Mazdutide 10 mg

Phase 3 published — approved in China only10 mg vialUpdated 9 Sep 2026

The GLP-1 that also pulls the glucagon lever, and the only one of this generation that is an approved prescription medicine anywhere — in China, since June 2025, at 4 mg and 6 mg. Two things get lost in the retelling. The headline weight-loss figure everyone quotes comes from a 9 mg dose that is approved nowhere on earth, in trials run entirely in Chinese adults with a starting BMI well below Western trial populations. And the reason people are excited about the glucagon half — that it raises your metabolic rate — has never been measured in a human being taking this drug.

ApprovedChina only4 mg and 6 mg · no FDA or EMA filing

Weight change, 60 weeks−16.65%GLORY-2 · at 9 mg, a dose approved nowhere

Head-to-head vs tirzepatideNonenor retatrutide · every such comparison is cross-trial

Vomiting at 9 mg53.1%vs 1.3% on placebo · GLORY-2, n = 461

AvailabilityNot stocked

CertificatePending

Certificate register

The short version

Plain English first. Everything below this section is the same material with the sources, the numbers and the caveats attached.

What it is

A once-weekly injectable built from oxyntomodulin, a gut hormone that naturally hits two receptors at once — GLP-1 and glucagon. Developed by Eli Lilly, licensed to Innovent Biologics for China. It is a genuine prescription medicine in China and an unapproved drug everywhere else.

What has actually been measured

A great deal, and it is good-quality work. Five phase 3 trials published in NEJM, JAMA and Nature. At the approved 6 mg dose, −14.0% body weight at 48 weeks. At the unapproved 9 mg dose, −16.7% at 60 weeks. It beats dulaglutide and it beats semaglutide 1.0 mg, both head to head.

What has not been measured

Anything past 60 weeks. Any cardiovascular outcome trial — there is none. Any phase 3 outside China; the only substantial non-Chinese dataset is a 179-person phase 2. And any head-to-head against tirzepatide or retatrutide, at any phase.

What most people get wrong

Two things, both about numbers being moved out of the context that gives them meaning. “About 20% weight loss” is a press-release figure for a dose no regulator has approved — the published primary result is 16.65%, and the approved dose gives 14.0%. And every “mazdutide vs tirzepatide” comparison you will ever read is fabricated, in the sense that it sets a Chinese cohort starting at BMI 31–34 beside a Western cohort starting at 37–39 and calls the difference a result.

What mazdutide is

Most of this shelf is a GLP-1 analogue with something bolted on. Mazdutide is the other approach: it starts from a hormone the body already makes that hits both receptors natively, and engineers that molecule to last a week.

Class	GLP-1 / glucagon (GCGR) dual receptor agonist. An analogue of mammalian oxyntomodulin
Other names	IBI362 · LY3305677 · OXM-3
CAS	2259884-03-0
Molecular weight	Unresolved — see below. We are not printing a single figure
Half-life strategy	A C19 fatty acid on a lysine, through a γGlu–AEEA–AEEA linker — albumin binding, the same trick semaglutide and tirzepatide use
Dosing interval	Once weekly, subcutaneous
Originator	Eli Lilly. Chinese rights licensed to Innovent Biologics in 2019; Lilly retains everything outside China

We could not settle the molecular weight, and we are not going to guess

Two formulas are in circulation for the same compound. One set of sources gives C₂₁₀H₃₂₂N₄₆O₆₇, MW 4563.14. A major chemical database displays C₂₀₇H₃₁₇N₄₅O₆₅. The residue count is inconsistent too — one supplier describes 39 amino acids, while the sequence another publishes lists 34.

Every route we tried to the arbitrating source was blocked. So this page prints no molecular weight, and a certificate quoting one should be checked against a WHO INN monograph or the Chinese package insert rather than against a catalogue listing. This matters more than it looks: molecular weight is what converts a milligram on a label into moles of drug, and two formulas differing by three carbons are not the same molecule.

Why the glucagon half is the whole point

Glucagon is the hormone people know as insulin's opposite — it raises blood sugar. Deliberately agonising its receptor in a metabolic drug looks perverse until you see the rest of what it does: it drives hepatic fat mobilisation and, in the textbook account, increases energy expenditure. The design bet is that GLP-1's appetite suppression covers the glucose side while glucagon adds a second, independent mechanism on top.

That bet is the reason to be interested in this compound rather than the fifteenth GLP-1 analogue. It is also the part of the story with the least human evidence behind it, and there is a whole section below on exactly which half of it has been measured.

