Novo Nordisk presented Phase 2 data on zenagamtide — the drug formerly called amycretin — at the American Diabetes Association's 2026 Scientific Sessions in New Orleans this weekend. In adults with type 2 diabetes, the highest dose produced up to 14.6% mean weight loss at 36 weeks alongside an A1C reduction of up to 1.71 percentage points.
What makes the readout notable is the molecule itself. Zenagamtide is a single engineered peptide that activates both the GLP-1 and amylin receptors at once — not two drugs co-formulated in one shot. Novo is treating it as its flagship next-generation obesity asset.
What the Phase 2 Data Showed
The trial Novo highlighted at ADA was a 36-week, dose-finding Phase 2 study in 262 adults with type 2 diabetes inadequately controlled (A1C 7.0–10.0%) on metformin, with or without an SGLT2 inhibitor. Participants were randomized to one of six once-weekly subcutaneous zenagamtide doses (0.4 mg to 40 mg) or matched placebo (225 on drug, 37 on placebo).
The study met its primary endpoint — change in A1C — across all doses, and its key secondary endpoint of body-weight reduction at doses of 1.5 mg and above.
| Endpoint (40 mg dose, 36 wk) | Zenagamtide | Placebo |
|---|---|---|
| A1C reduction (from 7.8% baseline) | up to −1.71 pts | — |
| A1C below 7% | 89.1% | — |
| A1C at or below 6.5% | 76.2% | — |
| Mean weight loss | up to 14.6% | 2.1% |
Secondary readouts moved in the expected direction: time-in-range glucose, systolic blood pressure, and lipids all improved. The majority of adverse events were gastrointestinal — nausea, the usual signature of incretin and amylin therapies — and most were mild to moderate. Novo's chief scientific officer, Martin Holst Lange, framed zenagamtide as "the first investigational treatment for type 2 diabetes to combine GLP-1 and amylin receptor agonist mechanisms" in a single molecule.
A separate poster on zenagamtide's Phase 2b results in type 2 diabetes and an oral presentation on its feeding-related brain mechanisms were also on the ADA 2026 schedule. Novo is developing both subcutaneous and oral formulations — the oral version is the more strategically interesting one, since an oral GLP-1/amylin combo would be a first.
Why a Single-Molecule GLP-1/Amylin Drug Matters
For the last three years the obesity race has been about stacking gut-hormone receptors. Semaglutide hits GLP-1. Tirzepatide adds GIP. Retatrutide piles glucagon on top. Amylin has been the quieter pathway — slowing gastric emptying, blunting the post-meal glucagon surge, and signaling satiety to the hindbrain.
Novo's existing amylin play, CagriSema, gets at this by co-formulating two separate drugs (cagrilintide plus semaglutide) in one injection. Zenagamtide does it differently: one molecule, both receptors. That has practical upside — simpler manufacturing, cleaner pharmacokinetics, and a path to an oral version that a two-drug co-formulation struggles to match.
The 14.6% figure here comes from a type 2 diabetes population, where weight loss typically runs lower than in obesity-only trials. The obesity Phase 3 program (REDEFINE) is where the headline body-weight numbers will land — and that program is already enrolling.
For buyers, the takeaway is simpler. Zenagamtide is years from a pharmacy shelf, but it confirms that the amylin pathway is real and that the accessible amylin peptide today — cagrilintide — sits on the leading edge of where obesity pharmacology is heading.
