Dual-agonist peptides combine GLP-1 receptor activation with a second incretin or hormone receptor to expand the pharmacology and weight-loss efficacy beyond GLP-1 monotherapy. The two dominant architectures: GLP-1/GIP (tirzepatide is the approved benchmark) and GLP-1/glucagon (survodutide is the leading example).
Covered here: Lilly's tirzepatide / Mounjaro / Zepbound franchise that overtook Keytruda as the world's #1 best-selling drug in Q1 2026; Viking Therapeutics' VK2735 dual GLP-1/GIP agonist with Phase 3 VANQUISH-1 subcutaneous (4,650 patients) and Phase 2 VENTURE-Oral 12.2% weight loss data presented May 12, 2026 at ECO 2026; Roche's enicepatide (formerly CT-388) dual GLP-1/GIP with two Phase 3 obesity trials (ENITH 1 and 2) initiated Q1 2026; Boehringer Ingelheim's survodutide dual GLP-1/glucagon with positive SYNCHRONIZE-1 Phase 3 data (16.6% mean weight loss); and Pfizer's MET-097i (PF'3944) ultra-long-acting GLP-1 in 10+ Phase 3 trials. Beyond these, dual GIP/glucagon-only agonists are emerging as a category that DiMarchi and Tschöp argue can match GLP-1 weight loss without the GI tolerability issues.
Stories here cover trial readouts, mechanism papers, and combination-therapy programs. See #tirzepatide, #vk2735, and #survodutide.
Viking Therapeutics (NASDAQ: VKTX) disclosed on the July 29, 2026 Q2 2026 earnings call that VK3019, a novel dual amylin and calcitonin receptor agonist peptide for obesity, has entered Phase 1 clinical development. The candidate extends the company's obesity pipeline beyond the flagship VK2735 (dual GLP-1/GIP agonist). VK2735 status: Phase 3 VANQUISH program in obesity and obesity/type 2 diabetes is fully enrolled and advancing on track; oral VK2735 Phase 3 trials are slated to initiate in Q4 2026, positioning Viking as a potential first-to-market oral dual GLP-1/GIP agonist. A novel maintenance dosing study for VK2735 is nearing completion, with results expected later in Q3 2026 exploring less frequent dosing regimens. Q2 2026 financials: net loss widened to $128.1 million from $65.6 million in Q2 2025 on increased R&D spending, with $502 million in cash and short-term investments down from $706 million at year-end 2025. VK3019 is mechanistically distinct from VK2735: amylin signaling adds brainstem-mediated satiety (via the calcitonin receptor complex with RAMPs) on top of a calcitonin receptor agonism that has a longer development history in postmenopausal osteoporosis (Miacalcin) and Paget's disease. The amylin plus calcitonin combination extends the amylin-analog obesity category anchored by Novo Nordisk's cagrilintide (a component of CagriSema) and the Novo amycretin oral amylin monotherapy program.
Boehringer Ingelheim's survodutide (BI 456906) Phase 2 MASH results continue to circulate through the pharma analyst community ahead of Phase 3 readouts expected in late 2026. Survodutide is a dual GLP-1 / glucagon receptor agonist administered by once-weekly subcutaneous injection. In the Phase 2 trial in patients with biopsy-proven metabolic dysfunction-associated steatohepatitis (MASH), 83% of survodutide-treated patients achieved histological improvement at 48 weeks (versus placebo comparator). Phase 3 trials for both MASH (LIVERAGE program) and obesity (SYNCHRONIZE program) are underway. Survodutide positions Boehringer Ingelheim to compete against Novo Nordisk semaglutide (Wegovy for obesity, Ozempic for type 2 diabetes) which has approximately 15% weight loss and Rezdiffra (resmetirion) FDA-approved March 2024 for MASH; Eli Lilly tirzepatide (Zepbound for obesity, Mounjaro for type 2 diabetes) which has approximately 21% weight loss; and the eventual Eli Lilly retatrutide triple GLP-1/GIP/glucagon agonist (Phase 3 TRIUMPH program) which showed 28.3% weight loss in Phase 3 obesity readouts earlier in 2026. The dual-agonist glucagon mechanism differentiates survodutide from the pure GLP-1 and GLP-1/GIP incumbents by adding hepatic glucose output modulation and potential MASH-specific liver benefit.
Novo Nordisk's AMAZE-12 Phase 3 trial of amycretin — a dual GLP-1 and amylin receptor agonist — began recruiting on May 18, 2026. The trial evaluates amycretin specifically for weight maintenance after initial weight loss, distinguishing it from AMAZE-1 (which measures body weight change over 84 weeks). The amycretin clinical rationale rests on Phase 1 weekly subcutaneous dosing producing 22% weight reduction at 36 weeks and oral formulation producing 13.1% at 12 weeks — both reported in the Lancet earlier in 2026. Amycretin sits within Novo's next-generation pipeline alongside CagriSema (cagrilintide + semaglutide, FDA filing under review with decision expected late 2026) and the orexin-related pipeline acquired via Centessa. The amycretin program is structurally Novo's most direct response to Lilly's retatrutide.
Viking Therapeutics presented full 13-week Phase 2 VENTURE-Oral data at ECO 2026 May 12 in Istanbul: once-daily oral VK2735 produced statistically significant, dose-dependent mean weight loss up to 12.2% (26.6 lbs) over 13 weeks with placebo-adjusted significance starting at Week 1. The favorable tolerability profile and rapid early onset of effect support Viking's Q4 2026 plan to initiate a Phase 3 trial of the oral formulation following positive FDA feedback. The data complements the Phase 3 VANQUISH-1 subcutaneous program (4,650 patients enrolled November 2025) and VANQUISH-2 in T2D+obesity (~1,000 patients, enrollment completed March 26, 2026). VK2735's dual GLP-1/GIP mechanism puts it in direct comparison with tirzepatide and the next-generation Mounjaro/Zepbound franchise.
Viking Therapeutics announced two poster presentations at ECO 2026 in Istanbul (May 12-15) on its VK2735 dual GLP-1/GIP agonist program. The first poster details 13-week efficacy and safety data from the Phase 2 VENTURE-Oral trial of oral VK2735, supporting Viking's Q4 2026 plan to launch a Phase 3 trial of the oral formulation following positive FDA feedback. The second poster details Phase 3 VANQUISH-1 design and enrollment demographics for subcutaneous VK2735, which completed enrollment of approximately 4,650 adults with obesity in November 2025. VANQUISH-2 (subcutaneous VK2735 in T2D + obesity, ~1,000 adults) completed enrollment March 26, 2026. Posters display May 12-15 with networking sessions Thursday May 14 18:00-19:15 TRT.
MetaVia dosed the first patient in a higher-dose Phase 1 study of DA-1726, its GLP-1 and glucagon dual agonist for obesity treatment, marking continued advancement in next-gen weight loss drugs.