Nomenclature note, because it trips people. Mazdutide, survodutide, pemvidutide and cotadutide are all GLP-1/glucagon dual agonists — the same two receptors. Tirzepatide is GLP-1/GIP, a different second receptor entirely. Retatrutide is triple: GLP-1, GIP and glucagon. The -dutide suffix marks a glucagon-family agonist, not a class of efficacy, and nothing about a shared suffix makes two of these compounds interchangeable.

What “approved” actually covers

This is the single most misreported fact about mazdutide, and the misreporting runs in both directions — people who think it is an approved obesity drug, and people who think it is an unapproved research chemical, are each half right.

Jurisdiction	Status	What for	Doses
China	Approved 27 Jun 2025	Chronic weight management — BMI ≥ 28, or ≥ 24 with a weight-related comorbidity	4 and 6 mg
China	Approved 19 Sep 2025	Glycaemic control in adults with type 2 diabetes	4 and 6 mg
China — 9 mg	Under review. Application accepted 25 Nov 2025	Moderate-to-severe obesity	9 mg
United States	Not approved. No filing identified	—	—
EU, UK, Canada, Australia	Not approved. No filing identified	—	—

Read that table twice, because the two rows that matter are next to each other. The approved doses are 4 mg and 6 mg. The dose that produces the figures used to sell it is 9 mg. Every “up to 20%” claim in circulation is describing a strength that no regulator anywhere has yet licensed, and which as of this writing is still sitting in a review queue.

Outside China, Lilly's own programme was still at phase 2 as of its June 2026 publication. So there is no near-term prospect of an FDA or EMA decision, and anyone implying one is imminent is inventing a timeline.

One limitation we owe you on this section. We worked from Innovent's approval announcements, not from NMPA primary documents or the Chinese package insert — those we could not retrieve. So the approval dates, indications and strengths above are well attested across multiple independent releases, but the label's own contraindications, warnings and escalation instructions are not established here. If you need those, the package insert is the document to get.

What the trials actually found

This is a serious evidence base — five published phase 3 trials in NEJM, JAMA and Nature, plus a nine-trial meta-analysis in 2,292 people judged at low risk of bias. Very little on this shelf can say that. The honesty problem here is not thin evidence. It is which numbers get quoted.

Obesity, without diabetes

Trial	n	Dose	Weight change	Placebo
GLORY-1 NEJM 2025 · 48 wk	610	4 mg 6 mg	−11.00% −14.01%	+0.30%
GLORY-2 JAMA 2026 · 60 wk	461	9 mg	−16.65%	−1.50%
Phase 2, China Nat Commun 2023 · 24 wk	248	3 / 4.5 / 6 mg	−6.7% / −10.4% / −11.3%	+1.0%
Phase 2, United States Lancet Diab Endo 2026 · 48 wk	179	3/6 · 10 · 16 mg	−7.3% to −18.1% at wk 32	−0.9%

GLORY-1 also moved the things that usually move with weight: waist circumference −10.96 cm at 6 mg, systolic blood pressure −9.21 mmHg against −2.46 on placebo, and uric acid down 44.79 µmol/L where placebo rose. At 48 weeks, 49.5% of the 6 mg group had lost at least 15% of their body weight, against 2.0% on placebo.

Where the “20%” comes from, and why we are not printing it as the result

Three different numbers describe GLORY-2, and they are not interchangeable:

−16.65% — the primary result as published in JAMA, on the treatment-policy estimand. This is the number that counts everyone who was randomised, including people who stopped.
−18.5% — the efficacy estimand, which describes people who stayed on the drug as directed.
“up to 20.1%” — a company press-release figure that matches neither. We could not open the paper to identify which analysis produces it.

None of these is dishonest in itself; estimands are a real and legitimate distinction. What is dishonest is quoting the largest one without saying which question it answers. The most useful figure for a person asking “what happens if I take this” is the treatment-policy one, because it has the dropouts in it. That is 16.65% — at a dose approved nowhere. At the approved 6 mg it is 14.01%.

Type 2 diabetes — including the two head-to-heads that do exist

Trial	Comparator	HbA1c	Weight
DREAMS-1 Nature 2026 · n = 320	Placebo	−1.57% (4 mg) −2.15% (6 mg)	−5.61% −7.81%
DREAMS-2 Nature 2026 · n = 731	Dulaglutide 1.5 mg	−0.24% / −0.30% better	−3.78% / −5.76% better
DREAMS-3 n = 349 · not yet peer-reviewed	Semaglutide 1.0 mg	−2.03% vs −1.84%	−10.29% vs −6.00%

DREAMS-1 and DREAMS-2 are published in Nature and are strong. DREAMS-3 is not peer-reviewed — it exists as a company release and a conference presentation — and it is open-label, which for a weight endpoint matters. Grade it accordingly.

