Evidence-Based Summary
There is no head-to-head trial. In SYNCHRONIZE-1 (adults with obesity without diabetes, mostly outside China, 76 weeks), survodutide groups lost 12.2% and 13.0% of body weight versus 5.4% with placebo. In GLORY-1 (Chinese adults with overweight or obesity, 48 weeks), mazdutide groups lost 11.0% and 14.0% versus a 0.3% gain with placebo. A U.S. phase 2 trial of mazdutide reported 7.3% to 18.1% at 32 weeks versus 0.9%, using an analysis that assumes people stayed on treatment. These trials differ in population, length, placebo response and statistical method, so they are not directly comparable. Survodutide has the more developed liver-disease (MASH) evidence; mazdutide has active-comparator diabetes data against dulaglutide and a Chinese approval. Neither is approved in the U.S.
Quick Comparison: Survodutide vs Mazdutide
A high-level comparison of molecule class, molecular receptor targets, FDA regulatory approvals, and verified clinical programs.
| Feature | Survodutide | Mazdutide |
|---|---|---|
| Class | Investigational dual agonist (acylated peptide) | Dual agonist; investigational in the U.S., approved in China |
| Target receptors | Glucagon and GLP-1 receptors | Glucagon and GLP-1 receptors |
| How it is given | Once-weekly injection under the skin, in trials | Once-weekly injection under the skin |
| U.S. regulatory status (October 2026) | Not FDA-approved; FDA has warned sellers of unapproved "research" survodutide | Not FDA-approved; FDA has warned sellers of unapproved "research" mazdutide. Innovent reports NMPA approval in China for weight management and type 2 diabetes (2025) |
| Strongest human evidence | Phase 3 placebo-controlled trials (SYNCHRONIZE-1, -2); phase 2 biopsy trial in MASH | Phase 3 trials in Chinese adults (GLORY-1; diabetes vs placebo and vs dulaglutide); U.S. phase 2 |
| Main safety concerns | Very frequent gastrointestinal effects (up to about 90% in one phase 3 group) | Gastrointestinal effects; 20% stopped treatment for adverse events in the highest U.S. phase 2 dose group |
| WADA status (2026 List) | Not named; as a drug with no regulatory approval it may fall under S0 (non-approved substances) | Not named; its approval in China suggests S0 may not apply, but WADA has not addressed it by name |
Same Receptor Pair, Different Molecules
GLP-1 receptor activation lowers appetite and supports insulin release. Glucagon receptor activation raises energy expenditure and increases fat burning in the liver, but can also raise blood glucose; the GLP-1 component helps offset that. Two drugs sharing a mechanism can still differ in receptor balance, half-life and tolerability.
Survodutide
Primary Target: Glucagon and GLP-1 receptors
Affinity Profile: Dual agonist; acylated (fatty-acid chain) for weekly action
In mice it reduced weight more than semaglutide by both lowering food intake and raising energy expenditure. In people with MASH it improved liver disease activity; how much is a direct liver effect versus weight loss is not settled.
Mazdutide
Primary Targets: Glucagon and GLP-1 receptors
Affinity Profile: Dual agonist
Human trials measure the combined effect on weight and glucose; published trial reports do not show how much each receptor contributes.
Not FDA-Approved; Mazdutide Approved in China
United States status checked 11 October 2026. A foreign approval does not make a drug approved or legal to market in the U.S.
Survodutide Status & Formulations
Not FDA-approved; no record appears in Drugs@FDA or DailyMed. FDA reports it has warned companies illegally selling unapproved survodutide falsely labelled "for research purposes" or "not for human consumption".
Mazdutide Status & Formulations
Not FDA-approved; no record appears in Drugs@FDA or DailyMed, and FDA reports warning companies selling unapproved mazdutide labelled "for research purposes". In China, Innovent announced NMPA approval for chronic weight management in adults (June 2025) and glycaemic control in adults with type 2 diabetes (September 2025); these come from company announcements, not a regulator page.
