Evidence reference only. Not medical advice, not a dosing guide, and not a recommendation to use any drug.
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Investigational and unapproved. Findings below describe what trials and reports have observed. Nothing here is an endorsement, a claim of safety or effectiveness, or a clinical recommendation.

Survodutide

INVESTIGATIONAL

Glucagon and GLP-1 receptor dual agonist

14
graded results
0
ongoing records
10
effect domains
Evidence spread
High evidence 0Moderate evidence 9Low evidence 2Very low evidence 3

Survodutide is investigational in the scoped programme below. Study records do not establish approval, safety or personal suitability. Results describe observations and do not provide treatment advice.

Dated status sources

INVESTIGATIONAL Global programme; Obesity and metabolic dysfunction-associated steatohepatitis; Subcutaneous injection; as of 2026-07-13. Zealand Pharma

The grade rates how strong the evidence is, not how good or safe the drug is. A low or very-low grade means the evidence is thin, not that an effect is harmful or ruled out.

Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
blood-pressure Decrease
Moderate evidence

Placebo-corrected reductions in systolic and diastolic BP at 4.8 mg

le Roux CW et al. Diabetes Obes Metab 2025 (post hoc, DOI 10.1111/dom.16052) Source
PopulationAdults with obesity, phase 2 post hoc analysis (n=387), 46 wk
Fundingindustry - Novo Nordisk (trial sponsor)
Comparatorsplacebo
Survodutide INVESTIGATIONAL
blood-pressure Decrease
Low evidence

Survodutide reduced blood pressure (with waist circumference and triglycerides) in phase 2 obesity cardiometabolic analysis.

Survodutide phase 2 cardiometabolic, Eur Heart J, 2024;45(Suppl 1):ehae666.2895 Source
PopulationN=387 adults BMI >=27 without diabetes; survodutide 0.6-4.8 mg vs placebo; 46 weeks; phase 2.
Fundingindustry - Boehringer Ingelheim / Zealand (trial sponsor; inferred from registration trial)
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
lipids-lipoprotein Mixed
Moderate evidence

Reductions in total cholesterol, LDL-C, triglycerides; increase in HDL-C

le Roux CW et al. Lancet Diabetes Endocrinol 2024;12:162-173 Source
PopulationAdults with obesity, phase 2 (n=387), 46 wk
Fundingindustry-Boehringer Ingelheim
Comparatorsplacebo
Survodutide INVESTIGATIONAL
lipids-lipoprotein Decrease
Low evidence

Survodutide reduced TG, total and LDL cholesterol and VLDL in phase 2 obesity; HDL relatively unchanged.

Survodutide phase 2 cardiometabolic, Eur Heart J, 2024;45(Suppl 1):ehae666.2895 Source
PopulationN=387 adults BMI >=27 without diabetes; survodutide 0.6-4.8 mg vs placebo; 46 weeks; phase 2.
Fundingindustry - Boehringer Ingelheim / Zealand (trial sponsor; inferred from registration trial)
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
Stomach and gut Increase
Moderate evidence

GI AEs (nausea, diarrhoea, vomiting) markedly more frequent than placebo; dose-dependent, titration-managed; high AE-related discontinuation, mainly GI.

Sanyal et al., Phase 2 Survodutide in MASH and Fibrosis, NEJM 2024; Boehringer phase 3 press Source
PopulationSurvodutide phase 2 (obesity/MASH); 48 weeks; s.c. 2.4/4.8/6.0 mg weekly vs placebo
Fundingindustry - Boehringer Ingelheim (disclosed in publication)
Comparatorsplacebo
Survodutide INVESTIGATIONAL
Stomach and gut Increase
Moderate evidence

GI events dominant; higher than placebo

Sanyal AJ et al. A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. N Engl J... Source
PopulationMASH (n=293) and obesity (n=387) phase 2 trials
Fundingindustry - Boehringer Ingelheim / Zealand
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
Liver and MASH Decrease
Moderate evidence

Survodutide (BI 456906; Boehringer/Zealand) is a GLP-1/glucagon dual agonist in phase 3 for obesity and MASH. In a 48-week phase 2 MASH trial, MASH improvement without...

