Mazdutide vs Survodutide: Two GLP-1/Glucagon Dual Agonists Compared
Mazdutide and survodutide are the two most advanced GLP-1/glucagon dual agonists in development. Both target the same two receptors — GLP-1 for appetite suppression and glucagon for increased energy expenditure and liver fat oxidation — but they come from different companies, have different clinical profiles, and are at different stages of development.
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
| Mazdutide | Survodutide | |
|---|---|---|
| Mechanism | GLP-1 + Glucagon (dual agonist) | GLP-1 + Glucagon (dual agonist) |
| Developer | Innovent Biologics (molecule from Eli Lilly) | Boehringer Ingelheim / Zealand Pharma |
| Development code | IBI362 / LY3305677 | BI 456906 |
| Brand name | Xinermei (China) | None assigned |
| Regulatory status | Approved in China (obesity: June 2025, T2D: September 2025). Not FDA approved. | Not approved anywhere. Phase 3 ongoing. |
| Dosing | Once weekly injection | Once weekly injection |
| Max dose tested | 9 mg (GLORY-2) | 4.8 mg (Phase 2) |
| Max weight loss | -20.1% (GLORY-2, 9 mg, 60 wks, non-T2D subgroup) | -18.7% (Phase 2, 4.8 mg, 46 wks) |
| MASH/liver fat data | 73-80% liver fat reduction (Phase 2 MASLD substudy) | 83% MASH resolution (Phase 2 biopsy-confirmed) |
| HbA1c reduction | -2.03% (DREAMS-3, 6 mg) | Not primary focus |
| Discontinuation rate (AEs) | 0.5-1.5% (GLORY-1, 6 mg); 2.9% (GLORY-2, 9 mg) | Higher than class average (Phase 2) |
| Primary indications | Obesity and type 2 diabetes | Obesity and MASH |
How the Mechanisms Compare
Both mazdutide and survodutide are GLP-1/glucagon dual agonists. They target the same two receptors, which means their fundamental mechanism is identical in concept: appetite suppression via GLP-1 and increased energy expenditure and liver fat clearance via glucagon. Neither drug targets GIP.
However, "same two receptors" does not mean "same drug." The two molecules differ in their:
- Receptor binding ratios: The relative potency at the GLP-1 receptor versus the glucagon receptor differs between the two drugs. Survodutide may have a relatively stronger glucagon signal, which could explain its particularly strong MASH data. Mazdutide's balance may favor a broader metabolic profile.
- Molecular structure: Mazdutide and survodutide are structurally distinct peptides with different half-lives, pharmacokinetic profiles, and dose ranges.
- Dose ranges: Mazdutide has been tested up to 9 mg. Survodutide has been tested up to 4.8 mg. These numbers are not directly comparable because the molecules have different potencies per milligram.
The Shared GLP-1 Component
Both drugs activate the GLP-1 receptor, providing the appetite-suppressing and insulin-sensitizing effects familiar from semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound). This reduces food intake and improves blood sugar control.
The Shared Glucagon Component
Both drugs activate the glucagon receptor, which is what sets them apart from semaglutide and tirzepatide. Glucagon receptor activation:
- Increases energy expenditure through thermogenesis
- Promotes hepatic fat oxidation — directly breaking down fat stored in the liver
- Stimulates lipolysis — fat breakdown in adipose tissue
This shared glucagon component is why both drugs show stronger liver fat reduction than GLP-1-only or GLP-1/GIP drugs, and why both are being studied for MASH.
What Neither Drug Targets: GIP
Neither mazdutide nor survodutide includes GIP (glucose-dependent insulinotropic polypeptide) agonism. GIP is the third receptor targeted by retatrutide, Eli Lilly's triple agonist, and is one of the two receptors targeted by tirzepatide. The absence of GIP agonism in both drugs is what distinguishes them from those drugs and may explain why their peak weight loss numbers are somewhat lower than retatrutide's.
