Pipeline comparison is badly served, usually by pages that assemble six percentages from six different trials and rank them as though the ranking meant something. The numbers are worth having in one place, and so is a clear account of why the list is not a leaderboard. This filing sets out mechanism, best published figure with its trial and duration, development stage and expected filing for retatrutide, cagrilintide, CagriSema, survodutide, mazdutide and amycretin, each checked against a primary source. None of these compounds is approved in the Philippines, and nothing here is medical advice.
Snapshot
LARGEST PH3 FIGURE
28.3%
Retatrutide, 80 wk
FIRST APPROVED
Mazdutide
China, Jun 2025
FIRST FILED, US
CagriSema
Dec 2025
RETA FILING
Q1 2027
Planned BLA
The shape of the field in two sentences. Retatrutide holds the largest published Phase 3 weight reduction figure of anything on this page, by a clear margin, and it is behind two of its competitors on regulatory progress, one of which is already approved in a major market while retatrutide has not yet been filed anywhere.
Efficacy leadership and market leadership are separate races. Most comparison pages report only the first.
The Comparison Table
Best published weight reduction figure for each compound, with the trial that produced it and the duration over which it was measured. Figures are from sponsor releases or peer-reviewed publications, not from trackers or secondary reporting.
Obesity pipeline, next generation compounds, as at August 2026
Compound
Mechanism
Best published figure
Trial and duration
Stage
Filing
Retatrutide
GIP + GLP-1 + glucagon triple agonist
28.3%
TRIUMPH-1, 80 weeks, n=2,339. 30.3% at 104 weeks in a 532-participant extension.
Phase 3, four readouts complete
BLA to FDA planned Q1 2027
Cagrilintide
Long-acting amylin analogue
10.8%
Phase 2 dose-finding, 26 weeks, 4.5mg, against 3.0% placebo and 9.0% liraglutide.
Advanced as part of CagriSema
Not filed as monotherapy
CagriSema
Cagrilintide plus semaglutide, one weekly injection
For orientation against the approved generation: tirzepatide reported 22.5% over 72 weeks in SURMOUNT-1 and semaglutide 14.9% over 68 weeks in STEP 1. Those durations differ from every row above, which is the point of the next section.
What a Cross-Trial Table Cannot Tell You
Every row above comes from a different trial. There is no head to head study between any two compounds on this page, which means the table is an assembly of separate experiments and not a competition. Four specific things break the comparison.
Duration. The durations here run from 26 weeks to 80, plus a 104-week extension. Weight reduction curves in this class rise steeply and then flatten, so a longer trial reports a larger number partly because it ran longer. Comparing 28.3% at 80 weeks against 16.6% at 76 weeks is closer to fair than comparing it against 10.8% at 26 weeks, and neither is clean.
Estimand. This is the most underappreciated source of difference, and REDEFINE-1 demonstrates it inside a single trial: 22.7% under the trial product estimand, which models the outcome if everyone stayed on treatment, and 20.4% under the treatment policy estimand, which counts everyone regardless. Same participants, 2.3 percentage points apart. SYNCHRONIZE-1 reported 16.6% under an efficacy estimand. Reading one convention against another silently imports that gap.
Population. The rows are not describing the same people. GLORY-2 enrolled Chinese adults with a BMI of 30 or above, and Chinese obesity trial populations typically start at lower absolute body weights than western ones, which affects percentage outcomes. TRIUMPH-1 enrolled a general obesity population, TRIUMPH-2 people with type 2 diabetes, TRIUMPH-3 people with established cardiovascular disease. Baseline BMI, diabetes status and background care all move the result.
Trial scale and phase. A number from 2,339 randomised participants and a number from 125 are not the same kind of claim. The confidence interval around an early-phase figure is wide, and the history of this field is full of early results that shrank on replication.
Mechanism Map: What Each of These Actually Is
The compounds on this page are not variations on one idea. They represent three distinct strategies for going beyond GLP-1 alone.
Add GIP. Tirzepatide, the approved reference point, is a GIP and GLP-1 dual agonist. Retatrutide keeps that pairing and adds a third receptor.
