Survodutide
also known as BI 456906
Dual GLP-1/glucagon receptor agonist developed by Boehringer Ingelheim and Zealand Pharma, currently in Phase 3 trials (SYNCHRONIZE program) for obesity and metabolic dysfunction-associated steatohepatitis (MASH). Phase 2 data demonstrated significant weight loss through reduced energy intake and increased energy expenditure. Acts centrally via circumventricular organs and peripherally on hepatic and pancreatic receptors. Once-weekly subcutaneous administration.
At a glance
SQ · Once Weekly
Primary target — GLP-1 receptor and glucagon receptor (GCGR) [yathindra-2026][zimmermann-2026].
Pathway — Central: CVOs → hypothalamic appetite regulation. Peripheral: GLP-1R → incretin effect; GCGR → hepatic lipid metabolism, energy expenditure [zimmermann-2026][long-2026].
Downstream effect — Decreased energy intake, increased energy expenditure, improved glucose homeostasis, hepatic fat reduction [zimmermann-2026][yathindra-2026].
| Parameter | Value |
|---|---|
| Standard dose | Not yet disclosed (Phase 3 ongoing)SYNCHRONIZE Phase 3 program underway. [rubino-2026] |
| Frequency | Once weekly |
| Route | Subcutaneous [yathindra-2026] |
| Evidence basis | Phase 2 RCT (obesity) · Phase 3 ongoing |
| Phase 2 findings | Significant weight loss and metabolic marker improvement [yathindra-2026] |
| MASH indication | Under investigation for MASH-cirrhosis [patil-2026][andonie-2026] |
Reconstitution
A pure mass-to-volume utility. Enter what you have in the vial; the atlas computes the volume per dose. No prescription information.
Phase 2 RCT in obesity · Phase 3 SYNCHRONIZE program ongoing
| Outcome | Finding |
|---|---|
| Primary fat target | Total body weight, visceral adipose tissue |
| Weight loss mechanism | Dual action: decreased energy intake + increased energy expenditure [zimmermann-2026] |
| Phase 2 efficacy | Significant weight loss demonstratedSpecific percentage not disclosed in abstracts. |
| Metabolic markers | Improvements in ALT, AST, LDL levels; significant ALT reduction (MD -22.10 vs placebo) [yathindra-2026][abulehia-2026][andonie-2026] |
| MRI-PDFF reduction | Hepatic fat reduction demonstrated in MASH trials [andonie-2026] |
| Network meta-analysis | Favorable efficacy profile vs other glucagon receptor agonists |
| Hepatic requirement | Hepatic GCGR required for maximal weight loss and metabolic effects [long-2026] |
| Energy expenditure | Increased energy expenditure contributes to weight loss [zimmermann-2026] |
| Comparative efficacy | Network meta-analysis shows competitive efficacy in GRA class |
- — Personal or family history of medullary thyroid carcinoma (class effect)
- — Multiple endocrine neoplasia syndrome type 2
- — Severe GI disease (inflammatory bowel disease, gastroparesis)
- — History of pancreatitis
- — Cardiovascular disease (monitor closely for glucagon effects)
- 01Reconstitution
Specific reconstitution protocol not yet publicly disclosed. Follow manufacturer instructions upon approval.
- 02Injection site
Subcutaneous — abdomen, thigh, or upper arm. Rotate sites weekly to minimize injection site reactions.
- 03Timing
Once weekly, same day each week. Can be administered at any time of day, with or without meals.
- 04Storage
Store refrigerated (2–8 °C) until use. Do not freeze. Protect from light. Specific reconstituted storage duration pending labeling.
- 05Needle
Subcutaneous injection with appropriate gauge needle (typically 27–31G). Use sterile technique.
Sources
of 54 rendered claims carry a resolvable citation.
- [abulehia-2026]Abulehia 2026 — Comparative Efficacy and Safety of Glucagon Receptor Agonists on Metabolic Outcomes: A Network Meta-Analysis of Randomised Controlled Trials.
journal, 2026 - [andonie-2026]Andonie 2026 — Comparative Analysis of Glucagon Receptor Agonists vs. Resmetirom in MASLD and MASH: Network Meta-Analysis of Clinical Trials.
journal, 2026 - [elmendorf-2026]Elmendorf 2026 — IUPHAR review: From foe to friend: Repurposing glucagon to treat obesity and type 2 diabetes.
journal, 2026 - [long-2026]Long 2026 — Hepatic GCGR is required for the superior weight loss and metabolic effects of a structurally related analogue of the dual GCGR/GLP-1R agonist survodutide in mice.
journal, 2026 - [patil-2026]Patil 2026 — Metabolic Dysfunction-Associated Steatohepatitis (MASH)-Cirrhosis Clinical Trials: Lessons Learned and Future Directions.
journal, 2026 - [rubino-2026]Rubino 2026 — Optimization of patient and site engagement in the SYNCHRONIZE™ phase 3 clinical trial program for survodutide in obesity through clinical trial simulation.
journal, 2026 - [yathindra-2026]Yathindra 2026 — A review of survodutide: a new dual acting agonist.
journal, 2026 - [zimmermann-2026]Zimmermann 2026 — Survodutide acts through circumventricular organs in the brain and activates neuronal regions associated with appetite regulation.
journal, 2026