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Survodutide

What it is. What the evidence says.

A lab-made peptide medicine being tested by Boehringer Ingelheim. It switches on two hormone signals, glucagon and GLP-1, that affect appetite, blood sugar and how the liver handles fat.

Moderate EvidenceInvestigational

Predominant research setting. Clinical confidence is claim-specific.

Updated Scientific review pending
Start with the basics Regulatory status ↓
Sequence diagram and chemical structure information for Survodutide.
Survodutide Chemical Structure & Sequence · Inside Peptides Scientific Library
Compound
Survodutide
Human effectiveness
Phase 3 trials show greater weight loss than placebo, and a phase 2 trial showed MASH improvement; not approved and longer-term outcomes are pending
Regulatory status
Investigational Drug
START HERE · PLAIN LANGUAGE

Survodutide: the basics

What is it?

A lab-made peptide medicine being tested by Boehringer Ingelheim. It switches on two hormone signals, glucagon and GLP-1, that affect appetite, blood sugar and how the liver handles fat.

Research paper 1 ↗Research paper 2 ↗Research paper 3 ↗

What do people claim it helps with?

Weight loss, better blood sugar in type 2 diabetes, and treatment of fatty liver disease with inflammation (MASH).

What has research actually shown?

Large controlled trials found more weight loss than placebo, and a smaller trial found more improvement in MASH on liver biopsy. Results vary between people.

Research paper 1 ↗Research paper 2 ↗Research paper 3 ↗

Has this been demonstrated in people?

Phase 2 and phase 3 randomized trials in adults, paid for by the manufacturer. Liver-outcome phase 3 trials are still recruiting.

Research paper 1 ↗Research paper 2 ↗Research paper 3 ↗

What side effects, risks and unknowns should I understand?

Nausea, vomiting and diarrhoea were very common in trials, more so than with placebo. Long-term safety is still being studied.

FDA safety information 1 ↗Research paper 2 ↗

Is it an approved medicine?

No FDA-approved medicine contains survodutide. FDA has warned companies selling it illegally as a "research" chemical for people to use.

FDA safety information ↗

Approval here means U.S. FDA approval and applies to a particular product, formulation and use. This is a starting overview, not a complete side-effect list. Sources checked 10 October 2026; independent scientific review pending.

How is it used or studied?

Tested as a once-weekly injection in clinical trials. There is no approved product; online "research" vials are not the trial medicine.

Different routes and formulations can have different effects. A study of one product does not validate every product with the same peptide name.

A common misunderstanding

Survodutide is not semaglutide or tirzepatide, and it is different from mazdutide and pemvidutide even though they target similar receptors.

What should I ask a clinician?
  • What diagnosis or goal are we trying to address, and what established options are available?
  • Was the expected benefit shown in people like me, using this exact product?
  • How could my medicines, health conditions or pregnancy plans affect the risks?
  • What monitoring is needed, and what would tell us the treatment is helping or should be stopped?
What do the research words mean?
Peptide
A short chain of amino acids, the building blocks of proteins.
Preclinical
Research in cells, tissues or animals before dependable treatment evidence in people.
Controlled trial
A study comparing a treatment with another treatment or a placebo to help separate its effects from other explanations.
Biomarker
A measurement, such as a hormone level. A change does not necessarily mean someone feels better or lives longer.
THE AVAILABLE RESEARCH

Survodutide Evidence & Clinical Profile

Human Clinical Evidence

Human Study Limits

Survodutide has been investigated in clinical contexts. Patient outcomes must be evaluated against study size, design, and control cohorts.

Preclinical & Pharmacological Data

Laboratory & In Vivo Assays

Cellular and animal disease models examine receptor binding affinities and signaling cascades, which require human confirmation.

Understand our evidence labels →

IDENTITY & STRUCTURE

What is Survodutide?

