PeptideInjectableGLP-1 receptor agonistGlucagon receptor agonistDual agonist

Survodutide

Also known as BI 456906 · SAR441255

Written by enwyReviewed 15 Jul 20261 sources0 comments

Survodutide is an investigational dual GLP-1 and glucagon receptor agonist developed by Boehringer Ingelheim and Zealand Pharma for obesity and metabolic dysfunction-associated steatohepatitis (MASH). Phase II trials show strong weight loss and improvement in liver disease, adding glucagon-driven energy expenditure to GLP-1 effects.

01 Overview

Survodutide is a once-weekly injectable peptide that agonises both the GLP-1 receptor and the glucagon receptor. The GLP-1 arm drives appetite suppression and glucose control, while glucagon receptor activation is intended to increase energy expenditure and improve hepatic fat handling.

In Phase II obesity trials, survodutide produced substantial weight loss, and a dedicated MASH trial showed significant improvement in liver histology. It remains investigational, with Phase III programmes ongoing. As a dual agonist it has a meaningful but still-maturing human evidence base and a GI-dominant side-effect profile.

02 Mechanism

Dual agonist of the GLP-1 and glucagon receptors: GLP-1 activity suppresses appetite and improves glucose handling, while glucagon receptor agonism increases energy expenditure and reduces hepatic fat.

03 Dosing

Tier	Dose	Route	Notes
Trial range	0.6–6 mg/wk	SubQ	Titrated weekly doses studied in Phase II obesity and MASH trials.

04 Effects

Effect	Magnitude	Evidence
Weight lossSubstantial weight reduction over months in Phase II obesity trials.	~10-19% body weight	Clinical
Improved liver histology (MASH)Significant improvement in MASH on liver biopsy in a Phase II trial.		Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Increased heart rateModest rise in resting heart rate, partly from glucagon receptor activity.	Mild	Common	Clinical
Nausea and GI upsetNausea, vomiting, and diarrhoea, especially during titration.	Moderate	Very common	Clinical
Pancreatitis (class signal)Rare pancreatitis is a class-level concern for incretin agonists.	Severe	Rare	Clinical

06 Legal status

United States

Investigational

Investigational drug; not yet approved as of review. · as of Jan 2026

07 References

Survodutide, a dual GLP-1/glucagon receptor agonist, in MASH: a Phase II trialNew England Journal of Medicine, 2024

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.