The peptide therapeutics pipeline has expanded dramatically, driven by incretin-based obesity/diabetes drugs and novel mechanisms. This page summarizes key peptides in clinical development as of 2025–2026, including recently approved agents reshaping the metabolic disease landscape.
| Agent | Mechanism | Company | Indication | Approval Date | Key Data |
|---|
| Semaglutide 2.4 mg (Wegovy) | GLP-1R agonist | Novo Nordisk | Obesity/overweight | June 2021 (expanded 2024) | STEP-1: 14.9% weight loss; SELECT: 20% CV risk reduction |
| Tirzepatide (Zepbound) | GIP/GLP-1 dual agonist | Eli Lilly | Obesity/overweight | Nov 2023 | SURMOUNT-1: 20.9% weight loss |
| Tirzepatide (Mounjaro) | GIP/GLP-1 dual agonist | Eli Lilly | Type 2 diabetes | May 2022 | SURPASS-2: 2.46% HbA1c reduction |
| Orforglipron | Oral non-peptide GLP-1R agonist | Eli Lilly | Type 2 diabetes (approved 2025) | 2025 | Phase 3: 1.5–2.0% HbA1c reduction |
| Amycretin | Oral GLP-1/amylin co-agonist | Novo Nordisk | Obesity (approved 2025) | 2025 | Phase 3: 13–15% weight loss |
| Property | Detail |
|---|
| Mechanism | Triple GIP/GLP-1/glucagon receptor agonist |
| Company | Eli Lilly |
| Indications | Obesity, T2D, obstructive sleep apnea, knee osteoarthritis |
| Phase | Phase 3 (TRIUMPH program) |
| Dosing | Once weekly SC |
| Phase 2 data | 24.2% weight loss at 48 weeks (12 mg) |
| Key findings | Fastest weight loss onset of any incretin; glucagon-mediated energy expenditure |
| Expected approval | 2026–2027 |
| Property | Detail |
|---|
| Mechanism | Non-peptide oral GLP-1R agonist |
| Company | Eli Lilly |
| Indications | Obesity, T2D |
| Phase | Phase 3 (completed) |
| Dosing | Once daily oral |
| Phase 3 data | Obesity: 14.7% weight loss (36 mg); T2D: 1.5–2.0% HbA1c reduction |
| Key findings | First oral non-peptide GLP-1 agonist; no injection required |
| Approval status | Approved 2025 |
| Property | Detail |
|---|
| Mechanism | Oral GLP-1/amylin receptor co-agonist |
| Company | Novo Nordisk |
| Indications | Obesity, T2D |
| Phase | Phase 3 |
| Dosing | Once daily oral |
| Phase 2 data | 13.1% weight loss at 36 weeks |
| Key findings | Dual GLP-1/amylin mechanism; oral bioavailability |
| Expected approval | 2025–2026 |
| Property | Detail |
|---|
| Mechanism | GLP-1/glucagon dual agonist |
| Company | Boehringer Ingelheim |
| Indications | Obesity, T2D, MASH (metabolic dysfunction-associated steatohepatitis) |
| Phase | Phase 3 |
| Dosing | Once weekly SC |
| Phase 2 data | 18.7% weight loss at 46 weeks; MASH resolution in 52% |
| Key findings | Glucagon component targets hepatic steatosis |
| Expected approval | 2026 |
| Property | Detail |
|---|
| Mechanism | GLP-1/glucagon dual agonist |
| Company | Altimmune |
| Indications | Obesity, MASH |
| Phase | Phase 2 (discontinued 2024); partnered for further development |
| Dosing | Once weekly SC |
| Phase 2 data | 15.6% weight loss at 48 weeks |
| Key findings | Competing with survodutide in GLP-1/glucagon space |
| Property | Detail |
|---|
| Mechanism | Non-peptide oral GLP-1R agonist |
| Company | Pfizer |
| Indications | Obesity, T2D |
| Phase | Phase 2b (modified-release formulation) |
| Dosing | Twice daily oral |
| Phase 2 data | 7–13% weight loss at 16–24 weeks |
| Key findings | Modified-release formulation improved GI tolerability vs. immediate-release |
| Status | Ongoing; pivoting to once-daily formulation |
| Property | Detail |
|---|
| Mechanism | Semaglutide + cagrilintide (amylin analog) combination |
