Survodutide vs tirzepatide

Survodutide acts on the glucagon and GLP-1 receptors and is in phase 3 trials for obesity and MASH, and it is not approved. Tirzepatide acts on the GIP and GLP-1 receptors and is approved in the US and EU for type 2 diabetes and weight management. 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, Tirzepatide
Outcome	Survodutide	Tirzepatide
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	−20.9% Mean percentage weight reduction at week 72 · Shown as a change. The study reports a mean percentage weight reduction at week 72 of this size. · tirzepatide 15 mg Placebo: −3.1% Dose studied: 5 mg, 10 mg or 15 mg once weekly72 weeks, including a 20-week dose-escalation periodn = 2,5392022
Glycemic controlMetabolic and weightCompared as: value in the arm that got the peptide, in percentage points	−0.9 percentage points HbA1c change · survodutide 3.6 mg Placebo: −0.2 percentage points Dose studied: 3.6 mg once weeklyn not reported2026	−1.99 percentage points HbA1c change Dose studied: 15 mg or maximum tolerated dose2 yearsn = 7942026
Gastrointestinal adverse eventsGastrointestinalCompared as: share of people in the arm that got the peptide, in %	49% Diarrhea incidence Placebo: 23% Dose studied: 2.4, 4.8 or 6.0 mg once weekly48 weeksn = 2932024	12 to 21% Diarrhea incidence Placebo: 10% Dose studied: 5 mg, 10 mg or 15 mg once weekly (started at 2.5 mg/week, escalated by 2.5 mg every 4 weeks)40 weeksn = 4752022
Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in %	8% Serious adverse events Placebo: 7% Dose studied: 2.4, 4.8 or 6.0 mg once weekly48 weeksn = 2932024	5 to 7% Serious adverse events Dose studied: 5, 10 or 15 mg once weekly40 weeksn not reported2021

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
- Tirzepatide
  −20.9%
  Mean percentage weight reduction at week 72 · Shown as a change. The study reports a mean percentage weight reduction at week 72 of this size. · tirzepatide 15 mg
  Placebo: −3.1%
  Dose studied: 5 mg, 10 mg or 15 mg once weekly72 weeks, including a 20-week dose-escalation periodn = 2,5392022
Glycemic controlMetabolic and weightCompared as: value in the arm that got the peptide, in percentage points
- Survodutide
  −0.9 percentage points
  HbA1c change · survodutide 3.6 mg
  Placebo: −0.2 percentage points
  Dose studied: 3.6 mg once weeklyn not reported2026
- Tirzepatide
  −1.99 percentage points
  HbA1c change
  Dose studied: 15 mg or maximum tolerated dose2 yearsn = 7942026
Gastrointestinal adverse eventsGastrointestinalCompared as: share of people in the arm that got the peptide, in %
- Survodutide
  49%
  Diarrhea incidence
  Placebo: 23%
  Dose studied: 2.4, 4.8 or 6.0 mg once weekly48 weeksn = 2932024
- Tirzepatide
  12 to 21%
  Diarrhea incidence
  Placebo: 10%
  Dose studied: 5 mg, 10 mg or 15 mg once weekly (started at 2.5 mg/week, escalated by 2.5 mg every 4 weeks)40 weeksn = 4752022
Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Survodutide
  8%
  Serious adverse events
  Placebo: 7%
  Dose studied: 2.4, 4.8 or 6.0 mg once weekly48 weeksn = 2932024
- Tirzepatide
  5 to 7%
  Serious adverse events
  Dose studied: 5, 10 or 15 mg once weekly40 weeksn not reported2021

Outcomes with a randomized result for one peptide only (6 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, Tirzepatide
Outcome	Survodutide	Tirzepatide
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.	≈ 5 days Half-life Dose studied: 5, 10 or 15 mg8 weeksn = 482022
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 15 randomized-trial results measure it in another way or another unit.
Appetite and food intakeMetabolic and weightCompared as: difference from placebo, in kcal	No randomized trial result 2 results from other study designs.	−524.6 kcal Estimated treatment difference n not reported2025
Blood pressureCardiovascularCompared as: difference from placebo, in mm hg	No randomized trial result 1 result from other study designs.	−6.8 mm Hg Net systolic blood pressure reduction · Shown as a change. The study reports a net systolic blood pressure reduction of this size. 72 weeksn not reported2024
Kidney functionKidney and urinaryCompared as: value in the arm that got the peptide, in %	No randomized trial result 6 results from other study designs.	−19.3% UACR percent change · tirzepatide 5 mg Dose studied: 5 mgweek 40/42n not reported2025
LipidsMetabolic and weightCompared as: value in the arm that got the peptide, in %	No randomized trial result 2 results from other study designs.	≤ 22.9% Variability in triglyceride change explained by apoC-III change Dose studied: 1, 5, 10 or 15 mg once weekly26 weeksn not reported2020

