At a glance
| Current name | Zenagamtide |
|---|---|
| Design | Single peptide with multiple receptor activities |
| Studied routes | Oral and subcutaneous |
| Study areas | Obesity; type 2 diabetes |
| Evidence | Early clinical and phase 2 studies |
Overview
Amycretin was the development name used in early studies of this single-molecule approach; 2026 research uses the name zenagamtide. The compound is distinct from CagriSema, which combines two separate active peptides. Both oral and subcutaneous formulations have entered clinical studies. Early obesity studies emphasized safety, exposure and exploratory weight change, while a 2026 oral phase 2 trial assessed glycated hemoglobin in type 2 diabetes. These different designs should not be collapsed into one promised weight-loss percentage or an assertion of established cardiovascular protection.
How it works
The molecule activates GLP-1 and amylin-related signaling, with calcitonin receptor activity also described in the phase 2 publication. The goal is to combine glucose-regulating and satiety effects within one peptide rather than administering separate drugs. Delivery changes exposure: an oral peptide formulation must overcome gastrointestinal degradation and absorption barriers, so injectable and oral study results cannot be translated by comparing nominal amounts.
What the trials investigate
Development targets weight management and glucose control. The oral type 2 diabetes trial studied adults already receiving metformin with or without an SGLT2 inhibitor, so its results do not establish use in untreated diabetes or type 1 diabetes.
Supporting sources [1]
Oral diabetes evidence
In the 2026 phase 2 trial, 186 participants were randomized and followed for thirty-six weeks. Oral zenagamtide lowered HbA1c more than placebo across tested groups. The primary question was glycemic efficacy, not cardiovascular events or long-term obesity complications.
Supporting sources [1]
Injectable obesity evidence
The phase 1b/2a study included 125 participants across several cohorts and reported substantial exploratory weight reduction. A high number withdrew, including many for reasons unrelated to adverse events. Small cohorts and missing-data assumptions limit certainty around headline percentages.
Supporting sources [2]
Tolerability and evidence gaps
Gastrointestinal events predominated in oral and injectable studies. Early trials cannot reliably exclude uncommon or delayed harms. Pregnancy, pediatric use, combination with other appetite medicines and long-term outcomes require dedicated evidence rather than extrapolation from receptor targets.
Is this the same as CagriSema?
No. Amycretin/zenagamtide is one engineered molecule, while CagriSema uses cagrilintide plus semaglutide. Similar therapeutic concepts do not mean identical pharmacology, exposure, safety or regulatory status.
Reading this profile
Jurisdiction: Investigational clinical-development program; no FDA marketing approval identified as of 2026-10-27.. Molecular class: Unimolecular GLP-1 and amylin receptor agonist peptide.
This profile was written with AI-assisted research and checked against the linked sources. It has not been represented as a clinician’s review. Evidence summaries describe the cited studies and products; they do not establish that a separately purchased preparation is equivalent.
Sources & references
Follow the original material. Product labels define specific formulations and uses; trial registration describes a study and does not by itself establish benefit.
- Efficacy and safety of once-daily oral zenagamtide, a novel unimolecular GLP-1 and amylin receptor agonist, in adults with type 2 diabetes: a multicentre, randomised, parallel, double-blind, placebo-controlled, dose-finding, phase 2 trial. ↗Original research · Checked 2026-10-27
- Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study. ↗Original research · Checked 2026-10-27
- Safety, tolerability, pharmacokinetics, and pharmacodynamics of the first-in-class GLP-1 and amylin receptor agonist, amycretin: a first-in-human, phase 1, double-blind, randomised, placebo-controlled trial. ↗Original research · Checked 2026-10-27
- ClinicalTrials.gov: A Research Study Investigating How Well the Medicine Zenagamtide Helps People With Excess Body Weight Lose Weight Compared to Semaglutide ↗Clinical trial source · Checked 2026-10-27