Mazdutide vs Retatrutide: Dual Agonist vs Triple Agonist Compared

Mazdutide and retatrutide both include glucagon receptor agonism in their design, which sets them apart from earlier drugs like semaglutide (GLP-1 only) and tirzepatide (GLP-1 + GIP). But they are not the same drug, and they take different approaches to multi-receptor agonism.

Mazdutide is a dual agonist targeting GLP-1 and glucagon. Retatrutide is a triple agonist targeting GLP-1, GIP, and glucagon. Both have shown significant weight loss and liver fat reduction in clinical trials, but they differ in mechanism, dosing, regulatory status, and the populations studied.

This page compares the two drugs based on published trial data. No head-to-head trial between mazdutide and retatrutide has been conducted, so all comparisons are cross-trial and should be interpreted with caution.

Side-by-Side Comparison

How the Mechanisms Differ

Both mazdutide and retatrutide include glucagon receptor activity, which is what makes them fundamentally different from semaglutide and tirzepatide. But they diverge in which other receptor they target alongside glucagon.

Mazdutide: GLP-1 + Glucagon

Mazdutide activates two receptors: GLP-1 and glucagon. GLP-1 reduces appetite and improves insulin secretion. The glucagon component promotes fat oxidation in the liver and increases energy expenditure. Notably, mazdutide does not target GIP.

This dual approach focuses on the combination of appetite suppression (GLP-1) and increased metabolic activity (glucagon). The absence of GIP agonism distinguishes mazdutide from tirzepatide and retatrutide.

Retatrutide: GLP-1 + GIP + Glucagon

Retatrutide activates all three receptors: GLP-1, GIP, and glucagon. GIP complements GLP-1 by further enhancing insulin secretion and may have additional effects on fat metabolism. The glucagon component provides the same liver fat and energy expenditure benefits seen with mazdutide.

The addition of GIP on top of GLP-1 and glucagon is what defines retatrutide as a triple agonist. Whether activating three receptors produces meaningfully better outcomes than two is a question only a head-to-head trial can answer definitively.

The Common Thread: Glucagon

What both drugs share — and what sets them apart from semaglutide and tirzepatide — is glucagon receptor activation. This is the receptor responsible for:

• Hepatic fat oxidation: directly breaking down fat stored in the liver
• Thermogenesis: increasing the body's energy expenditure
• Lipolysis: promoting fat breakdown in adipose tissue

This shared glucagon component is why both drugs show particularly strong liver fat reduction data, a benefit not seen to the same degree with GLP-1-only or GLP-1/GIP drugs.

Weight Loss Data

Mazdutide (GLORY-1 Trial)

The GLORY-1 trial was a Phase 3, randomized, double-blind, placebo-controlled study published in the New England Journal of Medicine in 2025. It enrolled 610 Chinese adults with obesity (BMI >= 28) or overweight (BMI >= 24) with at least one weight-related comorbidity (mean baseline weight 87.2 kg, mean BMI 31.1). Participants were randomized to mazdutide 4 mg, 6 mg, or placebo, once weekly for 48 weeks. Results at Week 48, reported under both the efficacy estimand (effect if treatment is taken as intended) and the treatment-policy estimand (effect regardless of adherence):

Responder rates at the 6 mg dose were high: 50.6% of participants achieved at least 15% weight loss, 67.9% achieved at least 10%, and 82.8% achieved at least 5% — versus 2.1%, 2.9%, and 11.5% on placebo. Mazdutide 6 mg also reduced waist circumference by 10.96 cm (versus 1.48 cm on placebo).

Retatrutide (Phase 2 and TRIUMPH-4)

Retatrutide's weight loss data comes from two key studies:

TRIUMPH-4 enrolled participants with obesity and knee osteoarthritis, a specific population that may not be directly comparable to GLORY-1's general obesity cohort.

Why These Numbers Cannot Be Compared Directly

The weight loss figures above come from different trials with significant differences:

• Population: GLORY-1 enrolled Chinese adults. Retatrutide trials enrolled primarily Western populations. Ethnic and genetic differences can affect drug response, body composition, and baseline metabolic profiles.
• Duration: GLORY-1 was 48 weeks. TRIUMPH-4 was 68 weeks. Longer trials generally produce greater weight loss, as the weight loss curve may not have plateaued.
• Max dose: Mazdutide was tested up to 6 mg. Retatrutide was tested up to 12 mg. Higher doses within a drug class often produce greater effects.
• Trial phase and size: Both GLORY-1 and TRIUMPH-4 are Phase 3 trials, but they differ in sample size, inclusion criteria, and study design.
• Comparator populations: TRIUMPH-4 specifically enrolled people with knee osteoarthritis, while GLORY-1 enrolled a broader obesity population.

The general trend suggests retatrutide produces greater absolute weight loss, but the precise magnitude of the difference and whether it holds across similar populations remains unknown without a direct head-to-head comparison.

Diabetes Management

Mazdutide (DREAMS-3 Trial)

The DREAMS-3 trial is notable because it is a head-to-head comparison — mazdutide 6 mg versus semaglutide 1 mg in adults with type 2 diabetes over 32 weeks.

This is one of the few head-to-head trials in this drug class, and it showed mazdutide outperforming semaglutide 1 mg on both glycemic control and weight loss. However, semaglutide's maximum approved dose for diabetes is 2 mg (Ozempic), and the trial used the 1 mg dose, not the highest available dose.