Survodutide (BI 456906) is Survodutide is an investigational once-weekly injectable peptide from Boehringer Ingelheim that activates both glucagon and GLP-1 receptors. Phase 3 obesity trials and a phase 2 liver (MASH) trial have reported benefits versus placebo, but it is not FDA-approved. Aliases include: BI 456906, BI456906, glucagon/GLP-1 dual agonist.

Chemical sequence and molecular parameters of Survodutide
Primary sequence schematic · Inside Peptides Molecular Database
Chemical reference
Sequence (one-letter)
N/A
Molecular formula
C192H289N47O61
Molecular weight
4232 g/mol (PubChem computed)
CAS Number
2805997-46-8
UNII Code
2ALA66NS64
PubChem CID
171378821

Identifiers checked against PubChem and FDA's Global Substance Registration System on 13 October 2026. FDA substance record ↗ · PubChem record ↗ See all names and codes in the peptide name index.

HUMAN RESEARCH

Clinical Trials & Human Cohorts

Human research can examine tolerability, symptoms or patient outcomes. The design and comparator determine what each result can establish.

Phase 3 double-blind, placebo-controlled randomized trial; 76 weeks2026

Survodutide Once Weekly for the Treatment of Adults with Obesity [1]

n = 725Adults with obesity, or overweight with a weight-related condition, without diabetes; lifestyle counselling for all

What was reported

Mean weight change was −12.2% and −13.0% in the two survodutide groups versus −5.4% with placebo; about 72% versus 46% lost at least 5% of body weight.

What limits the conclusion

Gastrointestinal adverse events were very common (80.9% and 89.7% vs 47.9% with placebo). Funded by Boehringer Ingelheim.

Read primary source ↗ (external website)
Phase 3 double-blind, placebo-controlled randomized trial; 76 weeks2026

Survodutide Once Weekly in Adults with Obesity and Type 2 Diabetes [2]

n = 752Adults with type 2 diabetes and BMI 27 or higher

What was reported

Mean weight change was −8.2% and −9.8% versus −3.9% with placebo; HbA1c fell 0.8 to 0.9 percentage points versus 0.2 with placebo.

What limits the conclusion

Weight loss was smaller than in people without diabetes. Gastrointestinal adverse events: 72.8% and 77.7% vs 38.6%.

Read primary source ↗ (external website)
Phase 2 randomized, placebo-controlled trial with liver biopsy; 48 weeks2024

A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis [3]

n = 293Adults with biopsy-confirmed MASH and fibrosis stage F1–F3

What was reported

Improvement in MASH without worsening fibrosis occurred in 43%–62% of survodutide groups versus 14% with placebo. Fibrosis improved by at least one stage in 34%–36% versus 22% (secondary endpoint).

What limits the conclusion

Phase 2 with a 48-week treatment period; biopsy outcomes can vary. Nausea (66% vs 23%), diarrhoea and vomiting were more common than with placebo.

Read primary source ↗ (external website)
Phase 2 double-blind, placebo-controlled randomized trial; 46 weeks2024

Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a dose-finding phase 2 trial [4]

n = 386Adults with BMI 27 or higher, without diabetes, 43 centres in 12 countries

What was reported

Mean weight change ranged from −6.2% to −14.9% across survodutide doses versus −2.8% with placebo.

What limits the conclusion

Only about 60% completed the treatment period. Gastrointestinal adverse events in 75% on survodutide vs 42% on placebo.

Read primary source ↗ (external website)
MECHANISMS OF ACTION

How the compound may work

Mechanisms describe how Survodutide may affect biological processes. Laboratory findings and patient outcomes answer different questions.

01
Cell assays and mice

Glucagon plus GLP-1 receptor activation

Survodutide is an acylated peptide (it carries a fatty-acid chain that extends its half-life) that activates both glucagon and GLP-1 receptors. In mice it reduced body weight more than semaglutide by both lowering food intake and raising energy expenditure. These are animal findings. [5]

02
Human phase 2 MASH trial

Liver-directed effects

In people with biopsy-confirmed MASH, survodutide improved liver disease activity and reduced liver fat versus placebo. How much of this is a direct liver effect rather than a result of weight loss is not settled by this trial. [3]

RESEARCH AREAS

Areas Being Studied

These research topics reflect active areas of scientific exploration, distinct from unverified commercial marketing claims.

