Survodutide vs retatrutide

Survodutide acts on the glucagon and GLP-1 receptors and is in phase 3 trials for obesity and MASH. Retatrutide acts on the GIP, GLP-1 and glucagon receptors and is in phase 3 trials for obesity, and neither is approved. This page compares their study results.

Best randomized result by outcome

For each outcome that two or more peptides have results for: the best result of a single randomized trial, on the same measure (the same kind of number, the same unit). When a trial has several dose arms, the cell shows the highest dose arm. The trials differ in people, length and dose, so a gap between two cells is not proof that one peptide works better.

Best randomized result by outcome for Survodutide, Retatrutide
Outcome	Survodutide	Retatrutide
Body weightMetabolic and weightCompared as: value in the arm that got the peptide, in %	−12.2% Mean body weight change · survodutide 3.6 mg Placebo: −5.4% Dose studied: up to 3.6 mg once weekly76 weeksn not reported2026	−23.7% Percent change in body weight · retatrutide 9 mg Placebo: −3.9% Dose studied: 9 mg80 weeksn not reported2026
Gastrointestinal adverse eventsGastrointestinalCompared as: share of people in the arm that got the peptide, in %	66% Nausea incidence Placebo: 23% Dose studied: 2.4, 4.8 or 6.0 mg once weekly48 weeksn = 2932024	14% Participants with nausea · retatrutide 4 mg Placebo: 8% Dose studied: 4 mgn = 5792026

Body weightMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Survodutide
  −12.2%
  Mean body weight change · survodutide 3.6 mg
  Placebo: −5.4%
  Dose studied: up to 3.6 mg once weekly76 weeksn not reported2026
- Retatrutide
  −23.7%
  Percent change in body weight · retatrutide 9 mg
  Placebo: −3.9%
  Dose studied: 9 mg80 weeksn not reported2026
Gastrointestinal adverse eventsGastrointestinalCompared as: share of people in the arm that got the peptide, in %
- Survodutide
  66%
  Nausea incidence
  Placebo: 23%
  Dose studied: 2.4, 4.8 or 6.0 mg once weekly48 weeksn = 2932024
- Retatrutide
  14%
  Participants with nausea · retatrutide 4 mg
  Placebo: 8%
  Dose studied: 4 mgn = 5792026

Outcomes with a randomized result for one peptide only (5 outcomes)

The other peptides have no randomized result on the same measure, so these results cannot be set side by side.

Outcomes with a randomized result for one peptide only: Survodutide, Retatrutide
Outcome	Survodutide	Retatrutide
Glycemic controlMetabolic and weightCompared as: value in the arm that got the peptide, in %	No comparable result 17 randomized-trial results measure it in another way or another unit.	−1.69% HbA1c change · retatrutide 4 mg Dose studied: 4 mg once weekly40 weeksn not reported2026
Liver fat and liver functionLiverCompared as: share of people in the arm that got the peptide, in %	47% MASH improvement responders · survodutide 2.4 mg Placebo: 14% Dose studied: 2.4 mg once weekly48 weeksn not reported2024	No comparable result 12 randomized-trial results measure it in another way or another unit.
PharmacokineticsPharmacologyCompared as: value in the arm that got the peptide, in days	No comparable result 1 randomized-trial result measure it in another way or another unit.	≈ 6 days Half-life · LY3437943 Dose studied: 0.5 mg, 1.5 mg, 3 mg, 3/6 mg and 3/6/9/12 mg once weekly12 weeksn not reported2022
Kidney functionKidney and urinaryCompared as: value in the arm that got the peptide, in %	No randomized trial result 6 results from other study designs.	−37% UACR difference vs placebo · retatrutide 12 mg, T2D, week 36 Dose studied: 12 mg36 weeksn not reported2025
Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in %	No comparable result 8 randomized-trial results measure it in another way or another unit.	63% Treatment-emergent adverse events · LY3437943 Placebo: 54% Dose studied: 0.5 mg, 1.5 mg, 3 mg, 3/6 mg and 3/6/9/12 mg once weekly12 weeksn = 722022

