Survodutide
Also known as: BI 456906
A dual GLP-1 and glucagon receptor agonist developed by Boehringer Ingelheim. It has shown strong results for both weight loss and fatty liver disease (MASH), and received FDA Breakthrough Therapy designation for MASH. Phase 3 results expected in 2026.
How it works
Survodutide activates both GLP-1 and glucagon receptors. The GLP-1 action reduces appetite and improves blood sugar control. The glucagon action increases energy expenditure and promotes fat burning in the liver, which is why it shows particular promise for fatty liver disease.
Common uses
- Obesity and weight management (Phase 3 trials)
- MASH/fatty liver disease (Phase 3 trials, Breakthrough Therapy designation)
- Type 2 diabetes (Phase 3 trials)
Side effects
- Nausea (3.3x higher risk than placebo)
- Vomiting (6.6x higher risk than placebo)
- Diarrhea
- Constipation
- Dyspepsia (indigestion)
- High discontinuation rate in Phase 2 (about 25%, though Phase 3 uses slower dose escalation)
- Modest heart rate increases
Key research
- Phase 2 obesity trial showed up to 18.7% weight loss at 46 weeks
- Phase 2 MASH trial showed 83% of patients achieved improvement in liver disease vs 18% on placebo
- SYNCHRONIZE-1 and -2 Phase 3 obesity trials are fully enrolled (1,481 patients combined), results expected H1 2026
- LIVERAGE Phase 3 trial for MASH enrolling approximately 1,800 adults
Safety notes
- Not yet FDA-approved. Phase 3 trials ongoing with approval likely no earlier than 2027
- Phase 2 had a 24.6% discontinuation rate due to GI side effects, mostly from rapid dose escalation
- Phase 3 trials use slower, more gradual dose titration to reduce GI issues
- FDA granted Breakthrough Therapy designation for MASH in adults
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