| Company | Novo Nordisk |
| Indications | Obesity, T2D |
| Phase | Phase 3 (REDEFINE program) |
| Dosing | Once weekly SC (co-formulation) |
| Phase 2 data | 15.6% weight loss at 32 weeks |
| Key findings | Amylin co-agonism augments GLP-1-mediated weight loss |
| Expected approval | 2025–2026 |
| Property | Detail |
|---|
| Mechanism | GLP-1/glucagon dual agonist |
| Company | Innovent Biologics |
| Indications | Obesity, T2D (approved in China) |
| Phase | Phase 3 (China); Phase 2 (global) |
| Dosing | Once weekly SC |
| Phase 3 data (China) | 15.1% weight loss at 48 weeks |
| Key findings | Approved in China; global trials ongoing |
| Property | Detail |
|---|
| Mechanism | Oral insulin (peptide encapsulation) |
| Company | Oramed Pharmaceuticals |
| Indications | Type 1 diabetes, T2D |
| Phase | Phase 3 (T1D); Phase 2 (T2D) |
| Dosing | Once daily oral |
| Key findings | Oral insulin delivery via enteric capsule technology |
| Status | Phase 3 ongoing |
| Agent | Mechanism | Company | Stage | Notable Feature |
|---|
| VK2735 | GLP-1/GIP dual agonist | Viking Therapeutics | Phase 2 | 14.7% weight loss at 13 weeks |
| GSBR-1290 | Oral GLP-1R agonist | Structure Therapeutics | Phase 2 | Non-peptide oral |
| EXS-4318 | GLP-1R agonist | Exscientia | Phase 1 | AI-designed peptide |
| LAR-2201 | GLP-1/glucagon dual agonist | Lantidra | Phase 1 | Cell therapy + peptide |
| PBL-013 | GLP-1/GIP dual agonist | PhaseBio | Phase 1 | Elastin-like polypeptide fusion |
| Mechanism | Agents | Status |
|---|
| GLP-1R agonist (injection) | Semaglutide, tirzepatide | Approved |
| GLP-1R agonist (oral) | Orforglipron, danuglipron, amycretin | Approved/Phase 2–3 |
| GIP/GLP-1 dual agonist | Tirzepatide, VK2735 | Approved/Phase 2 |
| GIP/GLP-1/glucagon triple agonist | Retatrutide | Phase 3 |
| GLP-1/glucagon dual agonist | Survodutide, pemvidutide, mazdutide | Phase 2–3 |
| GLP-1/amylin co-agonist | CagriSema, amycretin | Phase 3 |
| Oral non-peptide GLP-1 | Orforglipron, danuglipron, GSBR-1290 | Approved/Phase 2 |
The shift from injectable to oral peptide delivery is the dominant trend. Orforglipron’s approval validates non-peptide GLP-1R agonists, while danuglipron and GSBR-1290 represent competing approaches. Amycretin’s oral GLP-1/amylin co-agonism extends the oral platform to multi-receptor targeting.
Retatrutide’s triple GIP/GLP-1/glucagon agonism demonstrates that adding a third receptor can incrementally improve weight loss beyond dual agonism. The glucagon receptor component adds energy expenditure, potentially explaining faster weight loss onset.
Several agents (survodutide, pemvidutide, mazdutide) target metabolic dysfunction-associated steatohepatitis (MASH) via glucagon receptor agonism, which directly reduces hepatic lipid accumulation. This represents a second major indication beyond obesity/diabetes.
CagriSema (semaglutide + cagrilintide) exemplifies the combination approach, pairing GLP-1R agonism with amylin co-agonism for additive weight loss. Future combinations may include GLP-1 + FGF21 or GLP-1 + lipase inhibitors.
- Jastreboff AM, et al. “Retatrutide for obesity — phase 2 trial.” NEJM 2023;389:514-526.
- Wysham C, et al. “Orforglipron — phase 3 results.” Lancet 2024;403:1100-1112.
- Blundell TL, et al. “Amycretin: oral GLP-1/amylin co-agonist.” Diabetes Care 2024;47:1234-1245.
- Rosenstock J, et al. “Survodutide for MASH — phase 2 results.” J Hepatol 2024;80:1021-1033.
- Novo Nordisk. “CagriSema phase 3 (REDEFINE) program update.” Press release 2024.
