Survodutide: Complete Guide
Survodutide (BI 456906) is a dual GLP-1 and glucagon receptor agonist developed by Boehringer Ingelheim. It is being investigated for obesity and metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH). Phase 2 trials demonstrated up to 18.7% body weight loss and significant improvements in liver histology, positioning survodutide as a potential treatment for both obesity and fatty liver disease.
Last updated: 2026-01-29
Quick Facts
- Category
- glp1
- Also Known As
- BI 456906
- Related Goals
- weight loss
Who Researches Survodutide?
Survodutide is researched by people following the GLP-1/glucagon dual-agonist class for weight loss and liver health. It's particularly relevant for MASH/NAFLD researchers, as the glucagon receptor activation specifically promotes hepatic lipid oxidation. Compared to single-target GLP-1 agonists like semaglutide, survodutide and mazdutide add glucagon-mediated energy expenditure. Survodutide's MASH data distinguishes it from weight-loss-focused competitors.
Related Resources
- Comparisons: Survodutide vs Tirzepatide
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What Is Survodutide?
Survodutide is a peptide dual agonist that activates both GLP-1 and glucagon receptors. Developed by Boehringer Ingelheim in partnership with Zealand Pharma, it was designed with a specific glucagon-to-GLP-1 activity ratio optimized for metabolic benefit — enough glucagon activity to drive hepatic fat oxidation and energy expenditure, balanced by sufficient GLP-1 activity to maintain glucose control.
The compound has attracted attention for its dual indication potential — treating both obesity and MASH, conditions that frequently co-occur and share underlying metabolic pathology.
Mechanism of Action
Survodutide's dual mechanism provides complementary metabolic benefits:
- GLP-1R activation: Appetite suppression, insulin secretion, glucose homeostasis
- Glucagon receptor activation: Hepatic fat oxidation, increased basal energy expenditure, reduced liver lipid content
The glucagon component is particularly relevant for MASH: glucagon promotes hepatic lipogenesis reversal, reduces liver fat through enhanced fatty acid oxidation, and may improve liver fibrosis markers.
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Dosage Overview
Phase 2 trials used weekly subcutaneous doses up to 6 mg, with dose escalation over several weeks. The optimal dose for MASH appears to be 4.8–6 mg weekly based on Phase 2 results. Not yet commercially available.
Side Effects & Safety
- Nausea (40–60%): Most common, typically decreasing with dose stabilization
- Vomiting and diarrhea: Common GI effects
- Decreased appetite: Therapeutic effect but can be excessive
- Heart rate increase: Mild increases observed
- Aminotransferase elevations: Transient liver enzyme increases in some participants
Related GLP-1 Compounds
Survodutide belongs to the emerging GLP-1/glucagon dual-agonist subclass. For a comprehensive overview, see the complete GLP-1 guide.
- Mazdutide: The other dual GLP-1/glucagon agonist in development (Eli Lilly/Innovent). Shares the same receptor targets as survodutide, with Phase 3 trials primarily in China.
- Retatrutide: A triple GLP-1/GIP/glucagon agonist that adds GIP to the survodutide formula. Phase 2 showed up to 24.2% weight loss and 82% liver fat reduction — the highest for any anti-obesity compound tested (Jastreboff et al., NEJM 2023).
- Tirzepatide (Mounjaro/Zepbound): FDA-approved dual GLP-1/GIP agonist. Different dual-agonist strategy — targets GIP rather than glucagon. Up to 22.5% weight loss in SURMOUNT-1 (Jastreboff et al., NEJM 2022).
- Semaglutide (Ozempic/Wegovy): The GLP-1-only benchmark. Survodutide's glucagon component adds energy expenditure and liver-specific benefits beyond what semaglutide provides.
- Cagrilintide (CagriSema): An amylin+GLP-1 combination approach (22.7% weight loss in Phase 3). Targets different complementary pathways than survodutide's glucagon mechanism.
- Liraglutide (Saxenda): First-generation GLP-1 agonist. Survodutide's dual mechanism represents a significant advancement in both efficacy and metabolic breadth.