Glycemic controlMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Survodutide
  No comparable result
  17 randomized-trial results measure it in another way or another unit.
- Retatrutide
  −1.69%
  HbA1c change · retatrutide 4 mg
  Dose studied: 4 mg once weekly40 weeksn not reported2026
Liver fat and liver functionLiverCompared as: share of people in the arm that got the peptide, in %
- Survodutide
  47%
  MASH improvement responders · survodutide 2.4 mg
  Placebo: 14%
  Dose studied: 2.4 mg once weekly48 weeksn not reported2024
- Retatrutide
  No comparable result
  12 randomized-trial results measure it in another way or another unit.
PharmacokineticsPharmacologyCompared as: value in the arm that got the peptide, in days
- Survodutide
  No comparable result
  1 randomized-trial result measure it in another way or another unit.
- Retatrutide
  ≈ 6 days
  Half-life · LY3437943
  Dose studied: 0.5 mg, 1.5 mg, 3 mg, 3/6 mg and 3/6/9/12 mg once weekly12 weeksn not reported2022
Kidney functionKidney and urinaryCompared as: value in the arm that got the peptide, in %
- Survodutide
  No randomized trial result
  6 results from other study designs.
- Retatrutide
  −37%
  UACR difference vs placebo · retatrutide 12 mg, T2D, week 36
  Dose studied: 12 mg36 weeksn not reported2025
Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Survodutide
  No comparable result
  8 randomized-trial results measure it in another way or another unit.
- Retatrutide
  63%
  Treatment-emergent adverse events · LY3437943
  Placebo: 54%
  Dose studied: 0.5 mg, 1.5 mg, 3 mg, 3/6 mg and 3/6/9/12 mg once weekly12 weeksn = 722022

Comparing 2 peptides · Data version 308560

Only differences

Swipe sideways to see every peptide.

Comparison of Survodutide, Retatrutide
Peptide	Synthetic analog Survodutide	Synthetic analog Retatrutide
Identity
Kind	Synthetic analog	Synthetic analog
Area	Weight and metabolic	Weight and metabolic
Evidence
Amount of evidence	172	380
Evidence level	Has results from studies in people	Has results from studies in people
Safety
Safety results	37 (37 in people)	61 (61 in people)
Status
Approval
Sport (WADA)
Registered trials	35 · 10 active1 more mentions it but does not test it	34 · 11 active

Shared outcomes

Body weight140
Adverse events62
Glycemic control62
Liver fat and liver function49
Gastrointestinal adverse events29
Lipids29
Appetite and food intake21
Receptor activity and mechanism42
Kidney function20
Pharmacokinetics9
Mortality7
Inflammation markers15

Approval and sport status

From the regulatory data of each peptide.

Survodutide
Its most advanced trial is in phase 3. The FDA, the EMA and the other sources we use show no approval (as of 9 Oct 2026).
Retatrutide
Its most advanced trial is in phase 3. The FDA, the EMA and the other sources we use show no approval (as of 9 Oct 2026).

Amount of evidence by outcome

Outcome groups with study results for at least two of these peptides. Counts include only results from studies that gave the peptide. Bar length is the number of results, on one scale. The bars show how much was studied, not how large an effect was. A peptide with more studies can look stronger here without being stronger. For results, see the randomized results above.

Study results per shared outcome group and evidence class
Outcome group	Survodutide	Retatrutide
Body weightMetabolic and weight	42384	987919
Adverse eventsWhole body	2424	3838
Glycemic controlMetabolic and weight	30237	32266
Liver fat and liver functionLiver	29281	20137
Gastrointestinal adverse eventsGastrointestinal	1212	1717
LipidsCardiovascular	22	271611
Appetite and food intakeNervous system and cognition	22	19136
Receptor activity and mechanismPharmacology	185112	24816
Kidney functionKidney and urinary	66	1495
PharmacokineticsPharmacology	33	66
MortalityWhole body	11	66
Inflammation markersKidney and urinary	11	14410

Sequence alignment

Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.

Against GlucagonSurvodutide

Survodutide differs from Glucagon at 9 positions.

Top row: Glucagon (parent)
Bottom row: Survodutide

HQGTFTSDY

SKYLDRA

DFWL

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end

What is different

1Position 2: Ser is replaced by Ac4c, an amino acid that is not one of the standard 20.
2Position 16: Ser is replaced by Glu.
3Position 18: Arg is replaced by Ala.
4Position 20: Gln is replaced by Lys.
5Position 23: Val is replaced by Ile.
6Position 24: Gln is replaced by Lys.
7Position 27: Met is replaced by Glu.
8Position 28: Asn is replaced by Ser.
9Position 29: Thr is replaced by Ala.