Phase 3 randomized trials

Obesity

Weight loss with and without type 2 diabetes (SYNCHRONIZE program). [1]

Phase 2 trial; phase 3 under way

MASH (fatty liver disease with inflammation)

Biopsy-based MASH and fibrosis outcomes; LIVERAGE phase 3 trials are recruiting. [9]

Phase 3 outcomes trial

Cardiovascular safety

SYNCHRONIZE-CVOT is listed as completed; results were not found in the peer-reviewed literature at the time of review. [8]

AT A GLANCE

Compare the study designs.

Overview of Key Survodutide Studies: clinical and preclinical records
Study Design / sample Outcome type Key limitation
SYNCHRONIZE-1: obesity without diabetes · 2026 [1] Phase 3 double-blind, placebo-controlled randomized trial; 76 weeks
n = 725		 Clinical endpoint evaluation Gastrointestinal adverse events were very common (80.9% and 89.7% vs 47.9% with placebo). Funded by Boehringer Ingelheim.
SYNCHRONIZE-2: obesity with type 2 diabetes · 2026 [2] Phase 3 double-blind, placebo-controlled randomized trial; 76 weeks
n = 752		 Clinical endpoint evaluation Weight loss was smaller than in people without diabetes. Gastrointestinal adverse events: 72.8% and 77.7% vs 38.6%.
Phase 2: MASH and fibrosis · 2024 [3] Phase 2 randomized, placebo-controlled trial with liver biopsy; 48 weeks
n = 293		 Clinical endpoint evaluation Phase 2 with a 48-week treatment period; biopsy outcomes can vary. Nausea (66% vs 23%), diarrhoea and vomiting were more common than with placebo.
Phase 2: obesity dose-finding · 2024 [4] Phase 2 double-blind, placebo-controlled randomized trial; 46 weeks
n = 386		 Clinical endpoint evaluation Only about 60% completed the treatment period. Gastrointestinal adverse events in 75% on survodutide vs 42% on placebo.
FDA & SAFETY

Regulatory Status & Clinical Safety

Regulatory Classification

United States, checked 11 October 2026: not FDA-approved; no record appears in Drugs@FDA or DailyMed. FDA reports it has warned companies illegally selling unapproved drugs containing survodutide that are falsely labelled "for research purposes" or "not for human consumption".

Safety Realities & Impurities

Safety depends on the molecule, formulation, route and evidence. A laboratory purity measurement alone cannot establish safety for human use.

REGISTRY CHECK

Clinical Trials Registry Records

Official registry records from ClinicalTrials.gov. Study registration does not imply government endorsement or guaranteed efficacy.

Phase 3Completed

A Study to Test Whether Survodutide (BI 456906) Helps People Living With Overweight or Obesity Who do Not Have Diabetes to Lose Weight (SYNCHRONIZE-1) [6]

Planned enrollment
726 (actual enrollment)
Posted results
Pending in registry
Sponsor
Boehringer Ingelheim
Last updated
2026-03-12
NCT06066515 · Open registry ↗ (external website)
Phase 3Completed

A Study to Test Whether Survodutide (BI 456906) Helps People Living With Overweight or Obesity Who Also Have Diabetes to Lose Weight (SYNCHRONIZE-2) [7]

Planned enrollment
755 (actual enrollment)
Posted results
Pending in registry
Sponsor
Boehringer Ingelheim
Last updated
2026-08-06
NCT06066528 · Open registry ↗ (external website)
Phase 3Completed

A Study to Test the Effect of Survodutide (BI 456906) on Cardiovascular Safety in People With Overweight or Obesity (SYNCHRONIZE - CVOT) [8]

Planned enrollment
5531 (actual enrollment)
Posted results
Pending in registry
Sponsor
Boehringer Ingelheim
Last updated
2026-09-30
NCT06077864 · Open registry ↗ (external website)
Phase 3Recruiting