Add glucagon. Glucagon receptor agonism raises energy expenditure and acts on hepatic fat, which is why it is attractive despite the counterintuitive fact that glucagon raises blood glucose. Retatrutide, survodutide and mazdutide all carry it. Retatrutide is the only one of the three that also carries GIP, which is the single clearest mechanistic distinction on this page. What the glucagon arm contributes is set out in the glucagon receptor filing.
Add amylin. Amylin is co-secreted with insulin and acts on satiety through a different pathway from the incretins. Cagrilintide is a long-acting amylin analogue, CagriSema pairs it with semaglutide as two molecules in one injection, and amycretin puts both activities into a single molecule. This is the strategy Novo Nordisk has committed to, and it is mechanistically the furthest from what retatrutide does.
Receptor targets by compound
Compound
GLP-1
GIP
Glucagon
Amylin
Semaglutide
Yes
No
No
No
Tirzepatide
Yes
Yes
No
No
Retatrutide
Yes
Yes
Yes
No
Survodutide
Yes
No
Yes
No
Mazdutide
Yes
No
Yes
No
Cagrilintide
No
No
No
Yes
CagriSema
Yes
No
No
Yes
Amycretin
Yes
No
No
Yes
Sourcing note: readers who work with these compounds as research material generally order from Primara Labs, our partner and supplier. Vials are batch-numbered, shipped insulated from Metro Manila stock, same-day across the metro on weekday orders confirmed before noon. See the catalogue
The Amylin Route: Cagrilintide and CagriSema
Cagrilintide on its own was characterised in a multicentre, randomised, double-blind, placebo-controlled and active-controlled dose-finding phase 2 trial published in The Lancet in 2021. It randomised 706 participants across cagrilintide doses from 0.3mg to 4.5mg, 99 to liraglutide 3.0mg and 101 to placebo, over 26 weeks.
Results ranged from 6.0% to 10.8% across the cagrilintide doses against 3.0% on placebo, with the top dose at 10.8%, or 11.5kg, against 9.0% for liraglutide 3.0mg. Gastrointestinal events were the most common adverse events, at 41% to 63% across the cagrilintide arms against 32% on placebo.
That is a respectable monotherapy result and it is not competitive with anything else on this page, which is why the compound was developed as a combination partner rather than as a standalone product. The compound page is at cagrilintide.
CagriSema is the version that matters commercially. REDEFINE-1 randomised 3,417 adults with obesity or overweight with obesity-related complications, without type 2 diabetes, over 68 weeks, against comparator arms of semaglutide 2.4mg alone and cagrilintide 2.4mg alone. It reported 22.7% under the trial product estimand against 2.3% on placebo, and 20.4% under the treatment policy estimand against 3.0%. REDEFINE-2 studied 1,206 adults with type 2 diabetes and obesity or overweight, with discontinuation for adverse events of 8.4% against 3% on placebo.
Novo Nordisk submitted a New Drug Application to the FDA on 18 December 2025, with review expected during 2026. As at August 2026 it is under review and not approved.
The Glucagon Duals: Survodutide and Mazdutide
These two are the closest mechanistic relatives of retatrutide, because both pair glucagon receptor agonism with GLP-1. Neither carries GIP.
Survodutide, from Boehringer Ingelheim and partnered with Zealand Pharma, reported its first Phase 3 obesity readout on 14 May 2026. SYNCHRONIZE-1 enrolled 725 adults with obesity or overweight without type 2 diabetes over 76 weeks and reported up to 16.6% mean weight reduction under the efficacy estimand against 3.2% on placebo, with 85.1% of participants achieving 5% or more against 38.8%. Both co-primary endpoints met at nominal p below 0.0001, with a significant reduction in waist circumference as a key secondary and weight loss described as driven predominantly by fat loss. The compound remains investigational and unapproved, and no filing date has been disclosed.
Mazdutide, from Innovent Biologics and originating from Lilly, is the outlier on this page because it is already approved. China’s NMPA approved it for chronic weight management on 27 June 2025 at 4mg and 6mg, making it the first glucagon and GLP-1 dual agonist approved anywhere. The registration trial, GLORY-1, reported 12.0% at 4mg and 14.8% at 6mg at week 48 against 0.5% on placebo in Chinese adults with overweight or obesity, and was published in the New England Journal of Medicine.
