{"id":"eloralintide","name":"Eloralintide","aliases":["LY3841136","selective amylin receptor agonist"],"url":"https://lyoresearch.com/compounds/eloralintide","class":{"id":"glp-1-agonists","name":"GLP-1 and incretin agonists","url":"https://lyoresearch.com/classes/glp-1-agonists"},"summary":"Eloralintide is a once-weekly amylin receptor agonist from Eli Lilly, tested on its own and, more recently, paired with tirzepatide. In a 263-person phase 2 trial published in The Lancet in 2025, the top doses produced about 20% weight loss at 48 weeks against 0.4% on placebo. Nausea was dose-dependent and fatigue was unusually common. Added to tirzepatide in a phase 2b trial reported by press release in September 2026, it took weight loss in people with type 2 diabetes from 14.8% to 23.3% at 48 weeks. Phase 3 trials are running; it is not approved anywhere.","overall_grade":"C","overall_grade_meaning":"weak human evidence","human_trials":"1 phase 2 RCT published (n=263); 1 phase 2b topline with tirzepatide (n=367); phase 3 running","regulatory_status":"Investigational (phase 3)","molecule":{"formula":"C201H319N49O65S2","molecular_weight":"4526","cas":"2883634-40-8","pubchem_cid":175663130,"note":null},"pharmacokinetics":{"basis":"human","route":"Subcutaneous, once weekly","half_life":"Dose-proportional exposure at steady state reported; no half-life figure in the abstract","licensed_regimen":null,"product":null,"source":{"title":"Bhattachar S, et al. Eloralintide, a selective, long-acting amylin receptor agonist for treatment of obesity: phase 1 proof of concept. Diabetes Obes Metab 2026","url":"https://pubmed.ncbi.nlm.nih.gov/41559929/"}},"outcomes":[{"outcome":"Body weight","grade":"C","grade_meaning":"weak human evidence","effect_size":"large","adverse":false,"human_studies":"1 phase 2 RCT (n=263, 48 wk)","evidence":"Six dose regimens against placebo in adults with obesity and no diabetes. Loss ranged from 9% at 1 mg to 20% at 9 mg; placebo lost 0.4%. Efficacy estimand, so participants who stopped are not fully counted.","references":[{"citation":"Billings LK, et al. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial.","where":"Lancet, 2025","url":"https://pubmed.ncbi.nlm.nih.gov/41207310/"}],"verbatim":{"text":"The mean percent change in bodyweight from baseline after 48 weeks (efficacy estimand) was -9% (1 mg, 95% CI -12·6 to -6·3), -12% (3 mg, -14·9 to -9·8), -18% (6 mg, -20·7 to -14·5), -20% (9 mg, -22·7 to -17·5), -20% (6-9 mg, -22·7 to -17·0), and -16% (3-9 mg, -18·6 to -14·1), compared with -0·4% (-2·2 to 1·4) in the placebo group.","citation":"Billings LK, et al. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/41207310/"}},{"outcome":"Body weight (with tirzepatide, type 2 diabetes)","grade":"C","grade_meaning":"weak human evidence","effect_size":"large","adverse":false,"human_studies":"1 phase 2b RCT topline (n=367, 48 wk)","evidence":"Lilly press release, 30 September 2026, presented at the EASD meeting: in adults with obesity or overweight and type 2 diabetes, eloralintide 9 mg with tirzepatide 15 mg produced 23.3% weight loss at 48 weeks against 14.8% on tirzepatide 15 mg alone and 3.0% on placebo; HbA1c fell 2.9, 2.4 and 0.3 points. Eloralintide alone reached 12.3%. Read with care: 367 people across ten groups, an efficacy estimand, and 10.8–27.0% of the combination groups stopped for adverse events against 2.9% on tirzepatide alone. Not peer-reviewed.","references":[{"citation":"Eli Lilly. EloraTZP (combination of eloralintide and tirzepatide) delivered greater weight loss and A1C reduction vs. tirzepatide 15 mg in adults with obesity and