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Mazdutide vs Survodutide: Two GLP-1/Glucagon Dual Agonists Compared

Part of Weight Loss Drug Comparison Index.

Mazdutide vs Survodutide: Two GLP-1/Glucagon Dual Agonists Compared

Mazdutide and survodutide both activate GLP-1 and glucagon receptors. Mazdutide is approved in China, while survodutide remains investigational. Both now have Phase 3 results, including survodutide obesity and MASLD results reported in June 2026. No head-to-head trial establishes which is better for weight loss, liver disease or tolerability.
Mazdutide (brand name Xinermei) is developed by Innovent Biologics (based on a molecule originally discovered by Eli Lilly) and is already approved in China for both obesity and type 2 diabetes. Survodutide (development code BI 456906) is developed by Boehringer Ingelheim and Zealand Pharma and remains in Phase 3 trials with no regulatory approval anywhere.

No head-to-head trial has compared these two drugs directly. All comparisons on this page are cross-trial and should be interpreted with that limitation in mind.

Side-by-Side Comparison

MazdutideSurvodutide
ReceptorsGLP-1 and glucagonGLP-1 and glucagon
DeveloperInnovent; molecule licensed from LillyBoehringer Ingelheim / Zealand Pharma
Development codeIBI362 / LY3305677BI 456906
Regulatory statusApproved in China for weight management and type 2 diabetes; not FDA-approvedInvestigational; not approved
Selected Phase 3 weight resultGLORY-2: −16.65% at 60 weeks, 9 mg, treatment-policy estimandSYNCHRONIZE-1: −13.0% at 76 weeks, 6 mg, treatment-regimen estimand
Selected liver evidenceMRI-measured liver-fat reductionMRI liver-fat data and separate biopsy-based MASH trial
Administration studiedOnce-weekly subcutaneous injectionOnce-weekly subcutaneous injection

These estimates come from different populations and follow-up periods. They are study results, not a ranking or a dose-conversion table.

How the Mechanisms Compare

Both are GLP-1/glucagon dual agonists, but they are different molecules. Receptor potency, exposure and dose escalation differ; equal milligram doses are not equivalent.

The Shared GLP-1 Component

GLP-1 receptor activity helps regulate appetite and glucose-dependent insulin secretion. Both drugs have demonstrated weight effects in human trials.

The Shared Glucagon Component

Glucagon receptor activity provides a rationale for studying liver-fat metabolism and energy expenditure. That rationale does not show how much of an individual’s weight loss comes from increased energy expenditure, or prove superiority to drugs without glucagon agonism. The GLORY-1 authors describe glucagon-driven lipid oxidation as a possible explanation for the observed metabolic changes.

What Neither Drug Targets: GIP

Neither includes GIP receptor agonism. Retatrutide targets GLP-1, GIP and glucagon receptors, while tirzepatide targets GLP-1 and GIP. Cross-trial weight differences cannot isolate the contribution of one receptor.

Weight Loss Comparison

Mazdutide Weight Loss Data

The GLORY trials enrolled Chinese adults. GLORY-1 included 610 participants with obesity or overweight and a weight-related condition. GLORY-2 randomized 462 adults with BMI at least 30, including some with type 2 diabetes.

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TrialDoseTimepointMean weight changeAnalysis
GLORY-14 mg48 weeks−11.00% vs +0.30% placeboTreatment-policy
GLORY-16 mg48 weeks−14.01% vs +0.30% placeboTreatment-policy
GLORY-29 mg60 weeks−16.65% vs −1.50% placeboTreatment-policy
GLORY-29 mg60 weeks−18.55% vs −3.02% placeboEfficacy
Innovent’s earlier topline release reported 20.1% weight loss in the subgroup without diabetes. That subgroup estimate should not replace the whole-trial result. The GLORY-2 paper was published in JAMA in June 2026.

A U.S. Phase 2 study published in August 2026 adds evidence beyond the Chinese GLORY program. It randomized 179 adults without diabetes and studied doses up to 16 mg for 48 weeks. At the primary 32-week endpoint, the 16 mg group had 18.1% mean weight loss versus 0.9% with placebo under the efficacy estimand. Adverse-event discontinuation reached 20% at 16 mg, so the low GLORY discontinuation rates cannot be generalized to every mazdutide regimen.

Survodutide Weight Loss Data

The Phase 2 obesity paper reported the following results according to planned treatment at 46 weeks: −6.2%, −12.5%, −13.2% and −14.9% with 0.6, 2.4, 3.6 and 4.8 mg, respectively, versus −2.8% with placebo. The often-cited 18.7% result comes from a different analysis and should not be inserted into that series.