Weight Loss Comparison
Mazdutide Weight Loss Data
Mazdutide has Phase 3 weight loss data from two GLORY trials in Chinese adults:
| Trial | Dose | Duration | Weight Loss |
|---|---|---|---|
| GLORY-1 (Phase 3) | 4 mg | 48 weeks | -11.00% |
| GLORY-1 (Phase 3) | 6 mg | 48 weeks | -14.01% |
| GLORY-2 (Phase 3) | 9 mg | 60 weeks | -18.55% (all participants) |
| GLORY-2 (Phase 3, non-T2D) | 9 mg | 60 weeks | -20.1% |
In the GLORY-2 trial, 48.7% of participants without type 2 diabetes achieved 20% or greater weight loss at 60 weeks. Weight loss was still continuing at week 60 with no plateau observed. Discontinuation rates remained very low (2.9% for the 9 mg dose).
Survodutide Weight Loss Data
Survodutide has Phase 2 weight loss data from a trial of 387 adults with obesity:
| Dose | Weight Loss at 46 Weeks |
|---|---|
| 0.6 mg | -6.2% |
| 2.4 mg | -12.5% |
| 3.6 mg | -13.2% |
| 4.8 mg | -18.7% |
| Placebo | ~-2% |
At the highest dose (4.8 mg), up to 40% of participants achieved 20% or more weight loss. The weight loss curve had not plateaued at 46 weeks, suggesting longer treatment could yield greater reductions. Phase 3 results are pending.
Why These Numbers Are Not Directly Comparable
Cross-trial comparisons between these two drugs are particularly tricky:
- Population: Mazdutide's GLORY trials enrolled Chinese adults. Survodutide's Phase 2 trial enrolled a primarily Western population. Ethnic and genetic differences can affect drug response and body composition.
- Trial phase: Mazdutide has Phase 3 data. Survodutide's weight loss data is Phase 2 only. Phase 3 results may differ.
- Duration: GLORY-2 was 60 weeks. Survodutide Phase 2 was 46 weeks. Neither drug had plateaued at study end.
- Dose: Mazdutide was tested up to 9 mg. Survodutide was tested up to 4.8 mg. Different potencies make milligram-to-milligram comparison meaningless.
The topline numbers are broadly similar (18-20% range at the highest doses), suggesting that the two GLP-1/glucagon dual agonists produce weight loss in the same general range. Whether one is genuinely superior would require a head-to-head trial.
Liver Fat and MASH
Liver disease is where GLP-1/glucagon dual agonists may have their greatest clinical impact. Both drugs leverage the glucagon receptor to drive hepatic fat oxidation — a mechanism that pure GLP-1 drugs lack.
Mazdutide Liver Data
In a Phase 2 MASLD substudy, mazdutide produced 73-80% liver fat reduction. The GLORY-2 trial at the 9 mg dose showed 71.9% liver fat reduction in a MASLD substudy. Both results far exceed what semaglutide (~40-50%) or tirzepatide (~50-55%) achieve.
Survodutide Liver Data
Survodutide's MASH data is arguably its strongest differentiator. In a Phase 2 trial of adults with biopsy-confirmed MASH, 83% of participants showed biopsy-proven MASH resolution without worsening fibrosis at 48 weeks. The drug also met its secondary endpoint for improvement in liver fibrosis.
| Endpoint | Mazdutide | Survodutide |
|---|---|---|
| Liver fat reduction | 73-80% (Phase 2 MASLD substudy) | Not reported separately |
| MASH resolution (biopsy) | Not yet reported | 83% (Phase 2) |
| Fibrosis improvement | Not yet reported | Met secondary endpoint (Phase 2) |
| Phase 3 MASH program | Under investigation | Ongoing (major development focus) |
Different Endpoints, Different Strengths
It is important to note that mazdutide and survodutide have reported different liver endpoints. Mazdutide's published data focuses on liver fat reduction measured by imaging. Survodutide's MASH data reports biopsy-confirmed MASH resolution — a more clinically meaningful endpoint that measures actual disease reversal, not just fat reduction.
Both results are impressive compared to the current treatment landscape, where effective pharmacological options for MASH are extremely limited. Boehringer Ingelheim has made MASH a central part of survodutide's development strategy, which may give survodutide a regulatory and commercial advantage in this specific indication even if mazdutide matches it on weight loss.
Side Effects and Tolerability
Both drugs produce the gastrointestinal side effects typical of GLP-1 agonists: nausea, vomiting, diarrhea, and decreased appetite. However, they differ significantly in tolerability.
