Survodutide

Overview

Survodutide is a dual GLP-1 / glucagon receptor agonist co-developed by Boehringer Ingelheim and Zealand Pharma. NOT FDA-approved; received FDA Breakthrough Therapy Designation in 2024 for non-cirrhotic MASH with moderate/advanced fibrosis. Phase 3 ongoing (SYNCHRONIZE in obesity/T2DM; LIVERAGE and LIVERAGE-Cirrhosis in MASH).

Mechanism of Action

GLP-1R + GCGR co-agonism (similar to retatrutide's GLP-1/glucagon arms, without GIP). The glucagon arm drives thermogenesis and hepatic fat clearance — the basis for the MASH program — while GLP-1 suppresses appetite and slows gastric emptying.

Research Summary

Phase 2 MASH trial (Sanyal et al., NEJM 2024; 48 weeks, F1–F3 fibrosis): MASH resolution without worsening of fibrosis in 47% (2.4 mg), 62% (4.8 mg), and 43% (6.0 mg) vs 14% placebo. Phase 2 obesity trial reported ~19% weight loss at 46 weeks at the highest dose. Dose-dependent heart-rate elevation has been observed.

Dosing Information

Reported Side Effects

• Nausea
• Vomiting
• Diarrhea
• Fatigue
• Dose-dependent heart-rate elevation

Research References

• A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis (Sanyal AJ et al., NEJM) (2024)
• Boehringer receives U.S. FDA Breakthrough Therapy designation and initiates two Phase III trials in MASH for survodutide (2024)