The comparison that does not exist

Against	Head-to-head trial?
Dulaglutide 1.5 mg	Yes — phase 3, Nature
Semaglutide 1.0 mg	Yes — phase 3b, unpublished
Semaglutide 2.4 mg	Running. No results — GLORY-3
Tirzepatide	No. None, at any phase
Retatrutide	No. None, at any phase
Survodutide, pemvidutide, cotadutide	No

Every mazdutide-versus-tirzepatide table on the internet is built by putting two unrelated trials side by side. The Chinese trials enrolled people with a mean BMI of 31 to 34. The Western tirzepatide and retatrutide trials enrolled people at 37 to 39. Baseline weight, baseline BMI and ethnicity all independently affect percentage weight loss, so those columns are not measuring the same thing. This is not a technicality — it is the difference between a comparison and a coincidence.

The pooled analysis, for what it is worth: nine randomised trials, N = 2,292, low risk of bias, published in Diabetes, Obesity and Metabolism in 2026. Mean differences against placebo of −6.56% at 3 mg, −9.92% at 4 mg and −11.1% at 6 mg. The authors' own closing line is the one to keep: “longer-term multi-ethnic studies are needed.”

The glucagon claim, split into what was measured and what was assumed

This section exists because the glucagon receptor is the entire reason mazdutide is interesting, and the two things most often claimed for it have completely different evidential standing. One has real human data. The other has none at all.

Energy expenditure: not measured. Not once.

We could find no human study of mazdutide reporting indirect calorimetry, resting energy expenditure, thermogenesis, or any other direct measure of metabolic rate. Not a null result — an absence of the measurement.

The phase 2 investigators' own wording is the giveaway. They describe the effect as “expected given glucagon's effects to increase energy expenditure” — that is a mechanism being invoked to explain an observed weight loss, not a mechanism being measured. It is textbook glucagon pharmacology imported wholesale and presented as a finding about this drug.

So when a vendor page tells you mazdutide “raises your metabolic rate” or “burns calories at rest”, the honest translation is: glucagon does that in the physiology textbook, and nobody has yet checked whether this molecule does it in a person.

Liver fat: genuinely measured, and the numbers are large

Here the evidence is real, and it is the best argument for the compound.

Study	Dose	Liver fat by MRI-PDFF	Placebo
GLORY-1 substudy n = 69 · exploratory	4 mg 6 mg	−63.3% −73.2%	+8.2%
— in those starting ≥10% liver fat	6 mg	−80.2%	—
GLORY-2	9 mg	−71.9%	+5.1%
US phase 2 substudy n = 121	10 mg 16 mg	−67.7% −68.8%	−14.1%

In the US substudy, 69.6% of the 10 mg group had their liver fat drop below the 5% steatosis threshold entirely. ALT fell about 18%, fasting insulin about 50%, HOMA2-IR about 47%.

And here is the number that keeps the claim honest

In that same US substudy, liver-fat change correlated with weight loss at r = 0.73 (P < 0.001).

Which means the hepatic effect observed is largely explained by the weight loss, and a weight-independent glucagon effect on the liver has not been demonstrated. Demonstrating it needs a comparator producing matched weight loss — and that trial exists, is running, and has not reported. GLORY-3 puts mazdutide 9 mg against semaglutide 2.4 mg in people with fatty liver, with liver fat and body weight as co-primary endpoints. That is the experiment that answers this question, and until it reports, the answer is open.

Two limits on all of the above. Every hepatic dataset here is imaging and enzymes — there is no biopsy data, no MASH resolution endpoint and no fibrosis data, so “reverses fatty liver disease” is not a supportable sentence. And the GLORY-1 liver substudy is 69 people and was labelled exploratory by the sponsor itself, which is the right way to read a −80.2% headline.

Reported effects

The safety picture has one number in it that should stop anyone quoting the efficacy figures without it.