Retatrutide (Phase 2 T2D Data)

Retatrutide's diabetes data comes from a Phase 2 trial in people with type 2 diabetes, published in The Lancet in 2023:

• HbA1c reduction: -2.02% at the 12 mg dose
• This is comparable to tirzepatide's Phase 3 diabetes data and numerically similar to mazdutide's DREAMS-3 result

Both drugs show strong glucose-lowering effects. The glucagon component, which raises blood sugar in isolation, is more than offset by the GLP-1 activity (and GIP activity in retatrutide's case) in both drugs, resulting in net HbA1c improvement.

Liver Fat Reduction

Liver fat reduction is where the glucagon receptor really matters, and both mazdutide and retatrutide have produced striking data in this area.

GLORY-1's liver fat results are notable because they come from a Phase 3 trial, not a substudy: among participants with baseline liver fat content of at least 10%, mazdutide 6 mg cut liver fat by 80.2% at Week 48 (placebo: -5.27%). This is squarely in retatrutide's range and confirms that the glucagon component drives the effect in both drugs.

Both drugs dramatically outperform GLP-1-only and GLP-1/GIP drugs for liver fat reduction. This is directly attributable to glucagon receptor activation, which promotes hepatic fat oxidation — the liver directly breaks down stored fat at an accelerated rate.

For people with metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD) or its more severe form MASH (formerly NASH), both mazdutide and retatrutide represent a significant advance over existing options. Currently, there are very few effective pharmacological treatments for these conditions.

Retatrutide's Phase 3 TRIUMPH program includes a dedicated MASH trial, and Innovent has been investigating mazdutide in MASLD as well. Results from these larger studies will clarify the real-world potential of glucagon-containing agonists for liver disease.

The Mazdutide Trial Program

Mazdutide's evidence base comes from two Phase 3 program families in China — GLORY (obesity) and DREAMS (type 2 diabetes). Several of these are head-to-head designs against currently approved drugs, which is unusual in this class:

Retatrutide, by contrast, has no head-to-head trials against approved drugs — its Phase 3 TRIUMPH program is placebo-controlled. The GLORY-3 trial (mazdutide vs semaglutide in fatty liver disease) is the closest the field has to validating a glucagon-containing agonist against the standard of care for liver outcomes.

Regulatory Status and Availability

Mazdutide

Mazdutide was developed by Innovent Biologics, a Chinese biopharmaceutical company, based on a molecule originally discovered by Eli Lilly. It is approved in China under the brand name Xinermei:

• June 2025: Approved by China's National Medical Products Administration (NMPA) for chronic weight management
• September 2025: Approved in China for type 2 diabetes

Mazdutide is not approved by the FDA or the European Medicines Agency. US Phase 2 trials are ongoing, and an FDA approval timeline has not been established.

Retatrutide

Retatrutide is being developed by Eli Lilly and is in the Phase 3 TRIUMPH clinical trial program. It is not approved anywhere — neither in the US, Europe, nor China.

Based on Eli Lilly's trial timelines and the typical regulatory process, the earliest possible FDA approval is expected in 2027, though this depends on trial readouts and regulatory review.

Practical Implications

If you are outside China, neither drug is available by prescription. Within China, mazdutide (Xinermei) can be prescribed for obesity or type 2 diabetes. Retatrutide is only accessible worldwide through clinical trial enrollment. For how retatrutide itself is dosed in trials, see the retatrutide dosage guide.

Side Effects

Both drugs share the gastrointestinal side effect profile common to all GLP-1-based therapies: nausea, diarrhea, vomiting, and decreased appetite, particularly during dose escalation.

Mazdutide Tolerability

GLORY-1 reported very low discontinuation rates (0.5-1.5%), suggesting that mazdutide is well-tolerated at the doses studied. The gradual titration schedule helps mitigate GI side effects.

Retatrutide Tolerability

Retatrutide's Phase 2 data showed a dysesthesia signal — a tingling, burning, or prickling sensation not typically seen with other incretin drugs. This appears related to glucagon receptor activation and is being monitored in the Phase 3 TRIUMPH program.

Whether mazdutide, which also activates the glucagon receptor, produces a similar dysesthesia signal has not been clearly reported in published data.

For more detail on retatrutide's safety profile, see Side Effects & Safety.

Frequently Asked Questions

Sources

• Ji, L., et al. (2025). Mazdutide in Chinese Adults with Overweight or Obesity (GLORY-1). New England Journal of Medicine.
• Innovent Biologics. (2025). Phase 3 Clinical Study of Mazdutide in Chinese Adults with Overweight or Obesity (GLORY-1) Published in NEJM. Press release — Week 48 efficacy estimand (4 mg -12.05%, 6 mg -14.84%), responder rates, waist circumference, liver fat by baseline strata, heart rate, and the GLORY/DREAMS program overview.
• DREAMS-3 trial results. Mazdutide vs semaglutide 1 mg in type 2 diabetes. Phase 3, 32 weeks.
• 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
• Rosenstock, J., et al. (2023). Retatrutide, a GIP, GLP-1 and glucagon receptor agonist, for people with type 2 diabetes: a randomised, double-blind, placebo and active-comparator-controlled, parallel-group, phase 2 trial. The Lancet. DOI: 10.1016/S0140-6736(23)01053-X
• Eli Lilly and Company. (2025). Lilly's retatrutide achieved significant weight loss and pain relief in adults with obesity and knee osteoarthritis. Press release.
• ClinicalTrials.gov: Mazdutide trials, Retatrutide trials