Mazdutide vs Pemvidutide (2026): GLP-1/Glucagon Dual Agonists Compared on Trials and Status
Mazdutide vs pemvidutide: two GLP-1/glucagon agonists, 14.01% weight loss at 48 weeks vs 52-58% MASH resolution in Phase 2b. See how the data compare in 2026.
Research reference only. The information in this article is a summary of peer-reviewed scientific literature. It does not constitute medical advice and is not intended to guide human use. See our full disclaimer.
Mazdutide vs pemvidutide is a comparison between two once-weekly GLP-1 and glucagon receptor dual agonists that were built for different primary indications: mazdutide has been developed for obesity and type 2 diabetes and is approved in China, while pemvidutide has been developed first for metabolic dysfunction-associated steatohepatitis (MASH) and remains investigational. This page summarizes the published trial data for each compound side by side, and flags where the numbers cannot be compared directly.
Research reference only. All information on this page is a summary of peer-reviewed scientific literature and does not constitute medical advice. See individual library profiles for full compound data.
Quick Answer: Mazdutide and pemvidutide both activate GLP-1R and GCGR, but the evidence differs in focus. Mazdutide's Phase 3 GLORY-1 trial reported a 14.01% mean weight reduction at 48 weeks (6 mg), while pemvidutide's Phase 2b IMPACT trial reported MASH resolution without fibrosis worsening in 52-58% of participants versus 20% with placebo at 24 weeks.
TL;DR:
- Same receptor pair (GLP-1R + GCGR), once-weekly subcutaneous dosing, from different developers (Innovent/Eli Lilly vs Altimmune)
- Mazdutide: obesity-first evidence base, Phase 3 GLORY-1 and GLORY-2, approved by China's NMPA
- Pemvidutide: liver-first evidence base, Phase 2b IMPACT in MASH, FDA Breakthrough Therapy designation (January 2026)
- Pemvidutide is described as a balanced 1:1 potency co-agonist, a design aimed at the hepatic effects of glucagon receptor signalling
- No head-to-head trial exists, and the populations, endpoints and trial lengths differ
| Parameter | Mazdutide | Pemvidutide |
|---|---|---|
| Target | GLP-1R / GCGR dual agonist | GLP-1R / GCGR dual agonist (1:1 balanced potency) |
| Developer | Innovent Biologics (China), Eli Lilly collaboration | Altimmune |
| Most advanced stage | Approved in China (NMPA); Phase 3 trials | Phase 2b completed; Phase 3 PERFORMA (NCT07795164) in MASH initiated August 2026 |
| Lead evidence | GLORY-1: -14.01% weight at 48 weeks (6 mg) vs +0.30% placebo | IMPACT: MASH resolution 52-58% vs 20% placebo at 24 weeks |
| Obesity data | GLORY-2: up to 20.1% weight loss (9 mg) | MOMENTUM: 15.6% weight loss at 48 weeks (2.4 mg) |
| Dosing interval | Once weekly, subcutaneous | Once weekly, subcutaneous |
Mazdutide: mechanism and evidence base
Mazdutide (IBI362) is an acylated peptide based on a modified oxyntomodulin sequence, with a C18 fatty acid chain that extends exposure to support once-weekly administration. Oxyntomodulin is the gut hormone that activates both GLP-1R and GCGR, and mazdutide is engineered to retain that dual activity. In the published mechanism framing, the GLP-1R component is associated with satiety, slower gastric emptying and glucose-dependent insulin secretion, while the GCGR component is associated with thermogenesis, hepatic fatty acid oxidation and lipolysis.
The first randomized evidence came from a Phase 2 trial in 248 Chinese adults with overweight or obesity. Mean body weight changes at 24 weeks were -6.7%, -10.4% and -11.3% for the 3 mg, 4.5 mg and 6 mg arms, versus +1.0% with placebo (PMID 38092790).
Phase 3 GLORY-1 (NCT05607680, New England Journal of Medicine, 2025) randomized 610 participants to mazdutide 4 mg, 6 mg or placebo for 48 weeks. Mean weight changes were -11.00% and -14.01%, against +0.30% with placebo, and liver fat content fell by up to 80.2%. GLORY-2 (NCT06164873) reported up to 20.1% weight loss with a 9 mg dose in adults with a BMI of at least 30 kg/m². The DREAMS program extended the work into type 2 diabetes, and DREAMS-3 compares mazdutide with semaglutide in type 2 diabetes with obesity.
Pemvidutide: mechanism and evidence base
Pemvidutide (formerly ALT-801) is a unimolecular GLP-1R/GCGR dual agonist described as having balanced 1:1 potency at the two receptors. It is a peptide modified with a glycolipid moiety that supports once-weekly dosing. The design rationale published for the compound is that glucagon receptor signalling drives direct hepatic lipid oxidation, which complements the appetite-related effects of GLP-1R activation. That rationale is the main reason the program was positioned toward liver disease.
IMPACT was a multicentre, randomized, double-blind, placebo-controlled Phase 2b trial in 212 adults with biopsy-confirmed MASH and fibrosis stages F2/F3. Participants received pemvidutide 1.2 mg, 1.8 mg or placebo once weekly for 24 weeks. MASH resolution without fibrosis worsening was reported in 58% (1.2 mg) and 52% (1.8 mg) of pemvidutide recipients versus 20% with placebo (p<0.0001), and 34.5% of the 1.8 mg group had at least one stage of fibrosis improvement without MASH worsening. Liver fat, ALT and fibrosis biomarkers (ELF, PRO-C3) also fell (PMID 41237796).
