Mazdutide: A Dual GLP-1/Glucagon Receptor Agonist

Key Takeaways

• Regulatory Status: Not FDA-approved. As of April 2026, mazdutide has received approval from China's National Medical Products Administration (NMPA) for obesity; it has not been approved by the FDA or EMA for any indication. No US NDA or IND has been filed.
• Research Stage: Phase 3 data available from the GLORY-1 obesity trial and multiple DREAMS-program T2D/obesity trials in Chinese populations; head-to-head data vs. dulaglutide published; head-to-head vs. semaglutide ongoing (DREAMS-3).
• Availability: Not available for human use in the United States. Superpower does not offer this substance. For context on the investigational GLP-1/glucagon class in the US, see clinicaltrials.gov.
• What it is: A once-weekly injectable peptide co-agonist of the GLP-1 receptor (GLP-1R) and glucagon receptor (GCGR), developed by Innovent Biologics from a compound originally licensed from Eli Lilly.
• What the evidence actually shows: Phase 3 trials in Chinese adults with obesity or type 2 diabetes show clinically meaningful weight loss and glycemic improvement; direct comparisons to tirzepatide and semaglutide in non-Asian populations have not been completed as of April 2026.

Where Mazdutide Comes From and How It Works

Origin and licensing history

Mazdutide (INN: mazdutide; development name IBI362; original Lilly designation LY3305677) originated in Eli Lilly's GLP-1/glucagon co-agonist research program. Lilly licensed the compound to Innovent Biologics, a China-based biopharmaceutical company, and Innovent took it through clinical development under the IBI362 designation. The earliest human data, published in 2021 by Ji and colleagues in EClinicalMedicine, described the first-in-Chinese Phase 1b randomized placebo-controlled trial in 36 overweight and obese adults randomized 2:1 to IBI362 (3.0, 4.5, or 6.0 mg escalating weekly dosing) or placebo over 12 weeks; mean body weight reductions at week 12 were 4.81%, 6.40%, and 6.05% across the three mazdutide cohorts versus 0.60% with placebo, with mild gastrointestinal adverse events predominating and no treatment-related serious adverse events. A parallel Phase 1b trial in Chinese adults with type 2 diabetes, published in 2022 by Jiang and colleagues in Nature Communications, extended those dose-ranging observations to a diabetic population. A regulatory summary of the compound's development history and NMPA approval context was published in 2025 by Shirley in Drugs, providing an authoritative account of the Innovent-Lilly licensing path and the approved indications. Patent analysis of the Innovent-Lilly intellectual property landscape was subsequently published in 2026 by Abdul Fasi in Expert Opinion on Therapeutic Patents.

The dual GLP-1/glucagon receptor mechanism

Mazdutide engages two distinct receptor pathways: the glucagon-like peptide-1 receptor (GLP-1R) and the glucagon receptor (GCGR). Understanding why both are targeted — and how they complement each other — is central to understanding what makes this compound mechanistically distinct from either semaglutide (a selective GLP-1R agonist) or tirzepatide (a GLP-1R/GIP receptor dual agonist).

GLP-1R agonism produces the well-characterized metabolic effects that drive the entire incretin class: slowed gastric emptying, reduced appetite via hypothalamic signaling, and pancreatic beta-cell stimulation that raises insulin secretion in a glucose-dependent manner. These effects reduce caloric intake and lower blood glucose without directly driving energy expenditure.

GCGR agonism adds a complementary and mechanistically distinct effect: increased energy expenditure. Glucagon activates cAMP/PKA signaling in hepatocytes and brown adipose tissue, driving thermogenesis and fatty acid oxidation. A 2025 study by Long and colleagues in Journal of Hepatology demonstrated that glucagon controls obesity-specific energy expenditure via persistent cAMP/PKA signaling, providing mechanistic support for the GCGR component. GCGR agonism also promotes hepatic lipid clearance, which has drawn investigation into the compound's potential relevance for metabolic-associated steatotic liver disease (MASLD). A 2025 multiparametric MRI study by Xia and colleagues in Radiology documented liver fat reduction after GLP-1R/GCGR dual agonist treatment in a high-fat-diet mouse model. The mechanistic foundation for this class was established in landmark preclinical work: a 2009 study by Pocai and colleagues in Diabetes demonstrated that GLP-1/glucagon dual agonism reversed obesity in mice, providing the theoretical basis for the approach nearly two decades before mazdutide's Phase 3 program completed. A 2024 review by Winther and Holst in Diabetes, Obesity and Metabolism provides a comprehensive synthesis of the glucagon agonism rationale in metabolic disease, covering energy expenditure, hepatic lipid handling, and the mechanistic case for dual targeting.