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.
- Tirzepatide
  ≈ 5 days
  Half-life
  Dose studied: 5, 10 or 15 mg8 weeksn = 482022
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
- Tirzepatide
  No comparable result
  15 randomized-trial results measure it in another way or another unit.
Appetite and food intakeMetabolic and weightCompared as: difference from placebo, in kcal
- Survodutide
  No randomized trial result
  2 results from other study designs.
- Tirzepatide
  −524.6 kcal
  Estimated treatment difference
  n not reported2025
Blood pressureCardiovascularCompared as: difference from placebo, in mm hg
- Survodutide
  No randomized trial result
  1 result from other study designs.
- Tirzepatide
  −6.8 mm Hg
  Net systolic blood pressure reduction · Shown as a change. The study reports a net systolic blood pressure reduction of this size.
  72 weeksn not reported2024
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.
- Tirzepatide
  −19.3%
  UACR percent change · tirzepatide 5 mg
  Dose studied: 5 mgweek 40/42n not reported2025
LipidsMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Survodutide
  No randomized trial result
  2 results from other study designs.
- Tirzepatide
  ≤ 22.9%
  Variability in triglyceride change explained by apoC-III change
  Dose studied: 1, 5, 10 or 15 mg once weekly26 weeksn not reported2020

Comparing 2 peptides · Data version 308560

Only differences

Swipe sideways to see every peptide.

Comparison of Survodutide, Tirzepatide
Peptide	Synthetic analog Survodutide	Synthetic analog Tirzepatide
Identity
Kind	Synthetic analog	Synthetic analog
Area	Weight and metabolic	Weight and metabolic
Evidence
Amount of evidence	172	2,165
Evidence level	Has results from studies in people	Has results from studies in people
Safety
Safety results	37 (37 in people)	462 (462 in people)
Status
Approval
Sport (WADA)
Registered trials	35 · 10 active1 more mentions it but does not test it	254 · 162 active47 more mention it but do not test it

Shared outcomes

Body weight563
Glycemic control394
Adverse events237
Gastrointestinal adverse events191
Liver fat and liver function82
Lipids81
Mortality64
Blood pressure52
Kidney function46
Inflammation markers42
Appetite and food intake22
Pharmacokinetics19

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).
Tirzepatide
The FDA label for Mounjaro says: “Adjunct to diet and exercise for glycemic control in adults and pediatric patients 10 years and older with type 2 diabetes; reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes at high risk for these events”

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	Tirzepatide
Body weightMetabolic and weight	42384	521501182
Glycemic controlMetabolic and weight	30237	36435581
Adverse eventsWhole body	2424	213213
Gastrointestinal adverse eventsGastrointestinal	1212	179179
Liver fat and liver functionLiver	29281	5353
LipidsCardiovascular	22	79763
MortalityWhole body	11	635724
Blood pressureCardiovascular	11	5151
Kidney functionKidney and urinary	66	40391
Inflammation markersKidney and urinary	11	41347
Appetite and food intakeNervous system and cognition	22	20191
PharmacokineticsPharmacology	33	16133

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)Tirzepatide

Tirzepatide differs from Gastric inhibitory polypeptide (GIP) at 11 positions and in 1 end segment.

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

YEGTFSDY

SIDKIQ

FVWLA

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 7: Ile is replaced by Thr.
3Position 13: Ala is replaced by Aib, an amino acid that is not one of the standard 20.
4Position 14: Met is replaced by Leu.
5Position 18: His is replaced by Ala.
6Position 20: Gln is replaced by Lys.
7Position 21: Asp is replaced by Ala.
8Position 24: Asn is replaced by Gln.
9Position 27: Leu is replaced by Ile.
10Position 29: Gln is replaced by Gly.
11Position 30: Lys is replaced by Gly.
12Positions 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.

Tirzepatide254 registered trials

Top 3 of 254 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT04255433