Scientific Reference

Survodutide (BI 456906)

Evidence profile: Human Phase 3 evidence

Survodutide (BI 456906) is an investigational dual glucagon receptor (GCGR) and GLP-1 receptor (GLP-1R) agonist designed for once-weekly subcutaneous administration. This 29-amino acid peptide with C18 fatty acid acylation represents a novel approach to metabolic disease treatment by simultaneously targeting both energy intake reduction (via GLP-1R) and energy expenditure increase (via GCGR). The compound has demonstrated robust efficacy in clinical trials for obesity and metabolic dysfunction-associated steatohepatitis (MASH), showing superior weight loss versus semaglutide in head-to-head comparisons. Its dual mechanism addresses both energy intake and expenditure, potentially reducing weight regain compared to single-receptor approaches.

Mechanism of Action

Survodutide acts as a dual agonist at glucagon receptors and GLP-1 receptors. GLP-1 receptor activation suppresses appetite, slows gastric emptying, and improves glycemic control, while glucagon receptor activation increases energy expenditure and promotes hepatic fat oxidation. This balanced dual agonism produces additive metabolic effects, enabling significant weight reduction and improved metabolic health.

Molecular Information

  • Type: Dual GCGR/GLP-1R agonist (acylated peptide)
  • Length: 29 amino acids
  • Molecular weight: 4232 g/mol
  • Molecular formula: C192H289N47O61

Published Research

  • SYNCHRONIZE-1

    Survodutide Once Weekly for the Treatment of Adults with Obesity

    le Roux CW et al. · The New England journal of medicine · 2026 · Clinical

    PMID 42253238 — View on PubMed
  • SYNCHRONIZE-MASLD

    Survodutide in adults with obesity and metabolic dysfunction-associated steatotic liver disease: SYNCHRONIZE-MASLD, a randomized, double-blind, placebo-controlled phase 3 trial

    Kaplan LM et al. · Nature medicine · 2026 · Clinical

    PMID 42252333 — View on PubMed
  • A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis

    Sanyal AJ et al. · The New England journal of medicine · 2024 · Clinical

    PMID 38847460 — View on PubMed
  • Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial

    le Roux CW et al. · The lancet. Diabetes & endocrinology · 2024 · Clinical

    PMID 38330987 — View on PubMed
  • Baseline characteristics in the SYNCHRONIZE™-2 randomized phase 3 trial of survodutide, a glucagon receptor/GLP-1 receptor dual agonist, for obesity in people with type 2 diabetes

    Wharton S et al. · Diabetes, obesity & metabolism · 2026 · Clinical

    PMID 41216778 — View on PubMed
  • Dose-response effects on HbA(1c) and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial

    Blüher M et al. · Diabetologia · 2024 · Clinical

    PMID 38095657 — View on PubMed