The consequence of combining both targets is, in theory, greater total weight loss than GLP-1R agonism alone: appetite suppression and reduced caloric intake (GLP-1R) plus increased caloric expenditure and hepatic fat mobilization (GCGR). The Phase 3 data have now provided quantitative estimates of that combined effect.

How mazdutide differs from tirzepatide

Tirzepatide activates GLP-1R and the glucose-dependent insulinotropic polypeptide receptor (GIPR). The GIP receptor promotes insulin secretion and may enhance the tolerability of GLP-1R agonism by modulating the nausea response. Mazdutide activates GLP-1R and GCGR instead. The second target is entirely different: GIPR agonism primarily enhances insulin secretion, while GCGR agonism primarily increases energy expenditure and hepatic lipid mobilization. These are not equivalent mechanisms. Whether one combination produces superior outcomes compared to the other in head-to-head trials has not been established as of April 2026; no published direct comparison exists.

What the Phase 3 Evidence Shows

GLORY-1: the obesity pivotal trial

The GLORY-1 trial is the primary evidence base for mazdutide's obesity indication and the data supporting NMPA approval. Ji and colleagues published the full results in 2025 in the New England Journal of Medicine: a Phase 3 randomized controlled trial that enrolled 610 Chinese adults with obesity (BMI ≥28 kg/m² with at least one comorbidity) or overweight with multiple comorbidities, randomized to once-weekly subcutaneous mazdutide 4 mg, mazdutide 6 mg, or placebo for 32 weeks, with an extension to week 48. Placebo-subtracted body weight reductions at week 32 were approximately 10.5% at 4 mg and 13.0% at 6 mg (p < 0.001 for all comparisons with placebo), widening to approximately 11.3% and 14.3% by week 48. Gastrointestinal adverse events predominated, were mostly mild to moderate, and discontinuation due to adverse events was low across arms (1.5%, 0.5%, and 1.0% in the 4 mg, 6 mg, and placebo groups, respectively). Correspondence clarifying the trial design by Zhang and colleagues and an author reply by Ji and colleagues were also published in 2025 in the New England Journal of Medicine. A 2026 meta-analysis in Diabetes, Obesity and Metabolism by Azam and colleagues synthesized mazdutide efficacy and safety across trials in non-diabetic adults with overweight or obesity, providing a pooled weight loss estimate across the program.

DREAMS-2: head-to-head versus dulaglutide in type 2 diabetes

The DREAMS trial program covered multiple Phase 3 scenarios in Chinese adults with type 2 diabetes. DREAMS-2, published in 2026 in Nature by Guo and colleagues, provided an active comparator readout: the Phase 3 trial randomized 731 Chinese adults with T2D inadequately controlled on metformin-based therapy (mean baseline HbA1c 8.22%, weight 76.95 kg) 1:1:1 to mazdutide 4 mg, mazdutide 6 mg, or dulaglutide 1.5 mg subcutaneously for 28 weeks. Mean body weight reductions were 7.13% (4 mg) and 9.24% (6 mg) with mazdutide versus 2.86% with dulaglutide, a least-squares mean treatment difference of −3.78% and −5.76% respectively (both p < 0.0001 versus dulaglutide). The head-to-head advantage for mazdutide on the weight endpoint supports the hypothesis that GCGR co-agonism adds meaningful body weight reduction beyond what GLP-1R agonism alone achieves. A companion DREAMS-1 Phase 3 trial by Zhu and colleagues, also published in Nature in 2026, randomized 320 Chinese adults with T2D (mean HbA1c 8.24%, BMI 28.2 kg/m²) 1:1:1 to mazdutide 4 mg, mazdutide 6 mg, or placebo for 24 weeks, with HbA1c reductions of 1.57% and 2.15% versus 0.14% with placebo (treatment differences −1.43% and −2.02%, both p < 0.0001) and weight reductions of 5.61% and 7.81% versus 1.26% with placebo (both p < 0.0001), providing the pivotal placebo-controlled diabetes dataset alongside the dulaglutide comparison.