GLORY-2, 9 mg, 60 weeks, 461 people

Event	Mazdutide 9 mg	Placebo
Vomiting	53.1%	1.3%
Nausea	46.9%	3.2%
Diarrhoea	39.4%	6.5%
Any adverse event	98.7%	93.5%
Serious adverse events	7.2%	5.2%
Stopped because of an adverse event	2.9%	0%

More than half of everyone on the 9 mg dose vomited — and 97% of them stayed on it anyway. That gap is the most informative thing in the safety data. As reported, the gastrointestinal events are near-universal, concentrated during dose escalation, and mostly mild to moderate. They are not a footnote and they are not a reason nobody finishes the trial. Anyone selling this on the efficacy number without the 53% is telling you half of what the trial found.

At the approved doses the tolerability picture is much gentler. In GLORY-1, discontinuation for adverse events was 1.5% at 4 mg and 0.5% at 6 mg — against 1.0% on placebo. Read that again: at 6 mg, fewer people quit for side effects than quit on placebo. Dose is doing nearly all the work in this section.

Heart rate — the specific thing glucagon agonism raises

In the phase 2 trial, mean heart-rate change at 24 weeks was +8.75 bpm at 6 mg against +4.81 bpm on placebo — so roughly +4 bpm over placebo, with the lower doses much closer to it. Across 48 weeks in GLORY-1, the sponsor reports mean changes of no more than 5 bpm.

We could not find heart-rate data at 9 mg. It is not in the GLORY-2 press release and not in any coverage we could open; it will be in the paper, which was paywalled to us. Given that heart rate is the safety concern attaching specifically to glucagon receptor agonism, and 9 mg is the dose everyone is interested in, this is the most consequential gap on this page. We are flagging it rather than filling it with the 6 mg figure.

Hypoglycaemia, liver and the class warnings

Hypoglycaemia: no severe hypoglycaemia in DREAMS-1; mild-to-moderate rates similar to dulaglutide in DREAMS-2. Note both trials excluded insulin users.
Liver: no hepatotoxicity signal anywhere. The direction is the opposite — ALT and AST fell consistently. The theoretical concern with glucagon agonism is hepatic glucose output and amino acid handling, not liver injury, and we found no dedicated evaluation of that either way.
Class warnings: GLORY-1 excluded people with a personal or family history of medullary thyroid carcinoma or MEN2, and anyone with a history of pancreatitis — the standard GLP-1 exclusions. There is no mazdutide-specific data on thyroid C-cell tumours, pancreatitis, gallbladder disease or aspiration risk in anything we could open.

The pooled nine-trial analysis summarises it as: gastrointestinal adverse events more frequent, serious adverse events and discontinuation rates comparable to control. That is a fair summary of 2,292 people over trials of up to 60 weeks. It is not a statement about years.

Doses used in the trials

Everything in this section is the escalation schedule a published trial or a registry record actually specifies. Where we could not source a schedule, we say so and leave it blank. We are not reconstructing ladders by dividing a target dose into round steps, which is how most of the ones circulating online were produced.

Trial	Escalation, as recorded
GLORY-1 — 4 mg arm	2 mg weekly, wk 1–4 → 4 mg weekly, wk 5–48
GLORY-1 — 6 mg arm	2 mg wk 1–4 → 4 mg wk 5–8 → 6 mg wk 9–48
Phase 2 — 6 mg arm	2 mg wk 1–4 → 4 mg wk 5–8 → 6 mg wk 9–24
US phase 2 — 10 mg arm	1.5 → 3 → 6 → 8 → 10 mg, four weeks at each step
US phase 2 — 16 mg arm	1.5 → 3 → 6 → 9 → 12 → 16 mg, four weeks at each step
GLORY-OSA — 9 mg	2 → 4 → 6 → 9 mg, four weeks at each step
GLORY-2 — 9 mg	Not established. The registry says only “gradually escalated”; the schedule is in a supplementary appendix we could not open
DREAMS-1, DREAMS-2	Not established. In the paywalled methods

Note what those last two rows mean in practice. GLORY-2 is the trial everyone quotes, and its published record does not contain the escalation schedule. So any week-by-week 9 mg ladder you find presented as “the GLORY-2 protocol” was not copied from GLORY-2 — it was inferred. The GLORY-OSA ladder in the row above reaches the same dose in a different trial, and it may or may not match. We are not going to present one as the other.

The one thing every sourced schedule agrees on is the shape: start at 1.5 or 2 mg, hold four weeks, then step. Every trial escalates slowly, and the 53% vomiting rate at 9 mg is what the slow escalation is for.

Approved clinical dosing in China is 4 mg or 6 mg once weekly by subcutaneous injection. The escalation instructions in the actual approved label are in the package insert, which we could not obtain — so the GLORY-1 schedule above is the trial's, not necessarily the label's.