The Phase 3 SYNCHRONIZE-1 trial now provides 76-week results in adults without diabetes:

DoseMean weight changeAnalysis
3.6 mg−12.2%Treatment-regimen
6.0 mg−13.0%Treatment-regimen
Placebo−5.4%Treatment-regimen

Boehringer also reported up to 16.6% loss versus 3.2% with placebo under the efficacy estimand, which estimates the effect assuming continued treatment. It is a different statistical question from the treatment-regimen analysis.

Why These Numbers Are Not Directly Comparable

The trials differ in diabetes status, baseline characteristics, country, duration and handling of treatment discontinuation. A continuing weight curve does not establish what would happen after the measured endpoint. No direct comparison establishes equivalence or superiority between these drugs.

Liver Fat and MASH

Mazdutide Liver Data

Innovent reported a 71.9% relative reduction in MRI-measured liver fat at 60 weeks with mazdutide 9 mg, versus a 5.1% increase with placebo, in a GLORY-2 subgroup without diabetes and with baseline liver fat of at least 10%. This imaging endpoint does not establish MASH resolution or reversal of fibrosis.

Survodutide Liver Data

The published Phase 2 MASH trial tested 2.4, 4.8 and 6.0 mg for 48 weeks in adults with biopsy-confirmed MASH and fibrosis stages F1–F3. Its primary endpoint was MASH improvement without worsening fibrosis, not MASH resolution. In the modified intention-to-treat analysis, the endpoint occurred in 47%, 62% and 43% of the respective survodutide groups versus 14% with placebo.

The widely repeated “83%” headline described a different analysis of MASH improvement. Calling it an 83% resolution rate is incorrect. Fibrosis improvement was a secondary endpoint; the paper cautioned that secondary comparisons were not adjusted for multiplicity and should not establish definitive treatment effects.

In the separate Phase 3 SYNCHRONIZE-MASLD trial, Boehringer reported that 84.2% achieved at least a 30% relative liver-fat reduction at 48 weeks under the efficacy estimand, versus 24.3% with placebo. This is the proportion crossing an imaging threshold, not an 84.2% mean reduction or biopsy resolution rate.

Different Endpoints, Different Strengths

MRI fat reduction, biopsy-based inflammation improvement and fibrosis change answer different questions. Neither these results nor receptor biology establishes that one drug treats liver disease better than the other. Approved U.S. MASH treatments now include semaglutide for eligible adults; neither mazdutide nor survodutide is FDA-approved.

Side Effects and Tolerability

Both drugs commonly caused gastrointestinal adverse events. Discontinuation is one measure of tolerability, not a complete measure of safety.

Mazdutide: Low Discontinuation in GLORY Trials

GLORY-1 adverse-event discontinuation was 1.5% with 4 mg, 0.5% with 6 mg and 1.0% with placebo. GLORY-2 reported 2.9% with 9 mg versus 0% with placebo. Low discontinuation did not mean no adverse events: GLORY-1 reported nausea, vomiting, diarrhea and less frequent serious events, including an investigator-assessed treatment-related case of cholecystitis with obstructive pancreatitis.

Survodutide: Phase 3 Tolerability Data

In SYNCHRONIZE-1, Boehringer reported discontinuation due to gastrointestinal adverse events in 19% of survodutide-treated participants versus 2.9% with placebo. That GI-specific measure should not be presented as an all-adverse-event rate.

These separate trials do not prove mazdutide is the safest or best-tolerated drug in its class. Dose adjustments, follow-up, trial support and participant characteristics can affect whether people stop treatment.

Diabetes Data

Mazdutide: Strong Diabetes Evidence

Mazdutide is approved in China for type 2 diabetes (September 2025), supported by the DREAMS trial program. The most notable result comes from DREAMS-3, a head-to-head comparison against semaglutide 1 mg:
OutcomeMazdutide 6 mgSemaglutide 1 mg
Primary composite (HbA1c under 7% + 10%+ weight loss)48%21%
HbA1c reduction-2.03%-1.84%
Weight loss-10.29%-6.00%

These were 32-week efficacy-estimand results from DREAMS-3, an open-label trial in 329 Chinese adults with type 2 diabetes and obesity. The findings concern semaglutide 1 mg, not higher diabetes or weight-management doses.

Survodutide: Not a Diabetes Focus

Survodutide’s program focuses on obesity and liver disease. However, SYNCHRONIZE-2 is a Phase 3 obesity trial specifically enrolling adults with type 2 diabetes; saying there is no Phase 3 study in diabetes would be misleading. That study is distinct from a diabetes prescribing indication.

