UNIMOLECULAR GLP-1 / AMYLIN RECEPTOR AGONIST

Zenagamtide (amycretin)

Novo Nordisk’s dual GLP-1/amylin molecule has a Phase 3 obesity program; injectable and oral development have separate timelines.

Evidence Maturity · M4 — Advanced clinical Investigational — Phase 3
Evidence reviewed: September 19, 2026Source-labeled

Signal summary

Zenagamtide, previously called amycretin, is a single molecule designed to activate both GLP-1 and amylin receptors. The program is notable because Novo Nordisk is developing both injectable and oral formulations.

Signal interpretation: The program is strategically important because it combines two obesity-relevant pathways in one molecule and could eventually offer route-of-administration flexibility. Current evidence is still much stronger for weight loss than for muscle or functional outcomes.

Study details

Doses studied — not a dosing recommendation. Regimens belong to the named study, formulation and population.

Phase 2 subcutaneous diabetes trial

Population
262 adults with type 2 diabetes on metformin with or without an SGLT2 inhibitor.
Doses and administration studied
0.4, 1.5, 5, 10, 20 or 40 mg subcutaneously once weekly, with fixed escalation.
Duration
36 weeks; 40 mg group had only four weeks at target dose
Reported finding / status
Sponsor reported up to 14.6% mean weight loss in the 40 mg group, versus 2.1% placebo.
Interpretation and limitations
Diabetes-population results are not an obesity-label estimate. Oral and injectable programs have separate timelines and are not interchangeable.

Source tier E · Read the original study or record

Outcome Evidence Strength

Weight change2/5
Fat-mass change0/5
Lean-mass change0/5
Strength / function benefit0/5

Weight: sponsor-reported phase 2 results. Composition and function benefits are not established in the cited report.

Editorial evidence ratings for the cited outcomes, not effect size or treatment recommendations. A lean-mass score may describe loss. 0 means not established in the reviewed evidence, not proof of no effect. Read the rubric.

What is actually established?

  • Novo Nordisk initiated the AMAZE Phase 3 obesity program in the first quarter of 2026.
  • At ADA 2026, the company reported Phase 2 subcutaneous zenagamtide weight loss up to about 14.6% at 36 weeks in adults with type 2 diabetes.
  • The molecule is being developed in subcutaneous and oral formulations.

What is not established?

  • Zenagamtide is not FDA-approved.
  • The Phase 2 diabetes results do not establish the eventual obesity-label efficacy.
  • Lean-mass preservation and physical-function evidence are not yet mature.

Evidence sources

A = regulatory/official • B = peer-reviewed randomized/meta-analysis • C = peer-reviewed review/observational • D = registered trial • E = sponsor-reported • F = preclinical

Source tier E — Sponsor Phase 2 update
ADA 2026 zenagamtide Phase 2 results
Source tier E — Company pipeline report
AMAZE Phase 3 obesity program status

Last evidence review: September 19, 2026.

Educational use only. This page summarizes research evidence and regulatory status. Study doses describe research, not prescribing instructions. This page does not provide personalized dosing, self-use protocols, sourcing, or a recommendation to use this therapy.