Aleniglipron

GLP-1 agonist (oral SMD) · Structure Therapeutics

Top dose

120 mg

Weight loss

-12.1%

at week 36 · efficacy

AE discontinuation

10.4%

Status

phase 2

Weight loss trajectory #

Pivotal trial #

Trial: ACCESS
Indication: obesity (no T2D)
Duration: 36 weeks
ClinicalTrials.gov: NCT06693843
Sponsor: Structure Therapeutics

Dose-response: weight loss vs AE-led discontinuation #

Per-arm efficacy (bars, left axis) and AE-led discontinuation (dots, right axis) from ACCESS (Rosenstock Nat Med 2026). Higher doses generally trade extra weight loss for worse tolerability.

Notes #

ACCESS (Rosenstock, Nature Med 2026, NCT06693843): oral small-molecule GLP-1, Ph2b double-blind, 36-wk, n=230 (45/90/120 mg vs placebo), mean BMI 39.5. Efficacy-estimand absolute weight change at wk36: -9.0/-10.7/-12.1% (45/90/120 mg) vs placebo -0.8%; placebo-adjusted -8.2/-9.8/-11.3% (all P<0.0001); no plateau at 36 wk. Treatment-related discontinuations 10.4% across arms; no drug-induced liver injury. Same class as orforglipron, comparable efficacy from a much smaller company. 36-wk readout (shorter than the 68-72 wk registrational trials). Ph3 registered (NCT07654361/-74) but not yet recruiting.