Reconstitution arithmetic

Sentient Biogenix does not currently stock mazdutide. This page is a library reference. The arithmetic below assumes the 10 mg fill that is the common research presentation, and it is arithmetic rather than a protocol — there is no reconstitution guidance anywhere in the published record, because every trial used a manufactured pen.

Diluent into 10 mg	Concentration	1 unit on a U-100 syringe	2 mg is
1 mL	10 mg/mL	0.1 mg	20 units
2 mL	5 mg/mL	0.05 mg	40 units
2.5 mL	4 mg/mL	0.04 mg	50 units

At 2 mL the numbers come out whole against the trial doses, which is the only reason to prefer it: 2 mg is 40 units, 4 mg is 80 units, and 6 mg does not fit in a single U-100 syringe at all. That last point is worth sitting with — an approved maintenance dose of this compound does not fit in one insulin syringe at a 10 mg/2 mL reconstitution, which tells you the vial and the dose were not designed for each other.

Two things this table is not. It is not a solubility statement — we found no published solubility figure for mazdutide at all, and unlike NAD+ there is not even a supplier working concentration to quote. And it is not a dosing recommendation. The doses in the arithmetic are the ones trials used, reproduced so the syringe maths is visible; nothing on this page tells you to inject any of them.

Storage and the in-use window

Handle it as the acylated GLP-1-family peptide it is: lyophilised solid refrigerated, protected from light, reconstituted with bacteriostatic water, refrigerated after reconstitution, never frozen once in solution, never shaken.

Our recommended 28-day in-use window applies, and here more than usual it should be read as the recommendation it is. That figure is a microbiological convention resting on the preservative in bacteriostatic water and on how many times the stopper has been punctured — it is not a measured statement about how long mazdutide remains intact. We have no compound-specific stability data for this molecule in solution at any temperature, and we are not going to borrow semaglutide's. Sterility and stability are two different clocks, and for mazdutide we can only speak to the first.

See the storage guide for the general handling rules.

Regulatory and sport status

An approved medicine in one country is an unapproved drug in every other, and that is the position mazdutide is in almost everywhere this page will be read.

Canada

Mazdutide has no Canadian authorisation and no DIN. It is not named in Health Canada's 1 August 2025 seizure advisory, nor in the 9 April 2026 public advisory, nor in the CPSA advisory of the same date — but on this compound that absence should be read narrowly. Those documents name products the regulator has actually encountered in the Canadian market. Not being named is not a finding about the compound.

Health Canada's April 2026 wording covers the category regardless of which compounds it lists by name: unauthorised injectable peptides are “illegal in Canada and have not been assessed for safety, efficacy, and quality”, and “research use only” labelling “does not make these products legal or exempt from regulatory requirements.”

United States

Not approved, no filing identified. We checked FDA's Category 2 “may present significant safety risks” compounding list directly and mazdutide does not appear on it — but neither does it appear on any list permitting it, and it was not among the peptides heard at the July 2026 compounding advisory committee. It sits in the same gap most of this shelf sits in, and absence from a prohibition list is not a permission.

Sport

The 2026 Prohibited List does not name mazdutide. That does not make it permitted. Section S0 covers any pharmacological substance not addressed by another section and not currently approved by any governmental regulatory health authority for human therapeutic use — which is how unapproved investigational drugs are caught without being listed individually.

Mazdutide is an unusual case for that rule, because it is approved for human therapeutic use — by China's NMPA. Whether that satisfies S0's wording is a question for an anti-doping authority, not for us, and we are not going to guess at it in either direction. An athlete should ask their national body rather than reason from this paragraph. What we will say plainly: the 9 mg dose is approved by nobody, and for that strength the question does not even arise.

Sentient Biogenix supplies research compounds for laboratory research use only. This product is not an approved medicine in Canada, is not manufactured or tested to pharmaceutical standards, and is not for human or animal consumption, nor for diagnostic, therapeutic or clinical use. Approved mazdutide medicines exist in China and are prescription-only; this is not one of them.

Questions we actually get

Is mazdutide approved?

In China, yes — since June 2025 for weight management and September 2025 for type 2 diabetes, at 4 mg and 6 mg only. Nowhere else, and there is no FDA or EMA filing. The 9 mg dose that produces the headline figures is not approved anywhere, including China, where it is still under review.

How does it compare to tirzepatide or retatrutide?