Critical Regulatory Distinction
Investigational status means the drug is still in regulated clinical development. Products sold online as either drug are unapproved and unverified.
SYNCHRONIZE vs GLORY
Survodutide's phase 3 trials were multinational and used a treatment-regimen estimand (counting everyone, including those who stopped). GLORY-1 enrolled Chinese adults with Chinese BMI cut-offs and used a treatment-policy estimand; the U.S. mazdutide phase 2 used an efficacy estimand (as if everyone stayed on treatment). These differences alone can shift results.
Survodutide: Clinical Evidence Overview
SYNCHRONIZE-1 (725 adults with obesity without diabetes, 76 weeks): −12.2% and −13.0% vs −5.4% with placebo; about 72% vs 46% lost at least 5%. SYNCHRONIZE-2 (752 adults with obesity and type 2 diabetes, 76 weeks): −8.2% and −9.8% vs −3.9%; HbA1c fell 0.9 and 0.8 points vs 0.2. Phase 2 MASH trial (293 adults, 48 weeks): MASH improved without fibrosis worsening in 43%–62% vs 14% with placebo. Funded by Boehringer Ingelheim.
Mazdutide: Clinical Evidence Overview
GLORY-1 (610 Chinese adults, 48 weeks): −11.0% and −14.0% vs +0.3% with placebo. Type 2 diabetes vs placebo (320 Chinese adults, 24 weeks): HbA1c −1.57 and −2.15 points vs −0.14; weight −5.6% and −7.8% vs −1.3%. Vs dulaglutide (731 Chinese adults, 28 weeks): greater HbA1c reduction (differences −0.24 and −0.30 points) and weight reduction (−3.8 and −5.8 points). U.S. phase 2 (179 adults, 32 weeks): −7.3% to −18.1% vs −0.9%. Funded by Innovent or Eli Lilly.
Curated Clinical Evidence Table
A curated selection of the primary studies behind each compound’s evidence profile. Results from different studies are not directly comparable.
| Study & Citation | Population | Comparison & Dosing | Duration | Main Endpoint | Key Finding | Methodological Limitations |
|---|---|---|---|---|---|---|
| SYNCHRONIZE-1 (le Roux et al., NEJM 2026) | 725 adults with obesity, without diabetes | Survodutide (two dose groups) vs placebo | 76 weeks | Percent change in body weight (treatment-regimen estimand) | −12.2% and −13.0% vs −5.4% with placebo. | Gastrointestinal events 80.9% and 89.7% vs 47.9%. Industry funded. |
| SYNCHRONIZE-2 (Wharton et al., NEJM 2026) | 752 adults with obesity and type 2 diabetes | Survodutide (two dose groups) vs placebo | 76 weeks | Percent change in body weight | −8.2% and −9.8% vs −3.9%; HbA1c −0.9 and −0.8 vs −0.2 points. | Smaller weight loss than without diabetes; gastrointestinal events 72.8% and 77.7% vs 38.6%. |
| Survodutide MASH phase 2 (Sanyal et al., NEJM 2024) | 293 adults with biopsy-confirmed MASH and fibrosis (F1–F3) | Survodutide (three dose groups) vs placebo | 48 weeks | MASH improvement without worsening fibrosis | 43%–62% vs 14%; fibrosis improved by at least one stage in 34%–36% vs 22%. | Phase 2; nausea 66% vs 23%. |
| GLORY-1 (Ji et al., NEJM 2025) | 610 Chinese adults with overweight or obesity | Mazdutide (two dose groups) vs placebo | 48 weeks (primary endpoint at 32 weeks) | Percent change in body weight (treatment-policy estimand) | Week 48: −11.0% and −14.0% vs +0.3% with placebo. | Chinese adults only; industry funded. |
| Mazdutide vs dulaglutide (Guo et al., Nature 2026) | 731 Chinese adults with type 2 diabetes on oral drugs | Mazdutide (two dose groups) vs dulaglutide | 28 weeks | HbA1c change | HbA1c differences −0.24 and −0.30 points; weight differences −3.8 and −5.8 points vs dulaglutide. | Short; more gastrointestinal events than dulaglutide. |
| Mazdutide U.S. phase 2 (Hsia et al., Lancet Diabetes Endocrinol 2026) | 179 U.S. adults with obesity or overweight, without type 2 diabetes | Mazdutide (three dose groups) vs placebo | 48 weeks (primary endpoint at 32 weeks) | Percent change in body weight (efficacy estimand) | −7.3% to −18.1% vs −0.9% at 32 weeks. | Small; efficacy estimand; 20% discontinued for adverse events in highest dose group. Funded by Eli Lilly. |
Gastrointestinal Effects Dominate for Both
Neither drug has an FDA label. Safety information comes from trials, and the trials differ in how quickly doses were increased, which strongly affects gastrointestinal tolerability.