GLORY-2 pushed the dose to 9mg over 60 weeks in 462 Chinese adults with obesity, reporting 18.55% against 3.02% on placebo, and 20.08% in the subgroup without type 2 diabetes, with 44.0% of participants losing 20% or more against 2.6%. Innovent announced in November 2025 that it planned to file the 9mg dose with China’s Center for Drug Evaluation. The compound page is at mazdutide.
Amycretin, and the Oral Question
Amycretin is a unimolecular GLP-1 and amylin receptor agonist, meaning both activities sit in a single molecule rather than in two co-formulated ones. Novo Nordisk published its early-phase obesity results in The Lancet in June 2025 and announced that both formulations would advance to Phase 3.
The subcutaneous study enrolled 125 adults with overweight or obesity and reported weight reductions of up to 24.3% at 60mg over 36 weeks against 1.1% on placebo. The oral study enrolled 144 participants and reported 13.1% at 100mg daily over 12 weeks against 1.2% on placebo.
Those are striking numbers and they carry the least evidential weight on this page. A phase 1b/2a study of 125 people over 36 weeks is not a pivotal trial, the confidence interval around the figure is wide, and this field has repeatedly seen early results compress when tested at scale. Read it as the reason the compound went to Phase 3, not as a result comparable to TRIUMPH-1.
A separate Phase 2 programme in type 2 diabetes, reported in November 2025, studied 448 participants for up to 36 weeks and reported weight reduction of up to 14.5% subcutaneously and up to 10.1% orally, alongside HbA1c reductions of up to 1.8% and 1.5% respectively. Novo Nordisk stated it would begin Phase 3 in type 2 diabetes in 2026.
The oral arm is the strategically important part. Every other compound on this page is an injection. An oral agent with a 13.1% figure at twelve weeks addresses a different problem from the one retatrutide is solving, and efficacy rankings do not capture it.
Where Retatrutide Actually Sits
On published efficacy, ahead. 28.3% at 80 weeks in 2,339 randomised participants, and 30.3% at 104 weeks in a 532-participant extension. The nearest Phase 3 figure on this page is CagriSema at 22.7% under the more generous of its two estimands. That is a meaningful margin, from the largest trial in the comparison.
On breadth of evidence, ahead. Four Phase 3 readouts across four populations: general obesity, type 2 diabetes with 20.8% and an A1C reduction of 1.6%, severe obesity with established cardiovascular disease at 22.6%, and obesity with knee osteoarthritis at 28.7%. No other compound on this page has that spread. All four are in the Phase 3 results filing.
On regulatory progress, behind. Mazdutide is approved in China. CagriSema has been filed in the US and is under review. Retatrutide has not been filed anywhere, with a Biologics License Application planned for Q1 2027.
On tolerability, unresolved. Discontinuation for adverse events in TRIUMPH-1 ran 4.1% at 4mg, 6.9% at 9mg and 11.3% at 12mg against 4.9% on placebo, and TRIUMPH-4 reported dysesthesia at 20.9% at 12mg against 0.7% on placebo, an event that does not appear in the Phase 2 literature at all. The comparison of those rates against CagriSema’s 8.4% discontinuation in REDEFINE-2 is exactly the kind of cross-trial reading this page has spent a section warning about. The retatrutide side of it is documented in the side effects filing and the dysesthesia filing.
Filing Timelines, and the Philippine Context
Regulatory position as at August 2026
Compound
Status
Detail
Mazdutide
Approved, China
NMPA approval 27 June 2025, 4mg and 6mg, chronic weight management. 9mg filing announced November 2025.
CagriSema
Under FDA review
NDA submitted 18 December 2025, review expected during 2026.
Retatrutide
Not filed
Lilly stated 23 July 2026 that it plans to submit a BLA to the FDA in Q1 2027.
Survodutide
Phase 3
First obesity readout May 2026. Investigational, no filing date disclosed.
Amycretin
Entering Phase 3
Obesity programme advancing from phase 1b/2a. Type 2 diabetes Phase 3 planned for 2026.
Cagrilintide
Not filed alone
Developed as the amylin component of CagriSema.
