Zenagamtide

GLP-1 + amylin unimolecular co-agonist · Novo Nordisk

Top dose

20 mg (Ph 1b/2a; Ph 3 exploring up to 40 mg)

Weight loss

-22.0%

at week 36 · treatment regimen

AE discontinuation

21.0%

Status

phase 2

Weight loss trajectory #

Pivotal trial #

Trial: NN9490-7613 Ph 1b/2a
Indication: obesity (no T2D)
Duration: 36 weeks
ClinicalTrials.gov: NCT06064006
Sponsor: Novo Nordisk

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

Per-arm efficacy (bars, left axis) and AE-led discontinuation (dots, right axis) from Ph 1b/2a obesity (Dahl Lancet 2025). Higher doses generally trade extra weight loss for worse tolerability.

Notes #

Phase shown reflects the DATA, not the program: the plotted obesity numbers are Phase 1b/2a and the T2D readout is Phase 2 - zenagamtide has no Phase 3 results yet (the AMAZE Ph3 obesity program, 7 trials, only initiated Q1 2026). ae_disc not directly comparable: the 21% is a Phase 1b/2a study-withdrawal rate (small n=34, dose-escalating) rather than a Phase 3 treatment-discontinuation rate at a settled dose. Renamed from Amycretin (Novo company code NN9490 sc / NN9487 oral). Ph 1b/2a Dahl et al Lancet 2025 (PMID 40550231, NCT06064006). Obesity-cohort AE-led withdrawal (Table 2 main paper): 20 mg @ wk 36 = 7/34 (21%) at -22.0% WL; 60 mg DE arm @ wk 36 = 6/17 (35%) at -24.3% WL; 5 mg @ wk 28 = 1/16 (6%) at -16.2%; 1.25 mg @ wk 20 = 0/16 at -9.7%; placebo pooled ~6%. Drugs.json uses the 20 mg headline (largest cohort, clean maintenance dose). Small n (17-34 per arm) - wide confidence intervals. T2D Phase 2 dose-finding (n=262, 36 wk, presented ADA 2026): up to -14.6% WL at 40 mg, HbA1c -1.71 pp; AE-disc 20 mg = 34%, 40 mg = 34%, dysesthesia 21% at 40 mg.