What the human research shows
A published phase 2 with a moderate effect, and numbers at last behind the tolerability story the developers lean on. Grade C for stage: one 42-week dose-finding trial is not a phase 3 programme, and the three trials that will settle the size of the effect only started in September 2026.
Evidence profile0–5
- Metabolic & weightC1.3
- Cardiovascular—0.0
- Muscle & growth—0.0
- Healing & repair—0.0
- Neuro & sleep—0.0
- Immune & inflammation—0.0
- Sexual & hormonal—0.0
- Skin & appearance—0.0
- Ageing & longevity—0.0
| Outcome | Grade | Effect size | Human studies | Where the evidence comes from |
|---|---|---|---|---|
| Body weight | CWeak | Moderate | 1 phase 2 RCT (n=493, 42 wk); phase 1 | ZUPREME-1, published in The Lancet Diabetes & Endocrinology on 29 September 2026: 493 adults with obesity, or overweight with hypertension or dyslipidaemia, and no type 2 diabetes were randomised 5:1 to one of five weekly doses or placebo. At 28 weeks, the primary endpoint, weight had fallen 7.9–9.8% against 1.7% on placebo; by week 42 the largest loss was 10.7%. Efficacy estimand, so participants who stopped are not fully counted. The earlier phase 1 trial saw up to 8.6% at 16 weeks and measured a half-life of about ten days.31 |
| GI side effectsadverse | CWeak | Small | 1 phase 2 RCT (n=485 dosed); phase 1 | ZUPREME-1: nausea in 20% against 6% on placebo, described as predominantly mild and during dose escalation; vomiting 3% vs 6%, diarrhoea 7% vs 7%, constipation 7% vs 4%. No deaths. In the earlier phase 1 trial nausea occurred in 17–33% against 17% on placebo, and one participant stopped for gut symptoms. Whether the profile holds over 64 weeks in phase 3 is the open question.31 |
Literature searched to 7 October 2026. Human studies only; animal and cell work informs the mechanism section and nothing else.
Registered trials
ClinicalTrials.gov lists 9 interventional studies naming Petrelintide as an intervention — 4 completed, 4 recruiting, and none with results posted to the registry.
A registration is not a result. Anyone can register a study, and many never report — so this list shows what has been attempted, not what has been shown. The graded evidence above is the answer to whether something works.
1 further study is registered. Participant counts marked * are the sponsor's estimate, not a final enrolment. Source: ClinicalTrials.gov, read directly from the registry and refreshed weekly.
What it is
Petrelintide is a synthetic analogue of amylin, the pancreatic hormone released with insulin that signals fullness, engineered for a long half-life so that it can be given weekly. It is the third amylin agonist in late development after cagrilintide (Novo Nordisk) and eloralintide (Lilly), and the only one licensed to a large pharma partner outside its originator: Roche bought rights in 2025.
The phase 3 ZUPREME programme started on 22 September 2026: three placebo-controlled trials of about 7,000 participants in total — in obesity without type 2 diabetes, with type 2 diabetes, and with established cardiovascular disease — with the primary endpoint at 64 weeks.
How it is thought to work
Amylin receptor activation in the hindbrain slows stomach emptying and reduces meal size. The developers' claim is that a pure amylin agonist achieves meaningful weight loss with fewer gut side effects than GLP-1 drugs; the phase 1 nausea rates are consistent with that, but the sample is small.
What is still unknown
- Effect size beyond 42 weeks — the phase 3 trials run to 64 weeks and only started in September 2026.
- How it compares with cagrilintide and eloralintide; no head-to-head exists.
- Long-term safety beyond 42 weeks of exposure.
The molecule and how long it lasts
- Formula
- C185H305N49O61
- Molecular weight
- 4192 g/mol
- CAS number
- Not listed
- PubChem
- CID 172915807
No CAS number listed on the PubChem record
PubChem record, read 23 September 2026.
- Route
- Subcutaneous, once weekly
- Half-life
- About 10 days (phase 1)
From a published human pharmacokinetic study: Olsen MB, et al. Petrelintide phase 1 trials. Diabetes Obes Metab 2026
Regulatory status
Investigational.
Investigational; phase 3 running since September 2026. Products sold under the name are not the trial drug.
No MHRA licence.
Investigational only.
No Drug Identification Number.
Unapproved anywhere, so S0 (non-approved substances).
Questions people actually ask
How much weight do people lose on petrelintide?
Is petrelintide better tolerated than semaglutide?
One page per claimed effect
- CDoes Petrelintide help with body weight?1 phase 2 RCT (n=493, 42 wk); phase 1
- CHow common is GI side effects with Petrelintide?1 phase 2 RCT (n=485 dosed); phase 1
References
- 1Olsen MB, et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of petrelintide for weight management: two randomized, controlled phase 1 trials.Diabetes Obes Metab, 2026Single- and multiple-ascending-dose trials; 16-week part in adults with overweight or obesity.
- 2Genentech / Zealand Pharma. Positive phase II results for petrelintide (ZUPREME-1).Press release, 5 Mar 2026Topline only; not peer-reviewed.
- 3Garvey WT, et al. Petrelintide, a human amylin analogue for the treatment of obesity (ZUPREME 1): a randomised, double-blind, placebo-controlled, phase 2 trial.Lancet Diabetes Endocrinol, 2026 (online 29 Sep)493 randomised, 485 dosed; 32 sites in Poland, Romania and the USA; 42 weeks, primary endpoint at 28 weeks. NCT06662539.
- 4Zealand Pharma. Initiation of the registrational phase 3 ZUPREME programme of petrelintide in people with overweight or obesity.Press release No. 17/2026, 22 Sep 2026ZUPREME-3, -4 and -5; about 7,000 participants; primary endpoint percentage change in body weight at week 64.
Change log
- 2026-10-07ZUPREME-1 phase 2 published (Lancet Diabetes Endocrinol, 29 Sep 2026): weight and side-effect rows now rest on the paper, with new verbatim results replacing the phase 1 sentences; phase 3 start (22 Sep 2026) recorded. Grade held at C for stage.
- 2026-09-23Initial publication from the phase 1 paper. Grade C for stage.