No FDA label for either drug
Neither survodutide nor mazdutide has U.S. prescribing information, so there are no FDA-labelled warnings. Absence of a label is not evidence of safety. Long-term and cardiovascular safety data have not been published for either drug.
| Safety Consideration | Survodutide | Mazdutide |
|---|---|---|
| Gastrointestinal adverse events (obesity, phase 3) | SYNCHRONIZE-1: 80.9% and 89.7% vs 47.9% with placebo | GLORY-1: most frequent adverse events, mostly mild to moderate |
| Stopping treatment for adverse events | Phase 2 obesity: only about 60% completed treatment (similar in placebo) | GLORY-1: 0.5%–1.5% vs 1.0%; U.S. phase 2: 20% in highest dose group |
| Specific signals | Nausea, diarrhoea and vomiting much more common than placebo in MASH trial | Diarrhoea, decreased appetite and nausea most common in diabetes trial |
| Cardiovascular safety trial | SYNCHRONIZE-CVOT completed on the registry; results not yet published | No published cardiovascular outcomes trial found |
What Survodutide and Mazdutide Have in Common
Where the two compounds overlap in biology, evidence or regulatory context.
Same mechanism
Both activate glucagon and GLP-1 receptors with one weekly injection.
Not approved in the U.S.
Neither has FDA approval, and FDA has warned online sellers of both.
Gastrointestinal side effects
Nausea, diarrhoea and vomiting are the most common problems.
Key Scientific & Clinical Differences
Meaningful distinctions in mechanism, strength of evidence, safety and regulatory status.
Approval outside the U.S.
Mazdutide is approved in China (company-reported); the sources checked for this page show no approval for survodutide in any country.
Liver focus
Survodutide has a phase 2 biopsy trial in MASH and an ongoing phase 3 (LIVERAGE); comparable mazdutide liver data were not part of this review.
Trial populations
Mazdutide's phase 3 data are from Chinese adults; survodutide's phase 3 trials were multinational.
Scientific Comparison vs Clinical Recommendations
Inside Peptides compares scientific evidence, receptor pharmacology, and official regulatory documents to advance public and professional understanding. We do not determine which compound is appropriate for an individual patient, rank medications with arbitrary scores, or recommend initiating or switching treatments.
Decisions about any medicine require a licensed healthcare professional who can weigh personal medical history, contraindications, interactions and monitoring needs. Unapproved peptides have no established safe use, and products sold as “research chemicals” are not the preparations studied in clinical research.
Approved Uses vs Online Claims
A critical scientific distinction between verified, FDA-approved clinical uses and unverified claims circulating on social media and vendor platforms.
Mazdutide works better than survodutide
UnprovenNeither drug is FDA-approved.
Numbers from GLORY-1 and SYNCHRONIZE-1 come from different populations, trial lengths and analysis methods and are not directly comparable. No head-to-head trial exists.
