide, a glucagon receptor/glucagon-like peptide-1 receptor dual agonist, improves blood pressure in adults with obesity: A post hoc analysis from a randomized, placebo-controlled, dose-finding, phase 2 trial
Survodutide for treatment of obesity: rationale and design of two randomized phase 3 clinical trials (SYNCHRONIZE-1 and -2)
Phase 3 trial design paper describing SYNCHRONIZE-1 (n=726, obesity without T2D) and SYNCHRONIZE-2 (n=755, obesity with T2D), testing survodutide up to 3.6mg and 6.0mg weekly over 76 weeks.
Survodutide for the Treatment of Obesity: Rationale and Design of the SYNCHRONIZE Cardiovascular Outcomes Trial
Efficacy, tolerability and pharmacokinetics of survodutide, a glucagon/glucagon-like peptide-1 receptor dual agonist, in cirrhosis
A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis
Pivotal Phase 2 NEJM trial (n=293) demonstrating survodutide achieved MASH resolution without fibrosis worsening in 62% of participants at 4.8mg (vs. 14% placebo), with liver fat reduction of at least 30% in 67%, and fibrosis improvement in 36% at 48 weeks.
The dual GCGR/GLP-1R agonist survodutide: Biomarkers and pharmacological profiling for clinical candidate selection
Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial
Landmark Phase 2 dose-finding trial (n=387) in Lancet Diabetes Endocrinol showing survodutide achieved up to 14.9% mean weight loss at 46 weeks (4.8mg dose), with completers reaching 18.7%. Over 82% of the highest-dose group lost at least 5% body weight.
Related Peptides
Semaglutide
StrongBeginnerA GLP-1 receptor agonist FDA-approved for type 2 diabetes and chronic weight management, one of the most widely prescribed peptide drugs.
Tirzepatide
StrongBeginnerA dual GIP/GLP-1 receptor agonist FDA-approved for diabetes and weight management, producing the largest weight loss seen in clinical trials.
Retatrutide
EmergingAn investigational triple agonist (GIP/GLP-1/glucagon) from Eli Lilly. Not FDA-approved. Phase III TRIUMPH-4 results showed 23.7% weight loss — the most of any obesity drug in development.
Glucagon
StrongBeginnerA naturally occurring peptide hormone that raises blood sugar, FDA-approved as emergency treatment for severe hypoglycemia.
Liraglutide
StrongBeginnerA GLP-1 receptor agonist FDA-approved for diabetes (Victoza) and weight management (Saxenda), the predecessor to semaglutide.
Quick Facts
- Class
- Dual Glucagon/GLP-1 Receptor Agonist
- Evidence
- Emerging
- Safety
- Moderate Data
- Updated
- Apr 2026
- Citations
- 11PubMed
Also known as
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Evidence Score
Clinical Trials
View Clinical TrialsLinks to ClinicalTrials.gov for reference. Listing does not imply endorsement.