DREAMS-3: head-to-head versus semaglutide (ongoing)

DREAMS-3 is the most strategically significant comparison in the mazdutide trial program: a Phase 3 trial of mazdutide versus semaglutide in Chinese adults with T2D and obesity. The trial rationale and baseline characteristics were published in 2026 by Luo and colleagues in Contemporary Clinical Trials. As of April 2026, efficacy results from DREAMS-3 have not been published. The trial design places mazdutide in direct competition with the most widely studied GLP-1R agonist in the world; the readout will provide the most clinically informative comparison in the program.

Phase 2 dose-ranging and earlier evidence

The Phase 3 program was preceded by Phase 2 dose-ranging trials that established the dose-response relationship and safety profile. A 2024 trial in Diabetes Care by Zhang and colleagues randomized 250 Chinese adults with T2D to mazdutide 3 mg, 4.5 mg, 6 mg, open-label dulaglutide 1.5 mg, or placebo for 20 weeks; HbA1c reductions with mazdutide ranged from 1.41% to 1.67% versus 1.35% with dulaglutide and 0.03% with placebo (all p < 0.0001 versus placebo), with weight loss up to 7.1% at the 6 mg dose versus 2.7% and 1.4% respectively. The most common adverse events with mazdutide were diarrhea (36%), decreased appetite (29%), nausea (23%), vomiting (14%), and hypoglycemia (10%). A 2023 Phase 2 RCT in Nature Communications by Ji and colleagues randomized 248 Chinese adults with overweight or obesity to mazdutide 3 mg, 4.5 mg, 6 mg, or placebo for 24 weeks; placebo-subtracted weight reductions were 7.7%, 10.4%, and 12.3% respectively (all p < 0.0001), establishing the dose-response curve that informed the 4 mg and 6 mg doses selected for GLORY-1. Higher-dose data (9 mg and 10 mg) were examined in a 2022 Phase 2 trial in EClinicalMedicine by Ji and colleagues. A 2026 Phase 2 analysis in Med by Ji and colleagues extended the 9 mg dose readout to non-diabetic Chinese adults with BMI ≥30 kg/m², supporting a higher-dose obesity-specific signal. A 2025 high-dose Phase 1 trial in Diabetes, Obesity and Metabolism by Bhattachar and colleagues randomized 32 adults with overweight or obesity without diabetes (24 mazdutide, 8 placebo) across two dose-escalation cohorts (n = 12 each) to once-weekly subcutaneous mazdutide titrated to a target of 16 mg versus placebo for 20 weeks, with an 8-week post-dose observation. Mean weight change at week 20 was −20.0% (SE 1.9) in cohort 1 and −21.0% (SE 1.2) in cohort 2 versus −0.1% (SE 1.5) with placebo (p < 0.001 for both cohorts), with 66.7% of cohort 1 and 75.0% of cohort 2 achieving ≥15% weight loss versus 0% of placebo participants achieving ≥5%; no serious adverse events were reported, and GI events were predominantly mild to moderate. The very small sample size and short duration limit generalizability, but the data support the dose-escalation rationale used across the broader program.

Network meta-analyses and comparator context

Because no head-to-head trial between mazdutide and tirzepatide has been completed, indirect comparisons provide the only cross-compound weight loss context available. A 2024 network meta-analysis in Metabolism by Xie and colleagues compared seven GLP-1 receptor agonists and polyagonists for weight loss and positioned mazdutide within the class. A 2025 systematic review and network meta-analysis in Frontiers in Endocrinology by Liu and colleagues provided comparator data on glycemic control, body weight, and blood pressure across incretin drugs. A 2024 meta-analysis in Endocrine by Deng and colleagues pooled efficacy and safety data across GLP-1/glucagon dual agonists specifically, providing class-level context for mazdutide's results. A 2024 comparative analysis in American Journal of Therapeutics by Ayesh and colleagues directly compared mazdutide to dulaglutide for weight loss and diabetes management. A pooled safety and GI adverse event analysis in Frontiers in Endocrinology by Nalisa and colleagues synthesized the safety profile across diabetic and non-diabetic mazdutide trials.

