What is Survodutide?
Survodutide — also called BI 456906 — is an investigational peptide being studied for two major metabolic conditions: obesity and a serious liver disease called MASH (metabolic dysfunction-associated steatohepatitis, formerly known as NASH). It is a research compound, not an approved medicine, and is currently being evaluated in clinical trials.[1]
MASH is a condition where too much fat builds up in the liver, causing inflammation and scarring (fibrosis). Left untreated, it can progress to cirrhosis. Survodutide has attracted scientific interest because it targets two hormonal pathways at once — giving it a potentially broader effect than older single-target drugs.[4]
How Survodutide Works
Think of your metabolism like a thermostat system with two dials. Most existing weight-loss drugs only turn one dial. Survodutide turns both.
Specifically, survodutide is a dual agonist — meaning it activates two receptors simultaneously:
- GLP-1 receptor (GLP-1R): GLP-1 is a gut hormone that slows stomach emptying, reduces appetite, and helps regulate blood sugar. Drugs that activate this receptor are already widely used.[2]
- Glucagon receptor (GCGR): Glucagon is a hormone that tells the liver to burn more fat and boosts overall energy expenditure. Activating this receptor adds a fat-burning boost on top of the appetite-suppressing GLP-1 effect.[4]
Together, these two actions may work better than either alone — especially for burning liver fat, which is exactly why researchers are so interested in survodutide for MASH.[1] Survodutide is delivered as a once-weekly subcutaneous injection (a small shot just under the skin).[5]
What the Research Shows
Obesity / Weight Loss
A randomised, double-blind, placebo-controlled Phase 2 trial tested four different doses of survodutide against placebo in people with obesity over 46 weeks (a dose-escalation period followed by a maintenance period). Participants receiving survodutide lost significantly more body weight than those on placebo across all active dose groups.[5] Survodutide is now listed among the most promising incretin-based agents in the obesity drug pipeline, with ongoing Phase 3 trials underway.[3]
MASH with Liver Fibrosis
A landmark Phase 2 trial published in The New England Journal of Medicine in 2024 enrolled 293 adults with biopsy-confirmed MASH and fibrosis stages F1–F3 (that means early-to-moderate scarring). Participants were randomly assigned to one of three survodutide doses or placebo for 48 weeks.[1]
Here are the headline findings:[1]
- MASH improvement with no worsening of fibrosis: 47% (2.4 mg group), 62% (4.8 mg group), and 43% (6.0 mg group) achieved this goal — compared to just 14% on placebo.
- Liver fat reduction ≥30%: 57–67% of survodutide participants hit this target, versus 14% on placebo.
- Fibrosis improvement by at least one stage: 34–36% in survodutide groups versus 22% on placebo.
Researchers concluded that survodutide was superior to placebo for MASH improvement, and called for Phase 3 trials.[1] It is also notable that researchers specifically suggested dual GLP-1/glucagon agonism may be more effective than GLP-1 agonism alone for treating MASH.[1]
Side Effects Seen in Trials
The most common side effects in the MASH trial were gastrointestinal: nausea (66% on survodutide vs. 23% on placebo), diarrhea (49% vs. 23%), and vomiting (41% vs. 4%). Serious adverse events occurred in about 8% of survodutide participants versus 7% on placebo.[1] These GI effects are typical of GLP-1-class drugs.[2]
What Survodutide Is Being Studied For
- MASH (metabolic dysfunction-associated steatohepatitis) with liver fibrosis stages F1–F3[1]
- Obesity and weight management[5]
- Broader cardiometabolic conditions as part of the emerging GLP-1/glucagon dual-agonist class[2]
How Survodutide Is Dosed in Research
Research protocols use a careful dose-escalation approach — starting low and stepping up gradually — to help minimize gastrointestinal side effects. Doses and schedules differ between the obesity and MASH research programs. For full details, see the dosage chart on this page, and use the calculator to explore dose ranges used in published trials. All doses discussed here are strictly for research-reference purposes.
Mixing and Storing Survodutide
Survodutide is a peptide, which means it is a fragile chain of amino acids that must be handled carefully. In clinical trials it is supplied as a ready-to-use solution for subcutaneous injection — not a powder that needs to be dissolved.[1] For general research-use reference, peptides of this class are typically kept refrigerated (around 2–8°C / 36–46°F) and protected from light and heat. They should never be frozen once reconstituted, and any solution that appears cloudy or discoloured should not be used. Always follow the specific storage and handling instructions provided with the research-grade material, and consult the relevant study protocol or certificate of analysis. This information is provided for educational reference only and does not constitute handling or medical advice.
Sources
- A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. — The New England journal of medicine, 2024. PMID 38847460.
- Efficacy and Safety of GLP-1 Medicines for Type 2 Diabetes and Obesity. — Diabetes care, 2024. PMID 38843460.
- Emerging pharmacotherapies for obesity: A systematic review. — Pharmacological reviews, 2025. PMID 39952695.
- BI 456906: Discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacy. — Molecular metabolism, 2022. PMID 36356832.
- Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. — The lancet. Diabetes & endocrinology, 2024. PMID 38330987.
- Weight management treatment in obesity. — Medicina clinica, 2025. PMID 40865172.
EN
BR
ES
FR
DE
RU