This is a clear strategic divergence. Mazdutide is pursuing both obesity and diabetes indications. Survodutide is pursuing obesity and MASH.

Development Status and Availability

Mazdutide received Chinese approvals for chronic weight management in June 2025 and type 2 diabetes in September 2025. Its higher 9 mg weight-management application was accepted for review in November 2025; the inspected June 2026 update still described an application, not approval of that dose.

Survodutide remains investigational despite published Phase 3 obesity and MASLD results. Its biopsy-based MASH program includes the LIVERAGE studies.

Mazdutide’s U.S. Phase 2 study is completed and published, but it does not establish a submission or approval date. No confirmed U.S. commercial availability date for mazdutide was identified. Neither mazdutide nor survodutide is FDA-approved.

Where Retatrutide Fits

Retatrutide adds GIP receptor activity to GLP-1 and glucagon activity. It remains investigational. Its separate TRIUMPH-4 and liver-fat studies do not establish superiority over mazdutide or survodutide, or identify how much benefit comes from each receptor.
For the trial-specific evidence, see Retatrutide vs Mazdutide and Retatrutide vs Survodutide.

Frequently Asked Questions

Are mazdutide and survodutide the same type of drug?

Yes, both are GLP-1/glucagon dual agonists — they target the same two receptors. However, they are different molecules with different structures, different receptor binding ratios, and different clinical profiles. Think of them as two different drugs built on the same concept, similar to how semaglutide and liraglutide are both GLP-1 agonists but are distinct drugs.

Which drug produces more weight loss?

No head-to-head trial establishes that. GLORY-2 and SYNCHRONIZE-1 now both have Phase 3 results, but their populations, follow-up and statistical analyses differ. Compare each active group with its own placebo group rather than treating headline percentages as a ranking.

Which is better for liver disease (MASH)?

The available trials cannot answer that directly. Mazdutide imaging results and survodutide biopsy and imaging studies use different endpoints. MASH improvement is not the same as MASH resolution, and neither is interchangeable with a percentage reduction in liver fat.

Can I get either drug in the US?

Neither is FDA-approved. Check official sponsor and registry listings for any research opportunities; trial results do not authorize commercial treatment.

How do these drugs compare to retatrutide?

Retatrutide targets GLP-1, GIP and glucagon receptors; mazdutide and survodutide target GLP-1 and glucagon. Separate trials cannot isolate the extra receptor’s contribution or determine which drug would work best for an individual.

Which drug has better tolerability?

Mazdutide had low adverse-event discontinuation rates in the GLORY trials, while survodutide had substantial GI-related discontinuation in SYNCHRONIZE-1. These are different trials and measures, so they do not establish a universal safety ranking.

Sources

  • Hsia, S.H., et al. (2026). U.S. Phase 2 mazdutide trial. PubMed
  • Ji, L., et al. (2025). Mazdutide in Chinese Adults with Overweight or Obesity (GLORY-1). New England Journal of Medicine. NEJM
  • Innovent Biologics. (2026). GLORY-2 results and development update. Press release
  • Innovent. DREAMS-3 ADA 2026 results, 32-week efficacy estimand. Primary report
  • Gao, L., et al. (2026). GLORY-2. JAMA
  • le Roux, C.W., et al. (2026). SYNCHRONIZE-1. PubMed
  • Sanyal, A.J., et al. (2024). Survodutide in MASH and fibrosis. NEJM
  • Boehringer Ingelheim. (2026). SYNCHRONIZE-1 and MASLD results. Primary release
  • Boehringer Ingelheim. Survodutide Phase 2 obesity trial results. ClinicalTrials.gov (NCT04667377)
  • Jastreboff, A.M., et al. (2023). Triple-Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial. New England Journal of Medicine. DOI: 10.1056/NEJMoa2301972
  • ClinicalTrials.gov: Mazdutide trials, Survodutide trials
How we keep this honest
What this is
Educational information, not medical advice. It reports published research — it doesn’t recommend that you use, obtain, or supply anything.
Regulatory status
Mazdutide has NMPA approval in China for specific weight-management and type 2 diabetes indications. Survodutide remains investigational; study results do not establish approval in another country.
Our standard
Every claim traces to a primary source. We label the strength of evidence and flag estimates as estimates — never as clinical fact.
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We don’t sell, supply, or link to suppliers of any medicine, and aren’t affiliated with any manufacturer.

Do not make decisions about your health without consulting a qualified healthcare provider. For trial enrolment, see ClinicalTrials.gov. More on how we review.

Sources

Grounded in primary sources
NEJMThe LancetJAMAFDAClinicalTrials.gov

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