Mazdutide: Exceptional Tolerability
Mazdutide has the lowest reported discontinuation rate of any GLP-1-class drug in Phase 3 obesity trials:
- GLORY-1 (6 mg): 0.5-1.5% discontinued due to adverse events
- GLORY-2 (9 mg): 2.9% discontinued due to adverse events
For context, semaglutide 2.4 mg (STEP 1) had approximately 7% discontinuation, and tirzepatide (SURMOUNT-1) had 4-7% across dose groups. Mazdutide's gradual titration schedule likely contributes to this tolerability.
Survodutide: Higher Discontinuation in Phase 2
Survodutide's Phase 2 data showed notably higher discontinuation rates. The trial used a relatively rapid 20-week dose escalation, which likely contributed to gastrointestinal intolerance. Slower titration in Phase 3 trials may improve this number, but the Phase 2 data stands as a concern.
| Mazdutide | Survodutide | |
|---|---|---|
| Common side effects | Nausea, diarrhea, decreased appetite, vomiting | Nausea, diarrhea, vomiting |
| Discontinuation due to AEs | 0.5-2.9% (GLORY trials) | Higher than class average (Phase 2) |
| Key tolerability factor | Very gradual titration schedule | Rapid dose escalation in Phase 2 |
| Severity | Generally mild to moderate | Mild to moderate; GI events concentrated during escalation |
Tolerability is a genuine differentiator for mazdutide. In real-world clinical use, a drug that patients can tolerate and stay on long-term will often outperform a drug with slightly better efficacy but higher dropout rates. Mazdutide's tolerability advantage is one of its most important clinical features.
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:
| Outcome | Mazdutide 6 mg | Semaglutide 1 mg |
|---|---|---|
| Primary composite (HbA1c under 7% + 10%+ weight loss) | 48% | 21% |
| HbA1c reduction | -2.03% | -1.84% |
| Weight loss | -10.29% | -6.00% |
Mazdutide outperformed semaglutide 1 mg on both glycemic control and weight loss. Note that the trial used semaglutide 1 mg, not the maximum 2 mg dose.
Survodutide: Not a Diabetes Focus
Survodutide is not being primarily developed for type 2 diabetes. Its development program focuses on obesity and MASH. While the GLP-1 component provides glucose-lowering effects, Boehringer Ingelheim has not positioned survodutide as a diabetes drug, and no Phase 3 diabetes trials have been announced.
This is a clear strategic divergence. Mazdutide is pursuing both obesity and diabetes indications. Survodutide is pursuing obesity and MASH.
Development Status and Availability
| Milestone | Mazdutide | Survodutide |
|---|---|---|
| Phase 2 | Completed | Completed |
| Phase 3 | GLORY program completed | Ongoing |
| Regulatory approval | Approved in China (obesity: June 2025, T2D: September 2025) | Not approved anywhere |
| Brand name | Xinermei | Not assigned |
| US status | Phase 2 ongoing; no FDA timeline | Phase 3 ongoing; no FDA timeline |
| Availability | Available by prescription in China | Clinical trials only |
Mazdutide is further along in development and is the first GLP-1/glucagon dual agonist approved anywhere in the world. However, its approval is limited to China, and there is no established path to FDA approval.
Survodutide has no regulatory approvals but is being developed with a global strategy. If Boehringer Ingelheim's Phase 3 program succeeds, survodutide could be the first GLP-1/glucagon drug available in Western markets.
Where Retatrutide Fits
Both mazdutide and survodutide are dual agonists (GLP-1 + glucagon). Retatrutide is a triple agonist that targets GLP-1, GIP, and glucagon — adding the GIP receptor that both mazdutide and survodutide omit.
| Mazdutide | Survodutide | Retatrutide | |
|---|---|---|---|
| Receptors | GLP-1 + Glucagon | GLP-1 + Glucagon | GLP-1 + GIP + Glucagon |
| Max weight loss | -20.1% (GLORY-2, 60 wks) | -18.7% (Phase 2, 46 wks) | -28.7% (TRIUMPH-4, 68 wks) |
| Liver fat reduction | 73-80% | 83% MASH resolution | 82-86% |
| Developer | Innovent Biologics | Boehringer Ingelheim | Eli Lilly |
| Approval status | Approved in China | Not approved | Not approved |
Retatrutide's inclusion of GIP agonism on top of the GLP-1/glucagon combination likely contributes to its higher overall weight loss numbers. All three drugs share the glucagon component that drives liver fat reduction, which is why they all show strong MASH/MASLD potential.