Sanyal et al., Phase 2 Survodutide in MASH and Fibrosis, NEJM 2024; Boehringer phase 3 press Source
Full findingSurvodutide (BI 456906; Boehringer/Zealand) is a GLP-1/glucagon dual agonist in phase 3 for obesity and MASH. In a 48-week phase 2 MASH trial, MASH improvement without worsening fibrosis occurred in 47/62/43% (2.4/4.8/6.0 mg) vs 14% placebo; >=30% liver-fat reduction in 57-67% vs 14%; fibrosis (>=1 stage) improvement 34/36/34% (up to 36%) vs 22% placebo. A phase 2 obesity trial showed dose-dependent weight loss up to ~12% at 46 weeks; phase 3 reported 16.6% weight loss.
PopulationMASH: 293 adults, biopsy-confirmed MASH + fibrosis F1-F3, once-weekly s.c. 2.4/4.8/6.0 mg vs placebo, 48 wk; obesity phase 2: adults obesity/overweight, 46 wk
Fundingindustry - Boehringer Ingelheim (disclosed in publication)
Comparatorsplacebo
Survodutide INVESTIGATIONAL
Liver and MASH Decrease
Moderate evidence

In a 48-week phase 2 trial (biopsy MASH, fibrosis F1-F3), the GLP-1/glucagon dual survodutide was superior to placebo for histologic MASH improvement without fibrosis...

Sanyal AJ et al. A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. N Engl J... Source
Full findingIn a 48-week phase 2 trial (biopsy MASH, fibrosis F1-F3), the GLP-1/glucagon dual survodutide was superior to placebo for histologic MASH improvement without fibrosis worsening, with a NON-monotonic (quadratic) dose-response peaking at 4.8 mg. Liver fat strongly separated; the fibrosis-improvement secondary favoured survodutide only modestly (34-36% vs 22%).
PopulationNCT04771273; N=293 dosed (survodutide 2.4/4.8/6.0 mg vs placebo); biopsy MASH fibrosis F1-F3; 48 wk (24-wk escalation then maintenance).
Fundingindustry - Boehringer Ingelheim / Zealand
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
Heart rate Increase
Moderate evidence

In the phase 2 obesity dose-finding trial (NCT04667377), survodutide raised heart rate by a mean ~2.7 bpm (all doses pooled) versus ~0.1 bpm on placebo, with a...

le Roux CW et al., Diabetes Obes Metab 2024;27(2):993-996 (Letter; survodutide BP post hoc) Source
Full findingIn the phase 2 obesity dose-finding trial (NCT04667377), survodutide raised heart rate by a mean ~2.7 bpm (all doses pooled) versus ~0.1 bpm on placebo, with a post-hoc analysis reporting blood-pressure improvement; weight loss up to ~14.9% at 46 weeks.
Populationphase 2 obesity dose-finding trial (NCT04667377); post-hoc blood-pressure analysis (Letter)
Fundingindustry - Boehringer Ingelheim / Zealand (trial sponsor)
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
body-composition Decrease
Very low evidence

SYNCHRONIZE (phase 3) prespecified MRI substudy: survodutide reduced visceral adipose tissue ~34%, subcutaneous adipose tissue ~28% and lean body volume ~9.8%; fat...

Boehringer Ingelheim / Zealand, survodutide phase 2 MRI body-composition substudy (confer... Source
Full findingSYNCHRONIZE (phase 3) prespecified MRI substudy: survodutide reduced visceral adipose tissue ~34%, subcutaneous adipose tissue ~28% and lean body volume ~9.8%; fat mass ~78% / lean mass ~22% of total weight lost reported; lean tissue <=10.8% of total tissue-mass change at the highest dose.
PopulationPhase 2 obesity MRI substudy (survodutide / BI 456906); dose range to ~4.8 mg
Fundingindustry - Boehringer Ingelheim / Zealand
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
energy-expenditure-thermogenesis Increase
Very low evidence

Weight loss driven by increased energy expenditure plus reduced food intake (preclinical)

Zimmermann T et al. Mol Metab 2022;66:101633 Source
PopulationMouse obesity models (preclinical pharmacology)
Fundingacademic/independent analysis (manufacturer not study sponsor; per-study COI not individually audited)
Comparatorssemaglutide
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
pharmacology Not directional
Very low evidence

Acylated (C18) GCGR/GLP-1R dual agonist, once-weekly; engages both receptors in vivo

Zimmermann T et al. Mol Metab 2022;66:101633 Source
PopulationIn-vitro + in-vivo preclinical
Fundingacademic/independent analysis (manufacturer not study sponsor; per-study COI not individually audited)
Comparatorssemaglutide
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
safety-other No change
Moderate evidence

Serious adverse events comparable to placebo; no safety signal attributed to glucagon receptor agonism

Sanyal AJ et al. A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. N Engl J... Source
PopulationMASH phase 2 (n=293), 48 wk
Fundingindustry - Boehringer Ingelheim / Zealand
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Survodutide INVESTIGATIONAL
weight-loss Decrease
Moderate evidence

Dose-dependent weight loss vs placebo over 46 weeks in obesity without diabetes

le Roux CW et al. Lancet Diabetes Endocrinol 2024;12:162-173 Source
PopulationAdults BMI ≥27 without diabetes (n=387), phase 2 dose-finding, 46 wk, RCT double-blind, placebo-controlled (NCT04667377)
Fundingindustry-Boehringer Ingelheim
Comparatorsplacebo