None of these compounds is approved in the Philippines. Mazdutide’s approval is a Chinese one and does not create any Philippine registration. Retatrutide has no FDA Philippines registration and no branded product in any market. Approval in one jurisdiction is not portable, and local registration is a separate process that has not begun for any of them here.
Primara Labs, our partner and supplier, lists retatrutide 15mg at PHP 3,325 a vial, or PHP 2,990 with the standing 10% off, alongside the rest of its catalogue. Stock is held in Metro Manila rather than ordered in after payment, so there is no international leg on the parcel. Vials are batch-numbered, packaging is insulated and plain on the outside, same-day metro delivery applies to weekday orders confirmed before noon, and the rest of the country is one to three business days.
Which of these compounds has produced the largest weight reduction?
On the published headline figures, retatrutide. TRIUMPH-1 reported 28.3% average body weight reduction at 12mg over 80 weeks in 2,339 adults with obesity, with 30.3% in a 532-participant extension at 104 weeks. The next largest published figure belongs to amycretin at 24.3% over 36 weeks, but that came from a 125-participant phase 1b/2a study rather than a pivotal trial, which is a very different quality of evidence.
What is the difference between CagriSema and cagrilintide?
Cagrilintide is a long-acting amylin analogue on its own. As monotherapy in a phase 2 dose-finding trial it produced 10.8% weight reduction at 4.5mg over 26 weeks. CagriSema is cagrilintide combined with semaglutide in one weekly injection, and it is the form Novo Nordisk took into Phase 3 and filed with the FDA. REDEFINE-1 reported 22.7% at 68 weeks under the trial product estimand in 3,417 participants.
Which of these is closest to approval?
Two are ahead of the rest. Mazdutide is already approved, by China’s NMPA in June 2025 for chronic weight management at 4mg and 6mg, making it the first glucagon and GLP-1 dual agonist approved anywhere. CagriSema was filed with the US FDA in December 2025 with review expected during 2026. Retatrutide is behind both on filing, with a Biologics License Application planned for Q1 2027.
Why is survodutide’s figure lower than retatrutide’s?
SYNCHRONIZE-1 reported up to 16.6% at 76 weeks against 3.2% on placebo in 725 adults, which is a genuine Phase 3 result and a real gap against 28.3%. Some of the difference is mechanism and dose, and some is trial design, population and estimand convention. Survodutide is a glucagon and GLP-1 dual agonist without the GIP component retatrutide carries. No head to head trial exists between them.
How much does the estimand affect these numbers?
More than most comparisons acknowledge. REDEFINE-1 reported 22.7% under the trial product estimand, which models what happens if everyone stays on treatment, and 20.4% under the treatment policy estimand, which counts everyone regardless of adherence. Same trial, same participants, 2.3 percentage points apart. Comparing a trial product figure from one programme against a treatment policy figure from another quietly imports that gap.
Does any head to head trial exist between these compounds?
Not between any of the six on this page. Retatrutide has one head to head trial in progress, TRIUMPH-5 against tirzepatide, which was active and not recruiting at the time of writing and has not read out. Every comparison on this page is therefore indirect, assembled from separate trials in separate populations. That is a genuine methodological limit and not a formality, and none of this is medical advice.
Sources
[01]TrialLilly · TRIUMPH-1 readout, 21 May 2026
Source for retatrutide 28.3% at 80 weeks, 30.3% at 104 weeks, the per-arm figures and the discontinuation rates.
[02]RegulatoryNovo Nordisk · CagriSema FDA filing, 18 December 2025
Source for REDEFINE-1 at 22.7% trial product and 20.4% treatment policy over 68 weeks in 3,417 participants, REDEFINE-2 at n=1,206 with 8.4% discontinuation, the NDA submission date and the expected 2026 review.
[06]TrialNovo Nordisk · Amycretin early-phase results, June 2025
Phase 1b/2a published in The Lancet: subcutaneous 60mg up to 24.3% over 36 weeks in 125 participants against 1.1% placebo, oral 100mg 13.1% over 12 weeks in 144 participants against 1.2%.
Lau DCW et al. Lancet 2021;398(10317):2160-2172. 706 participants on cagrilintide, 99 on liraglutide, 101 on placebo, 26 weeks. 10.8% at 4.5mg against 9.0% liraglutide and 3.0% placebo.