The Phase 2b MOMENTUM trial (NCT05295875) in adults with obesity reported 15.6% weight loss at 48 weeks with the 2.4 mg dose versus 2.2% for placebo, with a 78.6% reduction in liver fat at the high dose. A Phase 2 trial in alcohol use disorder (RECLAIM) reported topline results in July 2026, and a Phase 2 trial in alcohol-associated liver disease (NCT07009860) is ongoing.
Side-by-side comparison
The table above summarizes the headline figures. Three points matter when reading them together. First, the primary endpoints differ: GLORY-1 and GLORY-2 measured percent body weight change, while IMPACT measured histological MASH resolution. Second, the populations differ: the mazdutide trials enrolled Chinese adults with overweight or obesity, whereas IMPACT enrolled adults with biopsy-confirmed MASH. Third, trial length and dose range differ, so the 14.01% (48 weeks), 20.1% (9 mg) and 15.6% (48 weeks) weight figures should not be ranked as if they came from a single study.
Liver fat is the one area of overlap. Mazdutide's GLORY-1 reported reductions of up to 80.2%, and pemvidutide's MOMENTUM reported a 78.6% reduction at the high dose. These are separate trials with separate measurement populations, so they illustrate a class feature of glucagon receptor co-agonism rather than a ranking. The same class logic appears in the mazdutide vs survodutide and pemvidutide vs survodutide comparisons listed below.
Differential research applications
Researchers studying obesity pharmacology have mainly worked from the mazdutide record because it contains multiple Phase 3 trials, dose-ranging data up to 9 mg and a large body of weight-change data. Researchers studying hepatic steatosis, fibrosis biomarkers or liver histology have mainly worked from the pemvidutide record because IMPACT used biopsy endpoints. For background on why glucagon receptor activity is studied alongside GLP-1R activity at all, see the glucagon vs semaglutide mechanism comparison and the semaglutide library profile.
For tracking registered studies of either compound, the clinical trial tracker lists status by NCT number. For exposure-duration context, the half-life chart places weekly-dosed peptides on a common scale.
Regulatory and compounding status
Mazdutide has been approved by China's National Medical Products Administration (NMPA) for type 2 diabetes and obesity management. It is not approved by the FDA or EMA, and global development with Eli Lilly is described as under evaluation.
Pemvidutide is investigational in all markets. The FDA granted Breakthrough Therapy designation in MASH in January 2026, along with Fast Track designation for MASH, alcohol use disorder and alcohol-associated liver disease. The registrational Phase 3 PERFORMA trial (NCT07795164) was initiated in August 2026. The library profiles list the 503A compounding status of both compounds as under review.
Cited studies
- PMID 38092790, "A phase 2 randomised controlled trial of mazdutide in Chinese overweight adults or adults with obesity" (Nature Communications, 2023). https://doi.org/10.1038/s41467-023-44067-4
- PMID 41237796: "Safety and efficacy of weekly pemvidutide versus placebo for metabolic dysfunction-associated steatohepatitis (IMPACT): 24-week results from a multicentre, randomised, double-blind, phase 2b study" (The Lancet, 2026). https://doi.org/10.1016/S0140-6736(25)02114-2
- GLORY-1 Phase 3 trial, NCT05607680, New England Journal of Medicine, 2025. https://doi.org/10.1056/NEJMoa2411528
Frequently asked questions
Q: What is the difference between mazdutide and pemvidutide?
A: Both are once-weekly GLP-1R and GCGR dual agonists. Mazdutide is an oxyntomodulin-based peptide from Innovent and Eli Lilly with an obesity-first Phase 3 record and Chinese approval, while pemvidutide is an Altimmune compound with balanced 1:1 receptor potency that has been studied mainly in MASH.
Q: Is pemvidutide the same as mazdutide?
A: No. They are separate molecules from different developers with different sequences and different clinical programs, although they act on the same two receptors.
Q: Which compound has more weight-loss data, mazdutide or pemvidutide?
A: Mazdutide has more published weight-loss data, including Phase 3 GLORY-1 and GLORY-2 with a reported range of 14.01% to 20.1%. Pemvidutide's weight data come mainly from the Phase 2b MOMENTUM trial, which reported 15.6% at 48 weeks.
Q: Why is pemvidutide studied for MASH?
A: The published rationale is that glucagon receptor activation drives hepatic fat oxidation. In the IMPACT Phase 2b trial, MASH resolution without fibrosis worsening was reported in 52-58% of pemvidutide recipients versus 20% with placebo, which supported the FDA Breakthrough Therapy designation.
Q: Has mazdutide been compared with pemvidutide in a head-to-head trial?
A: No. The two compounds have been studied in separate trials with different populations and endpoints, so cross-trial figures are descriptive only.
See also:
- Mazdutide vs Survodutide: mazdutide against the other leading obesity-focused GLP-1/glucagon agonist
- Pemvidutide vs Survodutide: the liver-focused pairing for pemvidutide
- Glucagon vs Semaglutide: why researchers pair GCGR and GLP-1R agonism
For laboratory research purposes only. Not for human or animal consumption. Compounds described are not approved by the FDA for human or veterinary use unless explicitly stated.