Entry 0027Rev 1.0Glucagon and GLP-1 dual agonist

Survodutide

Lipidated 29-residue oxyntomodulin analogue · C192H289N47O61

Reviewed

2 Nov 2026

Scientific editor

[Name, PhD]

References

13 sources

Survodutide is a 29-residue peptide from Boehringer Ingelheim and Zealand Pharma that acts on two receptors, glucagon and GLP-1. It is built on oxyntomodulin, a gut hormone that acts on both, and carries a C18 fatty chain that lets it last a week.1,12

Phase 3 SYNCHRONIZE trials reported in 2026. At this revision it is not approved anywhere and no application has been announced.5,9

Residues

29

Avg mass

4231.7 g/mol

SYNCHRONIZE-1

Up to −16.6% at 76 wk

Licensed

Not yet

01

Identity

Value
SequenceH-His-Ac4c-Gln-Gly-Thr-Phe-Thr-Ser-Asp-Tyr-Ser-Lys-Tyr-Leu-Asp-Glu-Arg-Ala-Ala-Lys-Asp-Phe-Ile-Lys*-Trp-Leu-Glu-Ser-Ala-NH2. Ac4c is 1-aminocyclobutanecarboxylic acid12
Fatty chain*Lys24 carries a C18 diacid through γ-glutamic acid and a Gly-Gly-Ser-Gly-Ser-Gly linker12
ReceptorsGlucagon and GLP-11
DeveloperBoehringer Ingelheim, licensed from Zealand Pharma in 201111
CodeBI 456906
CAS2805997-46-812
Survodutide residue chain: 29 residues, Ac4c at position 2, and the fatty chain on lysine 24
Fig. 1. The 29-residue chain. X is Ac4c; the red residue is lysine 24, which carries the C18 diacid side chain.
02

History

  1. Zealand and Boehringer Ingelheim sign a licence for glucagon/GLP-1 dual agonists.11

  2. Discovery and preclinical paper published.1

  3. Phase 1 papers report up to 13.8% placebo-adjusted weight loss over 16 weeks.2

  4. Phase 2 in obesity (46 weeks) and in MASH (48 weeks) published.3,4

  5. SYNCHRONIZE-1 (obesity) and SYNCHRONIZE-MASLD published.5,6

  6. SYNCHRONIZE-2 (obesity with type 2 diabetes) published. No regulatory filing announced.7,9

03

What the trials measured

Phase 3 results come in two forms. The journal papers lead with the treatment-regimen estimand, which counts everyone randomised. The company figures use the efficacy estimand, which counts people only while on treatment, and are higher.5,8

TrialPeopleDurationWeight changeSource
Phase 2, obesity387 adults without diabetes46 weeks−6.2% to −14.9% across doses; placebo −2.8%. 24.6% stopped for side effects vs 3.9%[3]
Phase 2, MASH293 with fibrosis F1–F348 weeksMASH improved without worse fibrosis in 43–62% vs 14% on placebo[4]
SYNCHRONIZE-1725 adults with obesity76 weeks−12.2% and −13.0% vs −5.4% placebo; up to −16.6% by the efficacy estimand[5],[8]
SYNCHRONIZE-2752 with obesity and type 2 diabetes76 weeks−8.2% and −9.8% vs −3.9% placebo; up to −13.1% by the efficacy estimand[7],[9]
SYNCHRONIZE-MASLD216 with obesity and fatty liver48 weeksLiver fat down 30% or more in 68.5% vs 28.6%[6]

Side effects were mostly gastrointestinal and came during dose escalation. In SYNCHRONIZE-1, 19% stopped for gastrointestinal events against 2.9% on placebo.8

04

Regulatory and sport status

As of this revision.

WhereStatus
USNot approved. FDA Fast Track and Breakthrough Therapy designations for MASH.8
EUNot authorised. EMA PRIME designation for MASH.8
UKNot authorised; no filing announced.9
SportNot named on the 2026 WADA list. As an unapproved substance it falls under class S0, prohibited at all times.13
05

Open questions

  1. Heart outcomes. The SYNCHRONIZE-CVOT trial had not reported at this revision.10
  2. Tolerability. About one in five people stopped for gastrointestinal effects in phase 3; slower dose escalation is being tested.8,9
  3. How it compares with approved incretin drugs. No head-to-head trial has been published.
06

Common questions

Is survodutide approved?

No. It is investigational everywhere at this revision, and no application has been announced.

How is it different from semaglutide?

Semaglutide acts on the GLP-1 receptor only. Survodutide also acts on the glucagon receptor.

What makes it last a week?

A C18 fatty chain on lysine 24 that binds albumin in the blood.

What did the phase 3 trials show?

In SYNCHRONIZE-1, 12.2% to 13.0% weight loss at 76 weeks against 5.4% on placebo, or up to 16.6% counting only people who stayed on treatment.

Is it banned in sport?

It is not named, but as an unapproved substance it falls under WADA class S0.

—

See also

Retatrutide Entry 0005Mazdutide Entry 0028Tirzepatide Entry 0008Metabolic Shelf
07

References

  1. Zimmermann T, et al. BI 456906: discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacy. Mol Metab. 2022;66:101633. PMID 36356832
  2. Jungnik A, et al. Phase I studies of the safety, tolerability, pharmacokinetics and pharmacodynamics of the dual glucagon receptor/glucagon-like peptide-1 receptor agonist BI 456906. Diabetes Obes Metab. 2023;25(4):1011–1023. PMID 36527386
  3. le Roux CW, et al. Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. Lancet Diabetes Endocrinol. 2024;12(3):162–173. PMID 38330987
  4. Sanyal AJ, et al. A phase 2 randomized trial of survodutide in MASH and fibrosis. N Engl J Med. 2024;391(4):311–319. PMID 38847460
  5. le Roux CW, et al. Survodutide once weekly for the treatment of adults with obesity. N Engl J Med. 2026;395(8):776–787. PMID 42253238
  6. Kaplan LM, et al. Survodutide in adults with obesity and metabolic dysfunction-associated steatotic liver disease: SYNCHRONIZE-MASLD. Nat Med. 2026;32(8):2948–2958. PMID 42252333
  7. Wharton S, et al. Survodutide once weekly in adults with obesity and type 2 diabetes. N Engl J Med. 2026. doi:10.1056/NEJMoa2607219. PMID 42820639
  8. Boehringer Ingelheim. Positive data from two Phase III SYNCHRONIZE obesity trials. 7 June 2026. boehringer-ingelheim.com
  9. Boehringer Ingelheim. Survodutide achieves up to 13.1% weight loss in a new Phase III trial in people with obesity and type 2 diabetes. 1 October 2026. boehringer-ingelheim.com
  10. Kosiborod MN, et al. Survodutide for the treatment of obesity: rationale and design of the SYNCHRONIZE cardiovascular outcomes trial. JACC Heart Fail. 2024;12(12):2101–2109. PMID 39453356
  11. Zealand Pharma. Licence and collaboration agreement with Boehringer Ingelheim, 16 June 2011; and financial results for the first half of 2026, 13 August 2026. zealandpharma.com
  12. NCATS Global Substance Registration System (UNII 2ALA66NS64) and PubChem CID 171378821, checked 3 Nov 2026.
  13. World Anti-Doping Agency. The 2026 Prohibited List (in force 1 January 2026). wada-ama.org Class S0.

Peptidarium Library. Survodutide (entry 0027), revision 1.0, 2 November 2026. peptidarium.com/library/survodutide

08

Revision history

RevDateChangeBy
1.02 Nov 2026Entry created.[Scientific editor]

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