Survodutide

clinical trials

Also known as: BI 456906

**Mechanism of Action** Survodutide (BI 456906) is a synthetic dual agonist of the glucagon receptor (GCGR) and glucagon-like peptide-1 receptor (GLP-1R). By simultaneously activating both receptors, it enhances energy expenditure via glucagon-mediated thermogenesis and lipolysis while reducing appetite and delaying gastric emptying through GLP-1 signaling. This dual mechanism aims to achieve greater weight loss and metabolic improvements than selective GLP-1 agonists alone. **Key Research Findings** Phase 2 trials demonstrated significant dose-dependent weight reduction in adults with obesity, with mean losses up to 18.7% at 46 weeks (vs. 2.0% placebo). In MASH (metabolic dysfunction-associated steatohepatitis), a Phase 2 study showed 83% of patients achieving MASH resolution without worsening fibrosis at 48 weeks (vs. 18.2% placebo). Common adverse events include gastrointestinal effects (nausea, vomiting), consistent with GLP-1 agonism. Phase 3 trials (SYNCHRONIZE program) are ongoing for obesity and MASH. **Clinical Relevance** Survodutide represents a promising next-generation incretin-based therapy for obesity and MASH, potentially offering superior efficacy over selective GLP-1 agonists. Its dual mechanism may address both weight loss and liver histology endpoints. Regulatory approval decisions await Phase 3 outcomes. For research purposes only — not medical advice.

Key data

Category
Metabolic & Weight
Molecular weight
4232 g/mol
Molecular formula
C192H289N47O61
CAS number
2805997-46-8
Administration
subcutaneous
Research status
clinical trials
References
67
Tags
glp-1, glucagon, dual-agonist

Research & studies

Survodutide Once Weekly for the Treatment of Adults with Obesity
The New England journal of medicine · 2026 · PubMed
Survodutide for treatment of obesity: Baseline characteristics of participants in a randomized, double-blind, placebo-controlled, phase 3 trial (SYNCHRONIZE™-1)
Diabetes, obesity & metabolism · 2026 · PubMed
Comparison of pharmacological therapies in metabolic dysfunction-associated steatohepatitis for fibrosis regression and MASH resolution: Systematic review and network meta-analysis
Hepatology (Baltimore, Md.) · 2025 · PubMed

Pegozafermin, cilofexor + firsocostat, and denifanstat were significantly better than placebo for fibrosis regression without MASH worsening.; Pegozafermin, survodutide, and tirzepatide were the most effective for MASH resolution without worsening fibrosis.; SUCRA rankings identified pegozafermin as top for both fibrosis regression (79.92) and MASH resolution (91.75).; Eight agents significantly improved fibrosis regression, while twelve agents significantly improved MASH resolution versus placebo.

Weight management treatment in obesity
Medicina clinica · 2025 · PubMed

GLP-1 receptor agonists (e.g., semaglutide) achieve 15-17% weight loss with a good safety profile.; Tirzepatide, a dual GLP-1/GIP agonist, achieves up to 22.5% weight loss at highest doses.; Combinations like Cagrisema and Retatrutide are expected to achieve similar weight loss ranges.; New drugs target gastroenteropancreatic hormones to improve cardiometabolic variables.

Therapeutic horizons in metabolic dysfunction-associated steatohepatitis
The Journal of clinical investigation · 2025 · PubMed

MASH is driven by obesity and type 2 diabetes, increasing risks of cirrhosis, hepatocellular carcinoma, and liver failure.; Current regulatory approval relies on histological endpoints, with growing interest in noninvasive biomarkers and personalized approaches.; Recent trials of agents like semaglutide, tirzepatide, and resmetirom show promise in resolving MASH and improving fibrosis.; Genetic variants (e.g., PNPLA3) and artificial intelligence may enhance patient stratification and trial design.

The pleiotropic effects of glucagon-like peptide-1 receptor agonists in patients with metabolic dysfunction-associated steatohepatitis: a review for gastroenterologists
Expert opinion on investigational drugs · 2025 · PubMed

GLP-1RAs and dual agonists (GLP-1/GIP or GLP-1/glucagon) show promise for treating MASLD/MASH.; Phase I-III trials demonstrate hepatic improvements: MASH resolution, liver fat reduction, and prevention of fibrosis progression.; Cardiometabolic benefits include improved glycemic control, weight loss, and better cardiovascular outcomes.; Potential benefits extend to comorbidities like obstructive sleep apnea, polycystic ovary syndrome, chronic kidney disease, and heart failure with preserved ejection fraction.

GLP-1, GIP/GLP-1, and GCGR/GLP-1 receptor agonists: Novel therapeutic agents for metabolic dysfunction-associated steatohepatitis
World journal of gastroenterology · 2024 · PubMed

GLP-1 receptor agonists (e.g., liraglutide, semaglutide) show efficacy in MASH management but with limited histological improvement of fibrosis.; Dual agonists like GLP-1/GIP RA (tirzepatide) and Glucagon/GLP-1 RA (survodutide) yield higher rates of MASH resolution and fibrosis improvement.; Gastrointestinal side effects are a major tolerability concern for these medications.; Future research should optimize drug regimens, identify responsive patients, and balance efficacy with tolerability.

Survodutide for the Treatment of Obesity: Rationale and Design of the SYNCHRONIZE Cardiovascular Outcomes Trial
JACC. Heart failure · 2024 · PubMed

Dual glucagon and GLP-1 receptor agonism may be more effective for weight loss than GLP-1 agonism alone, but cardiovascular effects are unknown.; SYNCHRONIZE-CVOT is a phase 3, event-driven, cardiovascular safety study of survodutide versus placebo.; The primary endpoint is time to first 5-point major adverse cardiovascular event composite.; This is the first trial to assess cardiovascular safety and efficacy of survodutide in people with obesity and increased cardiovascular risk.

Frequently asked questions

What is Survodutide?

**Mechanism of Action** Survodutide (BI 456906) is a synthetic dual agonist of the glucagon receptor (GCGR) and glucagon-like peptide-1 receptor (GLP-1R). By simultaneously activating both receptors, it enhances energy expenditure via glucagon-mediated thermogenesis and lipolysis while reducing appetite and delaying ga

How does Survodutide work?

Dual glucagon/GLP-1 receptor agonist in phase 3 for obesity and MASH.

What is the research status of Survodutide?

Survodutide is currently classified as clinical trials, with 67 research references on record. This is for research purposes only and is not medical advice.

What is the molecular weight of Survodutide?

Survodutide has a molecular weight of approximately 4232 g/mol (formula C192H289N47O61).

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