Because mazdutide is approved in China, "research" mazdutide is legal and safe to use
Not supportedFDA has warned companies selling unapproved mazdutide labelled for research.
A Chinese approval applies to a regulated product in China. Online research-labelled products are unapproved in the U.S., and their contents are unverified.
Evidence Strength Across Clinical Domains
Inside Peptides evaluates scientific certainty at the claim level. Because clinical evidence varies significantly depending on the therapeutic endpoint evaluated, each domain is assessed independently.
Weight reduction
Both have positive phase 3 placebo-controlled weight trials; neither is FDA-approved.
Glucose control in type 2 diabetes
Survodutide improved HbA1c in SYNCHRONIZE-2; mazdutide beat placebo and dulaglutide in Chinese phase 3 trials.
Liver disease (MASH)
Survodutide has a phase 2 biopsy trial; no comparable mazdutide biopsy trial was reviewed here.
Survodutide vs mazdutide directly
No head-to-head trial.
What Research Still Doesn’t Tell Us
Identifying open scientific questions, pending active-comparator trials, and areas where long-term clinical data remain incomplete.
No direct comparison
No trial has compared the two dual agonists.
Cardiovascular safety
SYNCHRONIZE-CVOT is listed as completed but unpublished; mazdutide has no published outcomes trial.
Populations outside China for mazdutide
Mazdutide's phase 3 evidence is in Chinese adults; non-Chinese data are limited to a small U.S. phase 2 trial.
Liver outcomes
Survodutide's phase 3 MASH trial (LIVERAGE) is recruiting; results will clarify whether the phase 2 biopsy findings hold.
Related Compound Profiles
Individual profiles provide full molecular datasheets, CAS numbers, preclinical histories, and compound monographs.
Related Educational Resources
Scientific & Regulatory References
Every pharmacological mechanism, clinical trial result, and regulatory approval cited on this page is traceable to official FDA prescribing documentation, ClinicalTrials.gov registries, or peer-reviewed medical publications.
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Phase 3 randomized controlled trial
Survodutide Once Weekly for the Treatment of Adults with ObesitySYNCHRONIZE-1; funded by Boehringer Ingelheim.
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Phase 3 randomized controlled trial
Survodutide Once Weekly in Adults with Obesity and Type 2 Diabetes
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Phase 2 randomized controlled trial
A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis
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Phase 2 randomized controlled trial
Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial
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Preclinical study
BI 456906: Discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacyCell and mouse data.
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Phase 3 randomized controlled trial
Once-Weekly Mazdutide in Chinese Adults with Obesity or OverweightGLORY-1; funded by Innovent Biologics.
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Phase 3 randomized controlled trial
Mazdutide versus placebo in Chinese adults with type 2 diabetes
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Phase 3 randomized controlled trial · Active comparator
Mazdutide versus dulaglutide in Chinese adults with type 2 diabetes
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Phase 2 randomized controlled trial
Efficacy and safety of mazdutide in adults with obesity or overweight: a US-based, multicentre, phase 2, randomised, placebo-controlled clinical trialFunded by Eli Lilly.
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Registry record
A Study to Test the Effect of Survodutide (BI 456906) on Cardiovascular Safety in People With Overweight or Obesity (SYNCHRONIZE - CVOT)
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Registry record
LIVERAGE: A Study to Test Whether Survodutide Helps People With a Liver Disease Called NASH/MASH Who Have Moderate or Advanced Liver Fibrosis
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Company press release
Innovent Announces Mazdutide, First Dual GCG/GLP-1 Receptor Agonist, Received Approval from China's NMPA for Chronic Weight ManagementCompany source, not a regulator page.
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Company press release
Innovent Announces Mazdutide Received Approval from China's NMPA for Glycemic Control in Adults with Type 2 DiabetesCompany source, not a regulator page.
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FDA safety communication
FDA's concerns with unapproved GLP-1 drugs used for weight loss