For detailed comparisons, 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?
The weight loss results are broadly similar at the highest doses tested: mazdutide 9 mg produced 18.55-20.1% weight loss at 60 weeks (GLORY-2), and survodutide 4.8 mg produced 18.7% at 46 weeks (Phase 2). Neither had plateaued. These results come from different trials with different populations (Chinese vs. Western) and durations, so a definitive answer requires a head-to-head trial.
Which is better for liver disease (MASH)?
Both drugs show strong liver effects due to their shared glucagon mechanism. Survodutide has the more impressive MASH-specific data: 83% biopsy-confirmed MASH resolution in Phase 2. Mazdutide has shown 73-80% liver fat reduction by imaging. These are different endpoints measured in different ways. Survodutide's biopsy data is considered more clinically meaningful, and Boehringer Ingelheim has made MASH a central development focus.
Can I get either drug in the US?
No. Neither drug is FDA approved. Mazdutide (Xinermei) is available by prescription in China only. Survodutide is not approved anywhere and is only available through clinical trial enrollment. There is no established FDA timeline for either drug.
How do these drugs compare to retatrutide?
Retatrutide is a triple agonist (GLP-1 + GIP + glucagon) while both mazdutide and survodutide are dual agonists (GLP-1 + glucagon). Retatrutide includes the additional GIP receptor, which likely contributes to its higher weight loss numbers (up to 28.7% at 68 weeks). All three drugs share the glucagon component and show strong liver fat reduction. See our detailed comparisons: retatrutide vs mazdutide and retatrutide vs survodutide.
Which drug has better tolerability?
Mazdutide has demonstrated the best tolerability of any GLP-1-class drug in Phase 3 trials, with only 0.5-2.9% of participants discontinuing due to side effects across the GLORY program. Survodutide's Phase 2 data showed higher discontinuation rates, though this may improve in Phase 3 with slower dose titration. Both drugs produce the standard GLP-1 gastrointestinal side effects (nausea, diarrhea, vomiting).
Sources
- Ji, L., et al. (2025). Mazdutide in Chinese Adults with Overweight or Obesity (GLORY-1). New England Journal of Medicine. NEJM
- Innovent Biologics. (2025). Mazdutide 9 mg Achieves Up to 20.1% Weight Loss in Chinese Adults with Obesity — GLORY-2 Study Results. Press release
- DREAMS-3 trial results. Mazdutide vs semaglutide 1 mg in type 2 diabetes. Phase 3, 32 weeks.
- Boehringer Ingelheim. Survodutide Phase 2 obesity trial results. ClinicalTrials.gov (NCT04667377)
- Boehringer Ingelheim. Survodutide Phase 2 MASH trial results. Boehringer Ingelheim
- 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
Medical Disclaimer
The content on glp3.wiki is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Survodutide is an investigational drug that has not been approved by the U.S. Food and Drug Administration (FDA) or any other regulatory agency. Mazdutide is approved in China but has not been approved by the FDA.
Do not use this information to make decisions about your health without consulting a qualified healthcare provider. The clinical trial data cited on this page reflects results from controlled research settings and may not reflect real-world outcomes.
If you are considering weight loss medication, talk to your doctor about currently approved options available in your country. For information about enrolling in clinical trials, visit ClinicalTrials.gov.
This site is not affiliated with Innovent Biologics, Eli Lilly, Boehringer Ingelheim, Zealand Pharma, or any pharmaceutical manufacturer.
Sources
- GLORY-1 trial (NEJM)
New England Journal of Medicine
- Survodutide Phase 2 trial
ClinicalTrials.gov
- GLORY-2 results
Innovent Biologics
Related reading
What Is Mazdutide (Xinermei)? The First GLP-1/Glucagon Drug Approved in China
The first GLP-1/glucagon dual agonist approved anywhere — how it works, what the trials show, and why it matters for the obesity drug landscape.
What Is Survodutide? The Dual GLP-1/Glucagon Agonist for Weight Loss and MASH
Boehringer Ingelheim's dual GLP-1/glucagon agonist — 18.7% weight loss in Phase 2, 83% MASH resolution, Phase 3 ongoing.
Retatrutide vs Survodutide
Two next-generation obesity drugs that both include glucagon agonism — how the triple and dual agonist approaches compare.