LIVERAGE: A Study to Test Whether Survodutide Helps People With a Liver Disease Called NASH/MASH Who Have Moderate or Advanced Liver Fibrosis [9]

Planned enrollment
1800 (estimated enrollment)
Posted results
Pending in registry
Sponsor
Boehringer Ingelheim
Last updated
2026-10-01
NCT06632444 · Open registry ↗ (external website)
COMPETITIVE SPORT

WADA & Anti-Doping Regulations

Not Prohibited

WADA Anti-Doping Status

Survodutide is not prohibited under current World Anti-Doping Agency (WADA) regulations. However, athletes must ensure unregulated preparations or unverified vendor products do not violate Section S0 (Non-approved substances). Last verified: October 2026.

SELECTED MILESTONES

Research Timeline

  1. 2022

    Preclinical profile published

    Boehringer Ingelheim describes BI 456906 and its effects in mice. [5]

  2. 2024

    Phase 2 results

    Dose-finding obesity and MASH trials report weight loss and liver improvements versus placebo. [3]

  3. 2026

    SYNCHRONIZE-1 and -2 published

    Phase 3 trials report 76-week weight results with and without type 2 diabetes. [1]

  4. 2026

    Current status

    Not FDA-approved. FDA has warned sellers of survodutide falsely labelled as research products. [10]

OPEN QUESTIONS

What Researchers Still Don't Know

Long-term safety profiles

Multi-year observational data in broader heterogeneous cohorts remains uncharacterized.

Optimal dose-response thresholds

Comparative trials optimizing minimal effective exposure versus adverse event rates.

Formulation bioavailability

Differences between oral, subcutaneous, and modified peptide delivery vehicles.

TRACEABLE SOURCES

References

Primary sources verified against PubMed / NLM and regulatory databases.

  1. Phase 3 RCT

    Survodutide Once Weekly for the Treatment of Adults with Obesity ↗ (external website)

    le Roux CW et al. · N Engl J Med · 2026 DOI: 10.1056/NEJMoa2600751 ↗ (external website)
  2. Phase 3 RCT

    Survodutide Once Weekly in Adults with Obesity and Type 2 Diabetes ↗ (external website)

    Wharton S et al. · N Engl J Med · 2026 DOI: 10.1056/NEJMoa2607219 ↗ (external website)
  3. Phase 2 RCT

    A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis ↗ (external website)

    Sanyal AJ et al. · N Engl J Med · 2024 DOI: 10.1056/NEJMoa2401755 ↗ (external website)
  4. Phase 2 RCT

    Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial ↗ (external website)

    le Roux CW et al. · Lancet Diabetes Endocrinol · 2024 DOI: 10.1016/S2213-8587(23)00356-X ↗ (external website)
  5. Preclinical study

    BI 456906: Discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacy ↗ (external website)

    Zimmermann T et al. · Mol Metab · 2022 DOI: 10.1016/j.molmet.2022.101633 ↗ (external website)
  6. Registry Record

    A Study to Test Whether Survodutide (BI 456906) Helps People Living With Overweight or Obesity Who do Not Have Diabetes to Lose Weight (SYNCHRONIZE-1) ↗ (external website)

    ClinicalTrials.gov · 2026
  7. Registry Record

    A Study to Test Whether Survodutide (BI 456906) Helps People Living With Overweight or Obesity Who Also Have Diabetes to Lose Weight (SYNCHRONIZE-2) ↗ (external website)

    ClinicalTrials.gov · 2026
  8. Registry Record

    A Study to Test the Effect of Survodutide (BI 456906) on Cardiovascular Safety in People With Overweight or Obesity (SYNCHRONIZE - CVOT) ↗ (external website)

    ClinicalTrials.gov · 2026
  9. 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 ↗ (external website)

    ClinicalTrials.gov · 2026
  10. FDA Safety Communication

    FDA's concerns with unapproved GLP-1 drugs used for weight loss ↗ (external website)

    U.S. FDA · 2026