Mazdutide: what the GLP-1/glucagon dual-agonist trials have reported

In GLORY-1, the pivotal phase 3 trial, participants on 6 mg of mazdutide lost a mean 14.0% of body weight at 48 weeks, while the placebo group gained 0.3%. That trial, run in China and published in the New England Journal of Medicine in 2025, is the backbone of the regulatory approval mazdutide now holds there. A second phase 3 trial testing a higher 9 mg dose and a US phase 2 trial add more detail.

What is mazdutide, mechanistically?

Mazdutide is a once-weekly dual agonist at the GLP-1 and glucagon receptors. The glucagon-receptor component is meant to add energy expenditure and hepatic fat metabolism effects on top of the appetite and gastric-emptying effects GLP-1 agonism already provides. Innovent Biologics states it holds an exclusive license from Eli Lilly to develop and commercialize it in China. The clinical program reflects that split: the phase 3 trials below were run in China (GLORY-1 was funded by Innovent), while the US phase 2 trial was funded by Lilly.

What did GLORY-1 find?

GLORY-1 (ClinicalTrials.gov NCT05607680) randomized 610 Chinese adults with a BMI of at least 28, or 24 to under 28 with a weight-related condition, to 4 mg mazdutide, 6 mg mazdutide, or placebo, once weekly for 48 weeks. The coprimary endpoints were percent weight change and the proportion reaching at least 5% weight loss, both assessed at week 32 using a treatment-policy estimand that counts everyone regardless of whether they stayed on treatment.

Every comparison against placebo was significant at P<0.001. The paper reports that prespecified cardiometabolic measures improved in both dose groups. Gastrointestinal events were the most frequent adverse events and mostly mild to moderate; discontinuation for adverse events was low and similar across arms (1.5% at 4 mg, 0.5% at 6 mg, 1.0% on placebo). The trial was funded by Innovent Biologics.

What did GLORY-2 add at the higher 9 mg dose?

GLORY-2 (NCT06164873), published in JAMA in 2026, tested a single 9 mg dose against placebo in 461 Chinese adults with obesity, 16.1% of whom had type 2 diabetes, over 60 weeks. At week 60, mean weight change was -16.65% with mazdutide versus -1.50% with placebo, a between-group difference of -15.15 percentage points (P<0.001). Weight loss of at least 5% was reached by 84.3% of the mazdutide group versus 33.1% on placebo. The GI adverse-event profile was more pronounced at this higher dose: vomiting occurred in 53.1% of the mazdutide group versus 1.3% on placebo, nausea in 46.9% versus 3.2%, and diarrhea in 39.4% versus 6.5%. Treatment discontinuation for adverse events was 2.9% with mazdutide versus 0% on placebo. Most events were described as mild to moderate.

How does the US phase 2 trial compare?

A separate, Lilly-funded phase 2 trial (NCT06124807, Lancet Diabetes & Endocrinology 2026) randomized 179 US adults with obesity or overweight and without type 2 diabetes across 24 centers to placebo (48 participants) or mazdutide at 3-6 mg (32), 10 mg (48) or 16 mg (51) for 48 weeks. At the week-32 primary endpoint, using the efficacy (hypothetical) estimand, least-squares mean weight change was -7.3% at 3-6 mg, -15.6% at 10 mg, and -18.1% at 16 mg, against -0.9% on placebo (P<0.0001 for every comparison). Discontinuation for adverse events was most frequent at 16 mg, at 20%, associated primarily with gastrointestinal disorders. The US and Chinese trials enrolled different populations with different baseline characteristics, so the dose-for-dose numbers should not be read as a direct comparison, but the pattern is the same: more weight loss at higher doses, and more GI-related discontinuation along with it.

Where does regulatory status actually stand?

China's National Medical Products Administration approved mazdutide on June 27, 2025 for chronic weight management in adults with a BMI of at least 28, or at least 24 with a weight-related condition. Innovent's announcement states the approved doses are 4 mg and 6 mg and that approval rested primarily on GLORY-1; a Shanghai municipal government notice confirms the approval and date (both checked October 8, 2026). GLORY-2 tested a higher 9 mg dose, and we found no record of an approval covering it. Mazdutide has no FDA approval and is not an approved product in the United States. Retatrutide and survodutide are other multi-receptor agonists still in trials; see our overview of the GLP-1/glucagon/GIP mechanism family for how the receptor biology compares.

Bottom line

Across three randomized trials in two countries, mazdutide produced dose-dependent weight loss: 14.0% at 6 mg over 48 weeks (GLORY-1), 16.65% at 9 mg over 60 weeks (GLORY-2), and 18.1% at 16 mg at 32 weeks in the US phase 2 trial. Gastrointestinal adverse events rose with dose, and the US trial's discontinuation rate reached 20% at 16 mg. It holds a China approval at the 4 mg and 6 mg doses and has no FDA approval. We found no record of approval for the 9 mg dose. Research-grade mazdutide is not the trial drug. For the compound summary and sourcing details, see the mazdutide profile.