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Survodutide (Dual GLP-1/Glucagon Receptor Agonist)
Also known as: BI 456906, BI-456906
Confidence
Updated 2026-03-20
Survodutide is a dual glucagon/GLP-1 receptor agonist developed by Boehringer Ingelheim in partnership with Zealand Pharma. It is unique among the incretin-based pipeline for its glucagon receptor agonism, which promotes hepatic fat oxidation and energy expenditure, making it particularly promising for metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH) in addition to obesity.
Class
Dual GLP-1/Glucagon Receptor Agonist
Routes
Subcutaneous
Half-Life
~6–7 days (enabling once-weekly dosing)
Survodutide activates both GLP-1 and glucagon receptors. GLP-1 receptor activation provides appetite suppression, insulin secretion, and gastric emptying delay. Glucagon receptor activation increases hepatic fat oxidation, energy expenditure, and amino acid catabolism. This dual mechanism targets both weight loss and direct liver fat reduction, distinguishing it from pure GLP-1 agonists. The glucagon component drives hepatic lipid mobilization, which is particularly relevant for MASH/NASH.
Half-Life
~6–7 days (enabling once-weekly dosing)
Bioavailability
Subcutaneous: estimated ~70–80%
No approved indications. Clinical development targets: MASH/NASH (primary), obesity/overweight, type 2 diabetes. Potential for liver fibrosis improvement.
Phase II trial (Lancet, 2024): survodutide demonstrated up to 18.7% weight loss at 46 weeks. In MASH patients, up to 83% achieved MASH resolution without worsening fibrosis (Phase II). SYNCHRONIZE-1 Phase III trial for MASH is ongoing with results expected 2026. Phase II obesity data showed dose-dependent weight loss comparable to high-dose semaglutide. The glucagon component appears to provide additive liver fat reduction beyond what GLP-1 alone achieves.
Human Studies
8
Animal Studies
15
GI adverse effects similar to GLP-1 class (nausea, vomiting, diarrhea). Glucagon component raises theoretical concerns about blood glucose elevation, though clinical data shows net glucose improvement due to GLP-1 counterbalance. Increased heart rate observed (class effect). Transient transaminase elevations in some patients (likely related to hepatic fat mobilization). Standard incretin class warnings apply.
Phase III (SYNCHRONIZE program) ongoing. Boehringer Ingelheim/Zealand Pharma partnership. MASH indication may provide accelerated regulatory pathway given unmet need. No FDA filing as of March 2026. If liver data confirms Phase II results, could be first dual agonist approved for MASH.
Drug Interactions: Similar to GLP-1 class — caution with insulin, sulfonylureas. Glucagon receptor activation may affect hepatic drug metabolism (theoretical). Warfarin monitoring recommended. Monitoring: Weight, A1C, liver function tests (ALT, AST), hepatic steatosis imaging (MRI-PDFF), lipid panel, heart rate. Research Gaps: Phase III MASH outcomes pending. Long-term liver fibrosis regression data needed. Cardiovascular outcomes trial not yet initiated. Optimal glucagon/GLP-1 ratio for different indications.
Subcutaneous
Common Range
0.3 mg → 4.8 mg (Phase II dose range; Phase III doses may differ)
Timing
Once weekly
Frequency
Weekly
Cycling
Dose escalation over 16–20 weeks to target maintenance dose
Important Note
Dose escalation critical to minimize GI side effects. Phase III dosing may differ from Phase II. Not commercially available — clinical trial access only.
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Triple Incretin Receptor Agonist (GLP-1/GIP/Glucagon)
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Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always consult with a licensed healthcare provider before starting, stopping, or modifying any peptide therapy. PeptideSupplierMatch does not prescribe, sell, or distribute peptides.
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