Survodutide
Survodutide is a dual GLP-1/glucagon receptor agonist developed by Boehringer Ingelheim, showing strong efficacy in NASH/MAFLD and obesity. Unlike tirzepatide (GLP-1/GIP), survodutide pairs GLP-1 with glucagon for enhanced hepatic fat metabolism.
Evidence Summary
Phase 2 NASH trial showed up to 83% reduction in liver fat and NASH resolution in 47% of patients at highest dose. Phase 2 obesity trial showed up to 19% weight loss. Phase 3 trials ongoing.
Evidence Scale
Mechanism of Action
Dual agonism of GLP-1 and glucagon receptors. GLP-1 component reduces appetite and improves glycemia. Glucagon receptor activation uniquely drives hepatic lipid oxidation, increases energy expenditure, and promotes thermogenesis. This combination specifically targets liver fat accumulation.
Who Is This For?
Expected: NASH/MAFLD, obesity. May be particularly suited for patients with metabolic syndrome and hepatic steatosis.
Protocol & Dosing
Dose
Phase 2: escalated to 0.3mg, 1.8mg, 2.7mg, 3.6mg, or 4.5mg weekly. Final dosing TBD pending Phase 3.
Frequency
Weekly injection (anticipated)
Duration
Ongoing (anticipated)
Protocol Summary
Dual GLP-1/glucagon agonist in Phase 3 for NASH and obesity. Differentiated from tirzepatide by targeting glucagon instead of GIP, potentially superior for liver-specific pathology.
Interactions & Precautions
Contraindications
- Not fully established
- Likely thyroid warnings per GLP-1 class
- Active liver disease requiring monitoring
Potential Risks
- •Glucagon-mediated cardiac effects
- •Transaminase elevations
- •Long-term safety data pending
Potential Side Effects
Practitioner Notes
Clinical annotations from Dr. Goel
Distinct from tirzepatide — targets liver fat specifically via glucagon pathway. May become preferred agent for NASH/MAFLD over pure GLP-1 RAs. Monitor transaminases. Not yet available clinically.
Dr. Sanjeev Goel
Chief Medical Officer, Peak Human
Cost & Access
Cost Range
TBD
Accessibility
Availability varies by location
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