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Survodutide and mazdutide are the two most advanced glucagon/GLP-1 dual agonists — the same receptor pairing, reached from different molecular starting points and carried by different companies to different milestones. One leads with fatty-liver disease; the other became the first of its class to win an approval anywhere.
Research reference only. Not medical advice, prescribing guidance, or a product recommendation.
| Dimension | Survodutide | Mazdutide |
|---|---|---|
| Receptor targets | Glucagon-R + GLP-1R | Glucagon-R + GLP-1R |
| Molecular basis | Engineered acylated peptide (de novo) | Oxyntomodulin-based (natural dual hormone) |
| Developer | Boehringer Ingelheim / Zealand (BI 456906) | Eli Lilly / Innovent (IBI362) |
| Distinctive milestone | FDA Breakthrough Therapy for MASH | First GCG/GLP-1 dual approved anywhere (China, 2025) |
| Approval status | Investigational (Phase 3 SYNCHRONIZE) | Approved in China; investigational elsewhere |
| Weight data | Double-digit mean (Phase 2/3) | ~14.8% (GLORY-1, 6 mg, 48 wk; ~20% at 9 mg) |
| Lead emphasis | Liver (MASH) + obesity | Obesity + type 2 diabetes |
| Molecular weight | 4232 Da | 4476 Da |
| FDA approval | None | None (US) |
The two molecules aim at exactly the same target — pairing GLP-1’s appetite and glycemic effects with glucagon-driven energy expenditure and hepatic-fat mobilization — but they were built differently. Survodutide (BI 456906) is a de-novo engineered, acylated once-weekly peptide from Boehringer Ingelheim and Zealand Pharma. Mazdutide (IBI362) is built on oxyntomodulin, the natural gut hormone that already activates both the GLP-1 and glucagon receptors on its own, developed by Eli Lilly and licensed to Innovent for China.
Where they diverge most is the path each has taken. Survodutide’s standout is the liver: it holds FDA Breakthrough Therapy designation for MASH, and in a Phase 2 MASH trial (NEJM 2024) 62% of patients on the 4.8 mg dose achieved MASH improvement without worsening fibrosis versus 14% on placebo. Mazdutide’s standout is regulatory: on the strength of the Phase 3 GLORY-1 trial (~14.8% mean weight loss at 6 mg over 48 weeks, and about 20% at 9 mg), China’s NMPA approved it in 2025 — making it the first glucagon/GLP-1 dual agonist approved anywhere. Neither is FDA-approved, and no head-to-head trial between them exists.
62% vs 14% (placebo)
MASH improvement, no worsening fibrosis · n=293 · 48 wk — NEJM 2024; earned FDA Breakthrough Therapy designation
−14.8% vs −0.5% (placebo)
Mean body-weight change (Chinese adults) · n=610 · 48 wk — Basis for China NMPA approval; ~20% reported at 9 mg
These are close siblings in the same drug class, distinguished by origin and trajectory rather than by mechanism. Survodutide is the engineered peptide with the strongest fatty-liver (MASH) evidence and Breakthrough designation; mazdutide is the oxyntomodulin-based one that reached the market first, in China, on its obesity data. Both pair glucagon with GLP-1, both are once-weekly, and there is no head-to-head trial — so the comparison is one of program focus and status, not a settled efficacy ranking. Neither is FDA-approved. This page is a research and educational reference.
Both are once-weekly glucagon/GLP-1 dual agonists that pair GLP-1’s appetite and glycemic effects with glucagon-driven energy expenditure and liver-fat reduction. Survodutide (Boehringer Ingelheim/Zealand) is a de-novo engineered peptide with a lead MASH program; mazdutide (Lilly/Innovent) is built on the natural hormone oxyntomodulin and is approved in China.
Mazdutide is approved in China (NMPA, 2025) for weight management and type 2 diabetes — the first glucagon/GLP-1 dual approved anywhere. Survodutide is investigational (Phase 3). Neither is FDA-approved in the United States.
Survodutide has the more advanced dedicated liver program — a Phase 2 MASH trial (NEJM 2024) showed 62% MASH improvement without worsening fibrosis at 4.8 mg versus 14% on placebo, earning FDA Breakthrough Therapy designation. Mazdutide’s lead data are in obesity and diabetes.
No. There is no head-to-head trial between survodutide and mazdutide; their numbers come from separate studies in different populations, so they are not directly comparable. This page is a research and educational reference.
Mechanism, evidence, and trade-offs between Survodutide and Mazdutide — citation-backed answers grounded in PubMed, PubChem, and ClinicalTrials.gov.