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Survodutide

Dual GLP-1/glucagon receptor agonist in development for metabolic diseases

Survodutide molecular structure

Overview

Survodutide (BI 456906) is an investigational dual GLP-1/glucagon receptor agonist being developed by Boehringer Ingelheim for treatment of obesity, type 2 diabetes, and metabolic dysfunction-associated steatohepatitis (MASH/NASH). The dual agonist mechanism combines GLP-1's appetite suppression and glucose-lowering effects with glucagon's ability to increase energy expenditure and promote hepatic fat oxidation. This combination addresses metabolic disease from multiple angles, potentially offering advantages over GLP-1-only agonists. Clinical trials have demonstrated significant weight loss approaching 20% of body weight in some studies, along with improvements in liver fat and markers of liver inflammation and fibrosis. The glucagon component specifically targets hepatic metabolism, making survodutide particularly relevant for fatty liver disease. Phase 3 clinical trials are ongoing for multiple metabolic indications. Survodutide represents the next generation of incretin-based therapies designed to provide comprehensive metabolic benefits beyond glucose control and weight loss.

Last reviewed: 2026-08-18

Identity & Aliases

Also known as

BI 456906Survodutide (INN)GLP-1/glucagon dual receptor agonist

Status: Phase 2 Clinical Trials - GLP-1/Glucagon dual agonist

CAS2805997-46-8
PubChem168429725

Full composition (formula, molecular weight, sequence) in Quick Facts →

Research Areas

Obesity and weight lossMetabolic dysfunction-associated steatohepatitis (MASH)Type 2 diabetesCardiometabolic disease

Available Evidence

Human

In a Phase 2 dose-finding trial in obesity, survodutide up to 4.8 mg weekly produced about 14.9% mean weight loss at 46 weeks versus about 2.8% with placebo. In a Phase 2 MASH trial, up to 83% of patients at the 4.8 mg dose achieved MASH resolution without worsening of fibrosis. Phase 3 programs in obesity and MASH are ongoing; the drug is not yet approved.

Animal

Mechanistic reviews of the dual-agonist class describe increased energy expenditure from glucagon agonism added to GLP-1 in obese rodent models, reducing body weight and liver fat beyond GLP-1 alone.

In Vitro

Survodutide is a balanced peptide dual agonist at the GLP-1 and glucagon (GCG) receptors.

Uncertain

Long-term cardiovascular outcomes, effects on hard MASH endpoints (cirrhosis, mortality), and Phase 3 efficacy and safety results are still pending.

Key Studies & Findings

2 studies

Benefits & Effects

4 documented

Metabolic health support

anecdotal

Enhanced fat burning

anecdotal

Appetite control

anecdotal

Advanced weight loss

anecdotal

Side Effects & Safety

9 reported

Nausea

MildUncommon

Diarrhea

MildUncommon

Constipation

MildUncommon

Appetite loss

MildUncommon

Rare pancreatitis

SevereRare

Mild-Moderate side effect

Mild-ModerateVery common (55-75%) Reversible

Onset: Days

Management: Slower dose escalation

Dose-dependent

GI events

ModerateCommon Reversible

Onset: within days

Nausea

MildCommon Reversible

Onset: within days

Diarrhea

MildCommon Reversible

Onset: within days

Limitations & Open Questions

Evidence is Phase 2 only; Phase 3 results are pending; gastrointestinal tolerability mirrors other incretin drugs; no approved indication yet; long-term safety (pancreatic, thyroid, cardiovascular) remains under study.

Pharmacology

Survodutide (BI 456906) is an investigational once-weekly subcutaneous dual GLP-1/glucagon receptor agonist designed to combine glucagon-mediated energy expenditure with GLP-1-mediated appetite suppression; Phase 2 doses ranged up to 4.8 mg weekly.

Reported Research Dosing

Reported values from research literature and community protocols. Educational reference only — not a dosing recommendation or medical advice.

Under clinical investigation, consult healthcare provider

Half-life: ~1 week

Research Protocols

Obesity - Conservative Start

Dose
0.6mg titrated over 24 weeks
Frequency
Once weekly with 4-week intervals
Route
Subcutaneous

Obesity - Standard Protocol

Dose
3.6-6.0mg
Frequency
Once weekly
Route
Subcutaneous (abdomen/thigh)

MASH Treatment

Dose
2.4-4.8mg
Frequency
Once weekly
Route
Subcutaneous

Type 2 Diabetes

Dose
0.3-2.7mg
Frequency
Once weekly
Route
Subcutaneous

Research protocols are for educational purposes only. Always consult qualified medical professionals.

Frequently Asked Questions

Is survodutide approved?

No. It is an investigational drug (Boehringer Ingelheim) with positive Phase 2 results in obesity and MASH; Phase 3 trials are ongoing.

How does survodutide differ from semaglutide?

Survodutide activates both the GLP-1 and glucagon receptors (a dual agonist), adding a glucagon-mediated energy-expenditure component, whereas semaglutide activates GLP-1 only.

Research Citations

1
Diabetes Mellitus and Chronic Kidney Disease: The Future Is Being Surpassed.

Alberto Martínez-Castelao, José Luis Górriz, Beatriz Fernández-Fernández, María José Soler, Juan F Navarro-González (2025)

2
Harnessing GLP-1 Receptor Agonists for Obesity Treatment: Prospects and Obstacles on the Horizon.

Riad Mohammed Abdelrahman, Taha Hussein Musa, Ismail Adam Arbab, Mohsen Hussein Suliman, Eltieb Omer Ahmed (2025)

4
A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis.

Sanyal AJ, Bedossa P, Fraessdorf M, Neff GW, Lawitz E, Bugianesi E, Anstee QM, Hussain SA, Newsome PN, Ratziu V, Hosseini-Tabatabaei A, Schattenberg JM, Noureddin M, Alkhouri N, Younes R, 1404-0043 Trial Investigators (2024)

+ 22 more citations

Related Resources

Quick Facts

Formula

C192H289N47O61

Molecular Weight

4.5

Sequence

MKSIYFVAGLFVMLVQGSWQRSLQDTEEKSRSFSASQADPLSDPDQMNEDKRHSQGTFTSDYSKYLDSRRAQDFVQWLMNTKRNRNNIAKRHDEFERHAEGTFTSDVSSYLEGQAAKEFIAWLVKGRGRRDFPEEVAIVEELGRRHADGSFSDEMNTILDNLAARDFINWLIQTKITDRK

Mechanism

Dual agonist targeting GLP-1 and glucagon receptors for synergistic effects

Safety Information

Investigational drug in clinical trials. Not approved for use outside of clinical studies.

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