type 2 diabetes.","where":"Press release, 30 Sep 2026","url":"https://investor.lilly.com/news-releases/news-release-details/lillys-eloratzp-combination-eloralintide-and-tirzepatide"}]},{"outcome":"Nausea and fatigue","grade":"C","grade_meaning":"weak human evidence","effect_size":"moderate","adverse":true,"human_studies":"Same RCT","evidence":"Nausea reached 64% at the 6 mg fixed dose and was lower with escalation. Fatigue in up to 46% — a side effect the GLP-1 drugs do not produce at that rate, and one to watch in phase 3.","references":[{"citation":"Billings LK, et al. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial.","where":"Lancet, 2025","url":"https://pubmed.ncbi.nlm.nih.gov/41207310/"}],"verbatim":{"text":"The most common adverse events with eloralintide were nausea (1 mg 11%, 3 mg 13%, 6 mg 64%, 9 mg 33%, 6-9 mg 54%, 3-9 mg 25%, and placebo 14%) and fatigue (1 mg 0%, 3 mg 13%, 6 mg 29%, 9 mg 43%, 6-9 mg 46%, 3-9 mg 21%, and placebo 12%).","citation":"Billings LK, et al. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/41207310/"}}],"regions":[{"region":"European Union","status":"Not authorised","note":"Investigational."},{"region":"United States","status":"Not approved","note":"Investigational; phase 3 running. Products sold under the name are not the trial drug."},{"region":"United Kingdom","status":"Not licensed","note":"No MHRA licence."},{"region":"Australia","status":"Not on the ARTG","note":"Investigational only."},{"region":"Canada","status":"Not authorised","note":"No Drug Identification Number."},{"region":"Sport (WADA)","status":"Prohibited at all times","note":"Unapproved anywhere, so S0 (non-approved substances)."}],"faq":[{"q":"Is eloralintide a GLP-1 drug?","a":"No. It acts only on the amylin receptor. That is the point: it tests whether the amylin pathway alone can deliver GLP-1-scale weight loss."},{"q":"How does it compare with cagrilintide?","a":"Cagrilintide alone produced about 10.8% loss at 26 weeks in its phase 2; eloralintide about 20% at 48 weeks. Different trials, different durations, no direct comparison."},{"q":"When will it be approved?","a":"Phase 3 trials are running. No filing has been made; any date is speculation."}],"references":[{"cite":"Billings LK, et al. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial.","where":"Lancet, 2025","url":"https://pubmed.ncbi.nlm.nih.gov/41207310/","note":"263 randomised, 46 US centres. NCT06230523."},{"cite":"Bhattachar S, et al. Eloralintide, a selective, long-acting amylin receptor agonist for treatment of obesity: phase 1 proof of concept.","where":"Diabetes Obes Metab, 2026","url":"https://pubmed.ncbi.nlm.nih.gov/41559929/"},{"cite":"Eli Lilly. EloraTZP (combination of eloralintide and tirzepatide) delivered greater weight loss and A1C reduction vs. tirzepatide 15 mg in adults with obesity and type 2 diabetes.","where":"Press release, 30 Sep 2026","url":"https://investor.lilly.com/news-releases/news-release-details/lillys-eloratzp-combination-eloralintide-and-tirzepatide","note":"Phase 2b, 367 randomised, 48 weeks, US and Argentina. Efficacy estimand; not peer-reviewed. NCT06603571."}],"last_reviewed":"2026-10-07","literature_searched_to":"2026-10-07","changelog":[{"date":"2026-10-07","note":"Phase 2b combination result with tirzepatide (press release, 30 Sep 2026) added as a new row, graded C: one small unpublished trial. Overall grade unchanged."},{"date":"2026-09-23","note":"Initial publication from the Lancet phase 2. Grade C for stage."}],"license":"CC BY 4.0 — cite as “LYO Research” with a link.","methodology":"https://lyoresearch.com/methodology"}