Against Gastric inhibitory polypeptide (GIP)Retatrutide

Retatrutide differs from Gastric inhibitory polypeptide (GIP) at 15 positions and in 1 end segment.

Top row: Gastric inhibitory polypeptide (GIP) (parent)
Bottom row: Retatrutide

YGTFSDY

SIDKQ

FLL

PSSGAPPPS

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end
Replaced segment
Parent context

What is different

1Position 2: Ala is replaced by Aib, an amino acid that is not one of the standard 20.
2Position 3: Glu is replaced by Gln.
3Position 7: Ile is replaced by Thr.
4Position 13: Ala is replaced by alphaMeLeu, an amino acid that is not one of the standard 20.
5Position 14: Met is replaced by Leu.
6Position 17: Ile is replaced by Lys.
7Position 18: His is replaced by Ala.
8Position 20: Gln is replaced by Aib, an amino acid that is not one of the standard 20.
9Position 21: Asp is replaced by Ala.
10Position 23: Val is replaced by Ile.
11Position 24: Asn is replaced by Glu.
12Position 25: Trp is replaced by Tyr.
13Position 28: Ala is replaced by Glu.
14Position 29: Gln is replaced by Gly.
15Position 30: Lys is replaced by Gly.
16Positions 31 to 39: the end of the peptide is a different stretch of amino acids, not a set of single swaps.

Trials side by side

Registered trials, ranked by phase (late phases first), then posted results and enrollment. Status is the registry status. Study results come from published studies. Results posted at ClinicalTrials.gov are shown on each trial page.

Survodutide35 registered trials

Top 3 of 35 trials, ranked by phase, then posted results and enrollment: 2 ongoing · 1 completed · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3NCT06077864

A Study to Test the Effect of Survodutide (BI 456906) on Cardiovascular Safety in People With Overweight or Obesity (SYNCHRONIZE™ - CVOT)

Boehringer Ingelheim5,531 participants20 Nov 2023 to 30 Jun 2026

Obesity

Trial page ClinicalTrials.gov

RecruitingPhase 3NCT06632444

LIVERAGE™: A Study to Test Whether Survodutide Helps People With a Liver Disease Called NASH/MASH Who Have Moderate or Advanced Liver Fibrosis

Boehringer Ingelheim1,800 participants14 Oct 2024 to est. 27 Dec 2031

Metabolic Dysfunction Associated Steatohepatitis (MASH) · Liver Fibrosis

Trial page ClinicalTrials.gov

RecruitingPhase 3NCT06632457

LIVERAGE™ - Cirrhosis: A Study to Test Whether Survodutide Helps People With a Liver Disease Called NASH/MASH Who Have Cirrhosis

Boehringer Ingelheim1,590 participants12 Nov 2024 to est. 5 Jun 2029

Metabolic Dysfunction Associated Steatohepatitis

Trial page ClinicalTrials.gov

1 more mentions it but does not test it. They only measure it or name it in their text.

Retatrutide34 registered trials

Top 3 of 34 trials, ranked by phase, then posted results and enrollment: 2 ongoing · 1 completed · source ClinicalTrials.gov (opens in a new tab)

Active, not recruitingPhase 3NCT06383390

The Effect of Retatrutide Once Weekly on Cardiovascular Outcomes and Kidney Outcomes in Adults Living With Obesity (TRIUMPH-Outcomes)

Eli Lilly and Company10,000 participants30 Apr 2024 to est. Feb 2029

Atherosclerotic Cardiovascular Disease (ASCVD) · Chronic Kidney Disease (CKD)

Trial page ClinicalTrials.gov

RecruitingPhase 3NCT07165028

A Master Protocol of Multiple Agents in Adults With Metabolic Dysfunction-Associated Steatotic Liver Disease (SYNERGY-Outcomes)

Eli Lilly and Company4,500 participants15 Oct 2025 to est. Aug 2032

Metabolic Dysfunction-Associated Steatotic Liver Disease

Trial page ClinicalTrials.gov

CompletedPhase 3NCT05929066

A Study of Retatrutide (LY3437943) in Participants Who Have Obesity or Overweight

Eli Lilly and Company2,335 participants10 Jul 2023 to 30 Apr 2026

Obesity · Overweight · Osteoarthritis, Knee · Obstructive Sleep Apnea

Trial page ClinicalTrials.gov

PepBank is a research reference. Talk to a doctor before you use any peptide.