Emerging pleiotropic signals

Beyond the primary endpoints of weight and glycemic control, the research base has begun to surface signals in organ systems affected by metabolic disease. A 2026 preclinical study in Pharmaceuticals by Gan and colleagues reported that mazdutide ameliorates MASLD via endoplasmic reticulum stress modulation, improved lipid metabolism, and reduced inflammation in animal models. A 2025 preclinical study in EBioMedicine by Dong and colleagues reported that mazdutide mitigates diabetes-associated cognitive dysfunction in animal models, adding a neurological dimension to the preclinical signal. A 2025 review in Diabetes, Obesity and Metabolism by Neff framed shared mechanistic pathways of glucagon signaling in obesity, MASLD, and cardio-kidney-metabolic conditions. These signals are preclinical; they have not been confirmed as efficacy endpoints in any published human trial of mazdutide.

Regulatory and Legal Status

NMPA approval in China

As of April 2026, mazdutide has received approval from China's National Medical Products Administration (NMPA) for use in adults with obesity. This approval was supported by the GLORY-1 Phase 3 trial data. The context for this regulatory pathway is described in a 2026 analysis in The Lancet Diabetes and Endocrinology by Pan and colleagues, which covers China's obesity burden, regulatory environment, and the policy landscape into which mazdutide was approved. The NMPA approval makes mazdutide the first GLP-1/glucagon dual agonist to receive full regulatory authorization for obesity anywhere in the world. A 2025 systematic review in Pharmacological Reviews by Kokkorakis and colleagues situates mazdutide within the broader global pipeline of emerging obesity pharmacotherapies and the regulatory landscape into which new incretin-based compounds are entering. A 2026 class review in Endocrine Reviews by Son and colleagues covers the expanding set of GLP-1-based medications for T2D and obesity and positions mazdutide among the dual and triple agonists currently under development.

FDA status in the United States

As of April 2026, mazdutide has not been submitted to the FDA for approval in the United States. No NDA or IND application for mazdutide has been announced by Innovent Biologics or any US development partner. The compound has no FDA-approved indication for any use, and no US clinical trials for mazdutide are registered on clinicaltrials.gov as of the time of writing. All published clinical data originate from trials conducted in China under NMPA oversight.

EMA and global status

As of April 2026, mazdutide has not received regulatory approval from the European Medicines Agency or any other major Western regulatory authority. Its global regulatory status remains China-only, with no announced development partnerships for US or European registration.

What this means practically

Mazdutide is not legally available for human use in the United States. Products sold through online vendors claiming to contain mazdutide are not regulated by the FDA, have not been manufactured under FDA-compliant quality standards, and have not undergone independent purity or potency verification. There is no legal pathway to obtain pharmaceutical-grade mazdutide for human use in the US as of April 2026. The compound cannot be prescribed, compounded, or dispensed by a licensed US healthcare provider under current law.

Mazdutide Versus Semaglutide and Tirzepatide: Key Context

Comparisons between mazdutide and the two dominant GLP-1-based drugs in the US market are a natural point of interest, and the mechanism differences are real. However, the comparison is limited by a fundamental asymmetry in the evidence base. Semaglutide has been evaluated in large global Phase 3 trials including non-Asian populations; tirzepatide similarly. Mazdutide's entire clinical dataset, as of April 2026, comes from trials conducted exclusively in Chinese populations. Whether the magnitude of weight loss observed in those trials would translate to US or European populations with different baseline BMI distributions, dietary patterns, and comorbidity profiles is unknown.

The network meta-analysis in Metabolism attempts to address this indirectly by placing mazdutide's weight loss results alongside other agents in a common analytic framework. The inference is hypothesis-generating, not definitive. No head-to-head trial between mazdutide and tirzepatide has been completed. The DREAMS-3 trial versus semaglutide in Chinese adults with T2D has not yet reported efficacy outcomes. The mechanistic distinction between GCGR co-agonism (mazdutide) and GIPR co-agonism (tirzepatide) is scientifically important and may ultimately produce different clinical profiles in specific populations, but the comparative evidence does not yet exist to support definitive claims in either direction.

