GLP-1s & incretins · Metabolic & endocrine

Zenagamtide

An investigational single-molecule GLP-1 and amylin receptor co-agonist now in Phase 3 obesity trials.

L3Early human studiesIn clinical trialsIn clinical developmentLow confidence in ratingLast reviewed 2026-09-06

SC injectionOral

How settled this rating is:: low confidence in the current evidence rating
Routes studied:: Subcutaneous injection, Oral
Also known as:: amycretin, GLP-1/amylin co-agonist, unimolecular co-agonist
Last reviewed:: 2026-09-06

Also known as: amycretin, GLP-1/amylin co-agonist, unimolecular co-agonist

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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): L3Early human studies
How settled this rating is: Low confidence in rating
Human efficacy evidence: 45 of 100 evidence strength
Human safety evidence: 25 of 100 evidence strength
Regulatory status: In clinical trials
Development: In clinical development
Routes: SC injectionOral
Evidence base: Includes human studies
Furthest stage: Phase III
Source curation: Sources fully curated
How far human research has progressed: Phase 2 data reported by the sponsor; Phase 3 programme started 2026

Overview

Human efficacy evidence strength45 of 100 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 (animal / lab) evidence strength70 of 100 evidence strength

Higher = more animal, tissue or cell research. Preclinical results are a starting point, not proof of a human benefit.

Human safety evidence strength25 of 100 evidence strength

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 2 data reported by the sponsor; Phase 3 programme started 2026

Routes & formulations

Studied / approved routes

SC injectionOral

Both subcutaneous and oral formulations have been studied. Results from one formulation do not transfer to the other, and dose-finding differs between them.

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

In clinical development

Active development. Phase 3 obesity trials started in early 2026; the diabetes Phase 3 programme was described as planned for the second half of 2026.

Last documented development: 2026 — Phase 3 obesity programme under way

What it is

A single engineered peptide designed to activate both the GLP-1 receptor and the amylin pathway, combining two separate satiety mechanisms in one molecule instead of two injections.

What people claim

Larger weight loss than GLP-1 therapy alone
Improved blood glucose control
Two satiety pathways in one molecule

What the evidence actually says

Sponsor-reported Phase 2 results in type 2 diabetes described weight reduction of up to roughly 14.6% and substantial HbA1c reduction at 36 weeks with the subcutaneous formulation. That is company topline reporting from a mid-stage trial, not settled peer-reviewed evidence, and the Phase 3 programme that would test it properly has only just begun. Promising, unfinished.

Useful next reads based on this compound — not recommendations.

Human evidence

Sponsor-reported Phase 2 subcutaneous data in type 2 diabetes: up to about 14.6% weight loss and strong HbA1c reduction at 36 weeks.
Phase 3 obesity programme (AMAZE) initiated in Q1 2026; Phase 3 type 2 diabetes programme (AMBITION) described as planned for H2 2026.

Preclinical evidence

Amylin and GLP-1 co-agonist pharmacology underpinning the single-molecule design.

Animal and cell findings are Level 1–2 evidence.

Mechanism and pathways

GLP-1 receptor agonism reduces appetite and improves glucose-dependent insulin release.
Amylin-pathway signalling in the hindbrain reduces meal size through a separate route.

Safety and unknowns

Gastrointestinal effects consistent with incretin and amylin pharmacology have been reported in trials.
No long-term safety dataset exists — the Phase 3 programme is what will generate one.

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

No demonstrated human cancer signal. Class-level precautionary considerations from incretin pharmacology apply and remain under trial surveillance.

Regulatory status

Not approved anywhere. Formerly known as amycretin. The obesity Phase 3 programme (AMAZE) began in the first quarter of 2026 and a type 2 diabetes Phase 3 programme (AMBITION) is planned for the second half of 2026. Nothing sold under either name is a licensed medicine.

Evidence grade

L3Early human studiesLow confidence in rating

Small, short or uncontrolled studies in people. A hint worth following up, not a conclusion you can rely on.

What would change our rating?

Peer-reviewed publication of the Phase 2 results in full.
Completed Phase 3 readouts with safety datasets.

References and sources

Sources fully curated

Sponsor / officialNovo Nordisk — company announcement on the zenagamtide (amycretin) Phase 3 programme
Sponsor / officialNovo Nordisk Annual Report 2025 — innovation and therapeutic focus (pipeline status)

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.