GLP-1s & incretins · Metabolic & endocrine
Survodutide
An investigational glucagon and GLP-1 dual agonist with a published Phase 3 obesity result.
- How settled this rating is:
- moderate confidence in the current evidence rating
- Routes studied:
- Subcutaneous injection
- Also known as:
- BI 456906, glucagon/GLP-1 dual agonist
- Last reviewed:
- 2026-09-06
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Evidence passport
Last reviewed 2026-09-06
A one-screen summary of what is known about this compound. Every field describes the evidence and legal status — not how safe or effective it is, and not a recommendation. The 0-100 figures are evidence-strength ratings, not percentages.
- Evidence level (type of study, not a quality rating)
- L4Good human trials
- How settled this rating is
- Moderate confidence in rating
- Human efficacy evidence
- 62 of 100 evidence strength
- Human safety evidence
- 35 of 100 evidence strength
- Regulatory status
- In clinical trials
- Development
- In clinical development
- Routes
- SC injection
- Evidence base
- Includes human studies
- Furthest stage
- Phase III
- Source curation
- Sources fully curated
- How far human research has progressed
- Phase 3 trial published in a peer-reviewed journal; not approved
Overview
Higher = more and better-quality human evidence. It does not mean the effect is bigger or that the compound works for you.
Higher = more animal, tissue or cell research. Preclinical results are a starting point, not proof of a human benefit.
Higher = more mature, better-documented human safety data. It does not mean the compound is safer than one with a lower number.
How to read these scores
Every number here rates the evidence, not the compound. They are editorial 0-100 strength ratings, not percentages, and not a rating out of five stars.
- Human efficacy evidence strength — Higher = more and better-quality human evidence. It does not mean the effect is bigger or that the compound works for you.
- Preclinical evidence strength — Higher = more animal, tissue or cell research. Preclinical results are a starting point, not proof of a human benefit.
- Human safety evidence strength — Higher = more mature, better-documented human safety data. It does not mean the compound is safer than one with a lower number. A score of 80 does not mean “80% safe”.
- Evidence level (L0-L5) — the strongest type of study behind the compound, from anecdote (L0) to large replicated human trials (L5). It is a description of the study evidence, not a quality, safety or recommendation rating.
- Confidence — how likely we think it is that this rating changes as new research lands. Low confidence means the picture is unsettled, not that the compound is bad.
None of these ratings is medical advice, a safety guarantee, or a recommendation to use anything. How we grade evidence.
How far human research has progressed: Phase 3 trial published in a peer-reviewed journal; not approved
Routes & formulations
Studied / approved routes
Route availability is not evidence of efficacy, and evidence from one route does not transfer to another. The Registry never provides dosing or sourcing information.
Peptide lifecycle
Discovery
Preclinical
Phase I
Phase II
Phase III
Furthest established stage
Approved
Active Phase 3 development. Peer-reviewed publication of SYNCHRONIZE-1 in 2026 puts its evidence base ahead of most pipeline compounds; approval status is unchanged.
Last documented development: 2026 — Phase 3 SYNCHRONIZE-1 published
What it is
A peptide that activates both the GLP-1 and glucagon receptors, pairing appetite suppression with glucagon-driven energy expenditure and hepatic fat mobilisation.
What people claim
- Substantial weight reduction
- Liver fat reduction
What the evidence actually says
This is one of the few pipeline compounds here whose pivotal result has been through peer review: SYNCHRONIZE-1 reported significantly greater weight reduction than placebo. That is meaningful evidence of effect. It is still not an approved medicine, and long-term safety and outcome data remain incomplete — read the paper rather than the press release for effect sizes.
Related evidence
Useful next reads based on this compound — not recommendations.
- Related compound
Eloralintide
An investigational selective amylin-pathway agonist now in a broad Phase 3 programme.
- Compare
Survodutide vs Eloralintide
Same questions, same fields, side by side — including how much human evidence exists.
- Context
GLP-1 Centre
How the incretin medicines compare on trial evidence and where they are actually licensed.
- Context
Safety Centre
What approved, investigational and unapproved actually mean for documented human safety.
Human evidence
- Phase 3 SYNCHRONIZE-1 randomised placebo-controlled trial, published in the New England Journal of Medicine (2026), reporting significantly greater weight reduction than placebo.
- Earlier randomised Phase 2 work in obesity and metabolic liver disease.
Preclinical evidence
- Dual glucagon/GLP-1 agonist pharmacology in rodent metabolic models.
Animal and cell findings are Level 1–2 evidence.
Mechanism and pathways
- GLP-1 receptor agonism reduces appetite and improves glycaemic handling.
- Glucagon receptor agonism increases energy expenditure and mobilises hepatic fat.
Safety and unknowns
- Gastrointestinal effects typical of the class, dose-related.
- Glucagon-related effects, including heart-rate changes, require monitoring in trials.
- Long-term safety is not established.
Cancer relevance
This section covers questions raised by how the compound works in the body, plus anything regulators and trial teams keep an eye on. It is not a statement that this compound causes cancer — for most compounds here, no human data exist in either direction.
Monitored in trials; not demonstrated in humans
Regulatory status
Not approved anywhere. Phase 3 development is under way; the SYNCHRONIZE-1 trial was published in the New England Journal of Medicine in 2026.
Evidence grade
Proper controlled trials in people, but not yet repeated or settled. The effect looks real; long-term safety or approval questions may remain open.
What would change our rating?
- Publication of the remaining Phase 3 programme with full safety data.
- A regulatory decision in a major region.
References and sources
Source hierarchy: regulatory documents and trial registries first, peer-reviewed work next, sponsor material flagged as non-independent. We never use supplier or clinic marketing as evidence, and where a verified source has not yet been curated we say so rather than inventing one.
Evidence change history
These entries record changes to our assessment of the published evidence — not changes to the compound itself.
No recorded changes yet. Baseline position set on 2026-09-06.