This comparison is for scientific context only. These compounds have different targets, different regulatory statuses, and different evidence bases. Any framing of superiority or equivalence would not be supported by current data.

Safety: What Is and Is Not Known

Safety signals from Phase 2 and Phase 3 trials

The safety profile of mazdutide across the trial program is consistent with the GLP-1R agonist class: gastrointestinal adverse events predominate, primarily nausea, vomiting, and diarrhea. These are dose-dependent and generally occur during titration. The pooled safety analysis across diabetic and non-diabetic trials characterizes the GI adverse event profile across doses. No unexpected safety signals outside the known GLP-1R agonist class profile have been reported in published trial data. A 2025 case report in Frontiers in Endocrinology by Cheng and colleagues documented dose-escalated mazdutide use in an adolescent with obesity, type 2 diabetes, and hyperuricemia, providing an early real-world tolerability signal outside the controlled trial setting; single case reports cannot establish general safety but are included here for context. However, all Phase 3 safety data come from Chinese populations in trials of 32 weeks or less; long-term safety beyond 32 weeks has not been systematically studied in published trials as of April 2026.

Absence of US safety data

No US-based Phase 1, 2, or 3 trials for mazdutide have been conducted or reported. The FDA's standard safety evaluation process, which requires a US-based Phase 1 safety trial before Phase 2/3 efficacy trials, has not been initiated for this compound. The extrapolation of safety data from Chinese Phase 3 trials to a US population with different average body weights, comorbidity profiles, and concurrent medication use is not supported by any published analysis.

Risks from unregulated sources

Because mazdutide is not available through licensed US pharmacies or providers, any product sold online as "mazdutide" exists entirely outside the FDA regulatory framework. Such products have not been verified for identity, purity, or potency, and no manufacturing quality standards apply. Contamination, incorrect labeling, and dosing inconsistency have been documented in independent testing of peptide products sold as research-use compounds in other parts of the GLP-1 class. These risks are not theoretical.

Who Should Not Use Mazdutide

The short answer: no one in the United States, outside an IRB-approved clinical research study. Mazdutide has no FDA approval, no US IND, and no legal pathway for prescribing, compounding, or dispensing. There is no US population for whom use of this compound is supported by evidence. The NMPA approval in China does not extend to the United States.

Several mechanistic considerations amplify that default position. These are illustrative, not a contraindication checklist — there is no US-approved indication:

• Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2) — GLP-1R agonism is associated with C-cell hyperplasia in rodent models; the class carries a precautionary note in FDA-approved GLP-1R agonist labeling, and applicability to mazdutide specifically has not been evaluated in published human data
• History of pancreatitis — GLP-1R agonism has been associated with pancreatitis risk in class-level post-marketing surveillance
• Pregnancy or breastfeeding — no reproductive or developmental toxicology data exists in any published trial
• Severe renal or hepatic impairment — pharmacokinetic data in these populations is not available from published mazdutide trials
• Concurrent insulin or insulin secretagogue use — combination with GLP-1R agonism raises hypoglycemia risk at the class level

Which Biomarkers Are Relevant if You Are Exploring Peptide Science?

Understanding your metabolic baseline provides objective reference points regardless of which investigational or approved therapy you are considering. The mechanisms mazdutide is studied for map directly to the following markers.

