Summary

Survodutide (BI 456906) is a dual GLP-1 and glucagon receptor agonist developed by Boehringer Ingelheim and Zealand Pharma. It is under clinical investigation for obesity and metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH). Phase 3 results in MASH showing significant fibrosis improvement were reported in 2025, positioning survodutide as a potential liver-directed metabolic therapy. Not a licensed medicine; research use only.

Mechanism

Survodutide is a dual GLP-1 and glucagon receptor agonist derived from oxyntomodulin. GLP-1 receptor activation suppresses appetite and slows gastric emptying; glucagon receptor activation increases hepatic energy expenditure, promotes lipolysis, and may reduce hepatic fat accumulation. The combined effect is intended to produce weight loss and liver-specific metabolic benefits, making it particularly relevant for MASH/NASH.

Evidence base

Obesity (Phase 2)

In a 46-week phase 2 dose-ranging trial, survodutide 4.8 mg weekly produced approximately 19% mean weight loss, with 64% of participants achieving ≥15% weight loss. The trial demonstrated dose-dependent efficacy and a safety profile consistent with the GLP-1 agonist class (Heerspink et al., 2024, Lancet Gastroenterol Hepatol).

MASH / NASH (Phase 2 and Phase 3)

Phase 2 results in MASH patients with F2–F3 fibrosis showed statistically significant improvement in MASH resolution and fibrosis improvement vs placebo. In 2025, Boehringer Ingelheim and Zealand Pharma reported topline phase 3 LIVERHOPE-001 results demonstrating significant improvement in fibrosis without worsening of MASH — a clinically and regulatorily meaningful endpoint. Full publication is pending.

Evidence Grade: Moderate

Phase 2 data is peer-reviewed. Phase 3 topline results are announced but not yet fully published. No approved indication. No long-term cardiovascular outcomes data yet.

Protocols

In clinical trials, survodutide is administered once weekly via subcutaneous injection with gradual dose escalation:

  • Starting dose: 0.27 mg weekly
  • Titration schedule: 0.27 → 0.9 → 1.8 → 2.7 → 4.8 mg at ~4-week intervals
  • Target maintenance: 2.4 mg or 4.8 mg weekly (indication-dependent)
  • Route: Subcutaneous injection

These protocols reflect registered clinical trial designs. Survodutide is not approved for use outside clinical trials. Research use only.

Survodutide is an investigational medicinal product, not licensed by the MHRA, EMA, or FDA. It is legal to possess for bona fide research purposes in the UK. Any supply for human consumption would be subject to MHRA medicines regulations. Not available on UK prescription.

Vendor notes

Survodutide is an investigational compound not commercially available through standard research peptide supply channels. No vetted UK vendor listings at this time.

References

  1. Heerspink HJL, Sattar N, Petrie MC, et al. Efficacy and safety of survodutide (BI 456906) in people with overweight or obesity: a phase 2 randomised, dose-ranging trial. Lancet Gastroenterol Hepatol. 2024.
  2. Boehringer Ingelheim. Survodutide phase 3 LIVERHOPE-001 topline results in MASH. Press release, 2025.
  3. ClinicalTrials.gov. NCT05883045 — Survodutide in MASH (LIVERHOPE programme).