Amylin is the second pancreatic hormone (after insulin) that Novo Nordisk and a handful of competitors are now building obesity drugs around. Amylin agonists slow gastric emptying, suppress glucagon secretion, and produce satiety effects that compound the GLP-1 signal.
Lead programs covered on this site: Novo's cagrilintide (long-acting amylin analog) and the CagriSema combination, Lilly's eloralintide, Zealand Pharma's petrelintide, and earlier-stage amylin-receptor agonists from competitors. Amylin biology is increasingly framed as the next add-on layer to GLP-1 therapy after GIP and glucagon.
Stories here cover the REDEFINE readouts, eloralintide and petrelintide trial data, and the combination economics. See #cagrilintide, #cagrisema, and #petrelintide.
A prespecified body-composition substudy of REDEFINE 1 presented at ECO 2026 reported that 252 participants on CagriSema 2.4 mg/2.4 mg (semaglutide + cagrilintide) achieved a 35.7% relative reduction in fat mass and a 14.4% reduction in lean soft-tissue mass at week 68 — compared with 5.7% and 4.3% on placebo. The headline 22.7% mean weight reduction in REDEFINE 1 (NEJM publication June 2025) thus broke down with a fat-mass-to-lean-tissue ratio of roughly 2.5:1, a more favorable body-composition profile than the typical 1.5-2:1 ratio reported for GLP-1 monotherapy. The data builds the case for combination amylin-GLP-1 therapy as preferentially fat-selective.
Ascletis Pharma will present multiple poster sessions at ECO 2026 covering programs beyond the already-presented ASC30. ASC47, an adipose-targeting thyroid hormone receptor beta (THRβ) agonist designed for muscle-preserving weight loss, demonstrated up to 111.8% greater relative weight loss when combined with semaglutide vs semaglutide monotherapy in obesity participants. ASC36, a once-monthly next-generation amylin receptor agonist peptide, posted a 32-day average observed half-life — six times longer than Zealand's petrelintide. ASC35, a once-monthly next-generation GLP-1R/GIPR dual agonist peptide, showed a 14-day average observed half-life (six times longer than tirzepatide) and 71% more relative weight loss than tirzepatide in a diet-induced obesity mouse model. Session Thursday May 14, 18:00-19:15 TRT.
Zealand Pharma reported Q1 2026 revenue of DKK 34M against DKK 8M a year earlier and the DKK 17M analyst consensus — a more-than-2× beat on the recognition of Roche's $700M (DKK 4.5B) milestone payment tied to petrelintide's advancement into Phase 3. The board authorized a share buyback of up to DKK 1.3B. Net operating expenses came in at DKK 573M (below the DKK 679M consensus), and the company reaffirmed petrelintide Phase 3 obesity initiation in H2 2026. Petrelintide is the long-acting amylin analog that posted ~10.7% mean weight loss with placebo-like tolerability in ZUPREME-1; the Roche partnership combines it with the GLP-1/GIP enicepatide (CT-388) in a fixed-dose Phase 2 starting mid-2026. Shares rose 8.4% to DKK 344.
Eli Lilly, with the Indiana Biosciences Research Institute, has disclosed an ADA Scientific Sessions Late-Breaking Poster slot (Poster 2839-LB, May 29) for a single peptide molecule that simultaneously activates five receptors: GLP-1, GIP, glucagon, amylin, and calcitonin. Lead investigator Jonathan Douros, PhD, will present rodent data showing weight-loss superiority over retatrutide in Lilly-sponsored animal studies. The compound is distinct from the DiMarchi/Tschöp/Müller GLP-1R/GIPR/PPARα/γ/δ quintuple agonist published in Nature on April 30 — that one is a peptide-drug conjugate combining GLP-1/GIP with the pan-PPAR agonist lanifibranor, while the Lilly + Indiana Biosciences molecule appears to be a single peptide hitting all five receptors directly. Both signal that the obesity-pharmacology ceiling is moving past the triple-agonist generation.
AstraZeneca's ASCEND program is active in Phase 2b, combining AZD9550 (GLP-1 + glucagon dual agonist) with AZD6234 (selective amylin analog) in a two-molecule triple-mechanism strategy aimed at fat-selective weight loss and organ protection. Individual assets are also in Phase 2. The combination reflects the February 2026 $1.2 billion CSPC Pharmaceuticals collaboration that brought both molecules into AstraZeneca's portfolio, alongside elecoglipron (AZD5004 / ECC5004), the small-molecule oral GLP-1 that posted 5.8% weight loss over four weeks in Phase 1b in China. AstraZeneca enters the next-gen obesity race later than Lilly, Novo, Roche, and Boehringer, but the triple-mechanism positioning targets the safety + organ-protection lane that competitors leave open.
Zealand Pharma announced April 29 that it and partner Roche have formally endorsed advancing petrelintide — a long-acting amylin analog suitable for once-weekly subcutaneous administration — into Phase 3 trials for chronic weight management, with initiation planned for H2 2026. The Phase 3 program will evaluate petrelintide as monotherapy and in combination with Roche's GLP-1/GIP receptor dual agonist enicepatide (CT-388). The decision follows positive Phase 2 ZUPREME-1 data showing up to 10.7% weight loss with placebo-like tolerability; petrelintide is now positioned as the lead non-GLP-1 obesity asset behind only Novo's CagriSema.
Novo Nordisk announced April 28 that it will present 52 abstracts at the European Congress on Obesity (ECO 2026, Istanbul, May 12–15), including new data from the REDEFINE 1 trial of CagriSema (cagrilintide 2.4 mg/semaglutide 2.4 mg): body composition and muscle strength, achievement of BMI/waist-to-height ratio targets, and cardiovascular risk reduction. Additional presentations will cover higher-dose Wegovy (semaglutide 7.2 mg), the Wegovy pill (oral semaglutide 25 mg) from OASIS 4 and ORION trials, and obesity treatment outcomes in women. The disclosure sets up a significant amylin/GLP-1 combination data event exactly as Zealand and Roche's amylin-only petrelintide moves into Phase 3.
C&EN published a comprehensive April 2026 feature examining whether amylin analogs — Novo's cagrilintide, Lilly's eloralintide, and Roche/Zealand's petrelintide — can carve meaningful share in a market dominated by semaglutide and tirzepatide. Wall Street initially expected amylin candidates to differentiate on muscle preservation and reduced GI side effects, but as Phase 2 readouts arrive investor enthusiasm has cooled. CagriSema Phase 3 head-to-head against tirzepatide is the make-or-break readout for Novo Nordisk's amylin strategy.
Roche reported Q1 2026 sales up 6% at constant exchange rates and used the earnings call to re-anchor its obesity strategy. Executives project $9 billion in peak annual sales from the emerging breast cancer pill plus four obesity candidates. Lead asset petrelintide (licensed from Zealand Pharma, ZUPREME-1 Phase 2 showed up to 10.7% weight loss with placebo-like tolerability) is positioned at a differentiated patient segment. CEO Schinecker said Roche is not investing in the first generation of obesity drugs, but the next — with petrelintide and CT-388 (enicepatide) data headed for ADA 2026.