• Fasting glucose and HbA1c: Mazdutide has been studied for glycemic effects in T2D populations across the DREAMS program. Baseline glucose and HbA1c establish the pre-intervention metabolic state and are the primary endpoints in the T2D trials. Glucose and HbA1c together provide the most complete picture of short-term and long-term glycemic regulation.
• Fasting insulin and HOMA-IR: Insulin resistance is the upstream metabolic abnormality that precedes T2D and contributes to obesity. The GCGR-mediated increase in energy expenditure that mazdutide is proposed to engage would theoretically affect insulin sensitivity. Measuring fasting insulin alongside glucose allows calculation of the homeostatic model assessment of insulin resistance (HOMA-IR), providing a more granular view of metabolic dysfunction than glucose alone.
• Lipid panel with triglycerides and ApoB: GLP-1R/GCGR co-agonism has been studied for effects on hepatic lipid metabolism. Triglycerides reflect fasting hepatic lipid output; ApoB reflects the total burden of atherogenic lipoprotein particles. Both are relevant to the metabolic-associated steatotic liver disease (MASLD) signal observed in preclinical mazdutide models and to the cardiovascular risk context in which obesity pharmacotherapy is typically evaluated.
• Liver enzymes (ALT, AST, GGT): The MASLD preclinical signal for mazdutide's GCGR component makes liver enzyme monitoring relevant. ALT and AST reflect hepatocyte injury; GGT reflects biliary and oxidative stress. These markers together provide a baseline for any individual considering investigational metabolic compounds and are part of a standard comprehensive metabolic panel.
• High-sensitivity CRP: Chronic low-grade inflammation is a feature of metabolic syndrome and obesity. The anti-inflammatory preclinical signal from the MASLD work by Gan and colleagues (2026) involved reduced hepatic inflammation; hs-CRP provides a systemic inflammatory baseline that is both independently informative and relevant to interpreting metabolic interventions.
• Body composition markers (where available): Because weight loss is the primary endpoint in mazdutide's obesity trials, understanding the composition of that weight — specifically the proportion of fat mass versus lean mass — matters clinically. Metabolic panels that include relevant markers alongside clinical body composition assessment provide the most complete picture.

When to Take This Seriously

If obesity, insulin resistance, T2D, or fatty liver disease is driving your interest in this compound, those are real clinical problems with established management pathways in the United States. Endocrinologists, primary care physicians, and obesity medicine specialists can evaluate and prescribe FDA-approved therapies — including semaglutide, tirzepatide, and others — that have completed the full US regulatory process, including large Phase 3 trials in diverse global populations, post-marketing safety surveillance, and FDA manufacturing oversight. These pathways exist and are legally accessible. Exploring an investigational compound without a licensed clinical pathway, based on Phase 3 data from a single population, while bypassing the safety evaluation that US approval requires, is not a like-for-like alternative. The appropriate starting point is understanding your metabolic biomarker profile, which provides the objective basis for any conversation with a provider about which interventions are appropriate for you.

That commitment to data before decisions is what drives Superpower's approach to preventive health: the understanding that the clearest path to better metabolic outcomes begins with knowing what your biology actually shows, not with following compounds through regulatory systems in other countries and hoping the results translate.

IMPORTANT SAFETY INFORMATION

Mazdutide is an investigational drug currently under clinical development by Eli Lilly (licensed to Innovent Biologics in China). It has not been approved by the FDA, or any other regulatory authority, for any medical use. Because Mazdutide is not FDA-approved, does not appear on the FDA's 503A bulk drug substances list, and is not a component of any approved drug, it is not lawfully available through compounding pharmacies in the United States. Mazdutide is not prescribed, compounded, or dispensed through Superpower. This page is provided for educational purposes only and does not constitute medical advice.

Mazdutide is not legally available through any US-licensed healthcare provider, compounding pharmacy, or pharmacy dispensing network. There is no legal pathway for human use of mazdutide in the United States as of April 2026.

Products sold online as "mazdutide" are not regulated by the FDA, have not been independently verified for identity, purity, or potency, and present unknown contamination and dosing risks. Use of such products has no clinical oversight and no established safety data in US populations.

Mazdutide should not be used by anyone in the United States outside an IRB-approved clinical research study; there is no approved indication and no contraindication table because there is no approved US use. Populations of particular theoretical concern based on the compound's proposed mechanism include: individuals with a personal or family history of medullary thyroid carcinoma or MEN2; individuals with a history of pancreatitis; pregnant or breastfeeding individuals; individuals with severe renal or hepatic impairment; individuals using insulin or insulin secretagogues concurrently.

Published safety data for mazdutide come exclusively from trials conducted in Chinese populations over durations of 32 weeks or less. Long-term safety, safety in non-Asian populations, and safety in individuals with comorbidities not represented in the published trial populations have not been established.

This article does not constitute medical advice. Always consult a qualified healthcare provider before making any decision about your health.