Independent · non-commercial · publishes on a quarterly cycle|Current cycle 2026 Q3
Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Compound monograph · Incretin receptor agonists

Survodutide — compound monograph

Dual glucagon and GLP-1 receptor agonist (acylated). Phase 3. The Institute assesses 3 outcomes for this compound and grades the strongest at moderate certainty.

Document identifier
CEI-MN-013
Series
Compound monograph
Version
3.1
Published
19 Nov 2025
Last reviewed
19 Nov 2025
Next review
19 Nov 2027
Identifier
10.71829/cei.mono.13
Certainty
Moderate
Cycle
2025 Q4

§1Identification and status

§1.1Nomenclature

Preferred name
Survodutide
Compound class
Dual glucagon and GLP-1 receptor agonist (acylated)
Assessment series
Incretin receptor agonists
Synonyms and codes
BI 456906 · survodutide (INN)
Route as evaluated
Subcutaneous once weekly

§1.2Chemistry

Chemical identifiers are reproduced where they are public. Where a structure has not been published the monograph records not disclosed rather than constructing one.[1]

CAS registry number
2260808-11-9
Molecular formula
not published in full
Average mass
≈4700 (approximate)
Monoisotopic mass
not published
ATC classification
not assigned

§1.3Sequence and structural notes

A 29-residue glucagon-based backbone with α-aminoisobutyric acid substitutions and a lysine-linked fatty-diacid conjugate

Unlike tirzepatide and retatrutide, which are built on the GIP scaffold, survodutide is built on glucagon. The engineering objective is a glucagon-to-GLP-1 potency ratio that delivers energy expenditure and hepatic benefit without net glycaemic deterioration.

§1.4Assessment status

The Institute assesses Survodutide across 3 indications and grades the strongest of them at moderate certainty. In confirmatory clinical development; no marketing authorisation.

Distribution of certainty ratingsShare of assessed outcomes at each certainty level.3assessed outcomes
HighModerateLowVery low
Figure 1. Distribution of certainty ratings across the 3 outcomes the Institute assesses for Survodutide. A rating attaches to a specific population, comparator and outcome and does not transfer between them.

Table 1. Assessed outcomes for Survodutide, ordered by certainty. Each row links to the per-indication evidence extract.

IndicationEffect as recordedCertaintyTrials
Obesity and overweight in adults−14.9 % body weight at 46 weeks with 6.0 mg in phase 2 versus −2.8 % with placeboModerate3
Metabolic dysfunction-associated steatohepatitisHistological improvement in fibrosis without worsening of steatohepatitis in 34.5 % at 4.8 mg versus 22.4 % with placebo at 48 weeksLow2
Type 2 diabetes mellitus−1.7 % HbA1c at 16 weeks in phase 2Low1
Effects are reproduced as the contributing trials reported them. Where a confidence interval is held it appears on the per-indication extract rather than in this summary table.

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use. ICH Q6B Specifications: Test Procedures and Acceptance Criteria for Biotechnological/Biological Products. ICH Harmonised Tripartite Guideline 1999;Step 4 version. identifier not held by the Institute

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

Nothing published by the Institute is medical advice, a diagnosis, a prescription, a treatment recommendation or a purchasing recommendation. Compounds supplied for research use are not approved for human or veterinary use in any jurisdiction, and a favourable analytical assessment of a supplier is not a statement that any product is safe or effective. The Institute publishes certainty ratings and never recommendations. No telephone number, messaging handle or ordering channel appears anywhere on this site.