Survodutide

TL;DR

- Survodutide (research code BI 456906) is an investigational once-weekly injectable that activates both the GLP-1 receptor and the glucagon receptor. It is in phase 3 development and is not an approved medicine. - In a phase 2 obesity trial, adults on the top maintenance dose lost up to about 14.9 percent of body weight at 46 weeks (le Roux et al., 2024, Lancet Diabetes & Endocrinology, PMID 38330987). - In a phase 2 trial for MASH, a fatty liver disease, survodutide was linked to disease improvement without worsening of fibrosis versus placebo, seen in up to 62 percent of a dose group against 14 percent on placebo (Sanyal et al., 2024, NEJM, NEJMoa2401755). - Its dual design sits between tirzepatide (GIP plus GLP-1, up to about 22.5 percent; Jastreboff et al., 2022) and retatrutide (GIP plus GLP-1 plus glucagon, up to about 24.2 percent; Jastreboff et al., 2023). - Gastrointestinal effects, mainly nausea, were the most commonly reported side effects (le Roux et al., 2024). Dose selection belongs to a qualified clinician, not this page.

What is survodutide?

Survodutide is an investigational peptide, coded BI 456906 in early research, that acts as a dual agonist at both the GLP-1 receptor and the glucagon receptor. It was developed as a once-weekly subcutaneous injection and studied for weight management and metabolic liver disease. As of the most recent published trials, it remains in phase 3 development and has not been approved as a medicine (le Roux et al., 2024, PMID 38330987).

How does survodutide work?

Survodutide is a single molecule that switches on two receptors at once: the GLP-1 receptor, which lowers appetite and slows stomach emptying, and the glucagon receptor, which research links to higher energy expenditure and lower liver fat. Single-target GLP-1 agonists such as semaglutide produced about 15 percent mean weight loss in their trials (Wilding et al., 2021), and the design idea behind survodutide is that adding the glucagon arm may act on energy use and the liver as well as appetite. In its phase 2 obesity trial, the highest survodutide dose reached up to about 14.9 percent weight loss at 46 weeks (le Roux et al., 2024, PMID 38330987).

What does research report on survodutide for weight loss?

In a phase 2 randomized, placebo-controlled trial, adults with overweight or obesity on the highest survodutide maintenance dose lost up to about 14.9 percent of body weight at 46 weeks, far more than placebo (le Roux et al., 2024, PMID 38330987). The trial used a slow dose escalation over several months before reaching maintenance doses that ranged from 0.6 mg up to 4.8 mg once weekly, and larger doses were associated with larger average weight reductions. These are phase 2 findings, and phase 3 trials are the stage that would confirm longer-term results.

What does research report on survodutide for liver disease?

In a phase 2 trial in adults with MASH, a significantly larger share of survodutide participants had improvement in the disease without worsening of fibrosis than those on placebo: 62 percent in the top-performing 4.8 mg group versus 14 percent on placebo (Sanyal et al., 2024, NEJM, NEJMoa2401755). MASH stands for metabolic dysfunction associated steatohepatitis, formerly called NASH, and it involves fat, inflammation, and scarring in the liver. The glucagon arm of survodutide is the reason researchers are testing it here, since glucagon receptor activation is associated with reduced liver fat. Confirmation in phase 3 is still pending.

What doses of survodutide were used in the trials?

Published phase 2 trials used a stepwise dose escalation with a once-weekly subcutaneous injection, and the obesity trial studied maintenance doses up to 4.8 mg (le Roux et al., 2024, PMID 38330987).

These figures describe what the trials reported. They are not a dosing recommendation. Any decision about a specific dose, schedule, or eligibility belongs to a qualified clinician.

How does survodutide compare with retatrutide and tirzepatide?

All three are multi-receptor metabolic agonists, but they target different receptor sets and have posted different peak weight-loss numbers in their trials.

These numbers come from separate trials with different designs and populations, so they are not a head-to-head comparison. They show where each compound landed in its own study, not a guaranteed result for any person.

What side effects did survodutide research report?

The most common side effects in survodutide trials were gastrointestinal, especially nausea and vomiting, matching the known profile of the GLP-1 receptor class (le Roux et al., 2024, PMID 38330987). The trials used slow dose escalation, an approach the field uses to limit these effects. Because survodutide also activates the glucagon receptor, trials monitored measures such as glucose and heart rate, and the full safety picture is still being characterized in phase 3.

Is survodutide approved or available?

No, survodutide is investigational and in phase 3 trials, so it has not been approved as a medicine, and any material is intended for laboratory research use only. It is not a treatment you can be prescribed as an approved product at this stage, and published data remain limited to phase 2 for both obesity and MASH (le Roux et al., 2024; Sanyal et al., 2024, NEJMoa2401755).