Weekly injectable peptide from Boehringer Ingelheim that acts on both GLP-1 and glucagon receptors. Being studied for obesity and fatty liver with inflammation (MASH).
Regulatory status
In clinical trials
Family
Dual glucagon and GLP-1 receptor agonist
Scientific evidence
High
Number of findings
3
Where it acts
Digestive and weight · Hormones and metabolism
Also known as
survodutide, BI 456906
Regulatory status
FDA (US): Not approved (phase 3 completed in obesity in 2026; not approved as of October 2026)
EMA (EU): Not approved
Dose
In the phase 3 SYNCHRONIZE-1 trial, a weekly subcutaneous injection was used with escalation up to 3.6 mg or 6.0 mg (clinical trial, PMID 42253238). There is no approved dose.
Safety
Digestive effects (nausea, vomiting, diarrhea) are very frequent: 81–90% vs 48% with placebo in phase 3, almost always mild or moderate. Investigational drug: only under medical supervision in trials.
Interactions
Like other drugs that delay gastric emptying, it may alter the absorption of oral medications; no specific studies have been published.
Differences between women and men
In phase 2, women lost more weight and more waist circumference than men, with similar adverse effects in both sexes. View the study →
Effect by goal · level of evidence
Weight loss in adults with obesity without diabetes (phase 3)
reducesHighRCT (AA)in people
−13% weight
SYNCHRONIZE-1 trial with 725 adults over 76 weeks. Weight dropped by 12.2% (3.6 mg) and 13.0% (6.0 mg) vs 5.4% with placebo.
Improvement in fatty liver with inflammation (MASH) and fibrosis
improvesModerateRCT (AA)in people
Phase 2 trial in patients with biopsy-confirmed MASH and fibrosis, over 48 weeks: the proportion with MASH improvement without worsening of fibrosis was clearly higher with survodutide than with placebo (around 43–62% vs 14%).
The GLP-1 part reduces appetite and delays gastric emptying. The glucagon part increases energy expenditure and fat burning in the liver. For this reason, a particularly marked effect on liver fat is expected.
What the evidence says
In people
Weight loss in adults with obesity without diabetes (phase 3). SYNCHRONIZE-1 trial with 725 adults over 76 weeks. Weight fell by 12.2% (3.6 mg) and 13.0% (6.0 mg) vs 5.4% with placebo. PubMed 42253238
Dose-dependent weight loss (phase 2). 387 adults over 46 weeks: loss of about 6% with the lowest dose and 12–15% with the high doses, vs 3% with placebo. PubMed 38330987
Improvement in fatty liver with inflammation (MASH) and fibrosis. Phase 2 trial in patients with biopsy-proven MASH and fibrosis, over 48 weeks: the proportion with MASH improvement without worsening of fibrosis was clearly higher with survodutide than with placebo (around 43–62% vs 14%). PubMed 38847460