Petrelintide is Zealand Pharma's long-acting amylin analog, licensed to Roche as part of the Swiss pharma's late entry into the obesity peptide market. The molecule posted up to 10.7% mean weight loss versus 1.7% with placebo at 42 weeks, with placebo-like gastrointestinal tolerability, in the 485-person Phase 2 ZUPREME-1 trial, published in The Lancet Diabetes & Endocrinology on September 29, 2026, and Zealand and Roche formally endorsed advancement to Phase 3 on April 29, 2026 with H2 2026 initiation confirmed.
Zealand's first-quarter report on May 7 included $700M (DKK 4.5B) in collaboration revenue tied to the Phase 3 milestone and authorized a DKK 1.3B share buyback, which was completed on October 5, 2026. The Roche partnership also pairs petrelintide with the GLP-1/GIP agonist enicepatide (CT-388) in a combination Phase 2 trial planned for the second half of 2026. Roche executives have projected $9B in peak annual sales from the combined obesity pipeline. Like Novo's cagrilintide and Lilly's eloralintide, petrelintide mimics amylin, a hormone that slows stomach emptying, suppresses glucagon, and increases fullness.
Phase 3 began on September 22, 2026, when Zealand announced the start of the ZUPREME program: three placebo-controlled trials enrolling about 7,000 people in total. ZUPREME-3 covers about 3,900 people with overweight or obesity and a weight-related comorbidity but no type 2 diabetes, ZUPREME-4 about 600 people with type 2 diabetes, and ZUPREME-5 about 2,500 people with established cardiovascular disease. Each trial measures percentage change in body weight at week 64. On October 7, 2026, Zealand reported topline results from the 28-week Phase 2 ZUPREME-2 trial in 220 adults with type 2 diabetes: weight fell 7.4% to 9.2% across three doses versus 2.0% on placebo, and 1.9% of people on petrelintide stopped because of stomach side effects, versus 1.7% on placebo.
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