Nobody knows, because nobody has run the trial. There is no head-to-head against either, at any phase. Comparisons you see are two separate trials printed side by side — and the populations differ enough (mean BMI 31–34 in the Chinese trials against 37–39 in the Western ones) that the columns are not measuring the same quantity.

What has it actually been compared against?

Dulaglutide 1.5 mg, in a 731-person phase 3 published in Nature — mazdutide won on both HbA1c and weight. And semaglutide 1.0 mg in a 349-person open-label study that has not been peer-reviewed. A trial against semaglutide 2.4 mg is running and has not reported.

Does the glucagon receptor raise your metabolic rate?

That is textbook glucagon pharmacology, and it has never been measured in a human taking mazdutide — no indirect calorimetry, no energy expenditure study, nothing. The trial investigators themselves describe the effect as “expected”, which is the language of an assumption, not a finding.

Does it fix fatty liver?

Liver fat drops a lot — 63% to 80% by MRI in the substudies. But liver-fat change tracked weight loss at r = 0.73, so what has been shown is that losing weight on mazdutide reduces liver fat, not that mazdutide does something to the liver that weight loss alone would not. There is no biopsy data and no fibrosis data, so nothing here supports “reverses MASH”.

Is it gentler on the stomach than semaglutide?

No, and the claim appears to come from nowhere. At 9 mg, 53.1% vomited, 46.9% had nausea and 39.4% had diarrhoea. Against dulaglutide, gastrointestinal events were higher for mazdutide. What is fair to say is that people largely stayed on it anyway — discontinuation was 2.9% at 9 mg and under 2% at the approved doses.

Does it preserve lean mass better than retatrutide?

That claim compares two different quantities. The mazdutide finding is that the proportion of lean mass rose — which happens arithmetically whenever fat is lost faster than lean. The retatrutide figure people set against it is an absolute lean-mass decline. The mazdutide body-composition substudy was 22 people. No trial has compared body composition between these two drugs.

How long has it been studied?

The longest randomised exposure in the published record is 60 weeks. There is no cardiovascular outcome trial, no non-Chinese phase 3, and essentially nothing on older adults — the mean age in GLORY-2 was 33.9.

Do you sell it?

No. This is a library reference page, and there is no mazdutide product in our catalogue — we checked the catalogue rather than relying on recall before writing that. If that changes, the page will say what certificate it carries and, if none, will say that plainly the way our KPV page does.

References

Ji L, Jiang H, Bi Y, et al; GLORY-1 Investigators. Mazdutide in Chinese adults with overweight or obesity. N Engl J Med 2025;392(22):2215–2225. DOI 10.1056/NEJMoa2411528. NCT05607680. — the pivotal obesity trial at the approved doses.
Gao L, Jiang H, Cai H, et al; GLORY-2 Trial Investigators. Mazdutide 9 mg in adults with moderate to severe obesity: a randomized clinical trial. JAMA 2026;336(5):377–388. DOI 10.1001/jama.2026.8142. NCT06164873. — the source of the −16.65% primary result and the 53.1% vomiting rate.
Ji L, Jiang H, Cheng Z, et al. A phase 2 randomised trial of mazdutide in Chinese overweight adults or adults with obesity. Nat Commun 2023;14:8289. DOI 10.1038/s41467-023-44067-4. NCT04904913. — the heart-rate data, and the “expected given glucagon's effects” wording.
Hsia SH, Bays HE, Billings LK, et al. Mazdutide in adults with overweight or obesity in the United States: a phase 2 randomised trial. Lancet Diabetes Endocrinol 2026;S2213-8587(26)00160-9. NCT06124807. — the only substantial non-Chinese dataset, and the r = 0.73 liver-fat correlation.
Zhu D, Zhao J, Cai H, et al. Mazdutide in Chinese adults with type 2 diabetes (DREAMS-1). Nature 2026;652:174–180. DOI 10.1038/s41586-025-10026-w. NCT05628311.
Guo L, Zhang B, Xue X, et al. Mazdutide versus dulaglutide in Chinese adults with type 2 diabetes (DREAMS-2). Nature 2026;652(8108):181–188. DOI 10.1038/s41586-025-10031-z. NCT05606913. — the one published head-to-head.
Kamrul-Hasan ABM, Chatterjee S, Ashraf H, et al. Efficacy and safety of mazdutide: a systematic review and meta-analysis. Diabetes Obes Metab 2026;28(10):8777–8794. DOI 10.1111/dom.71058. — nine trials, N = 2,292, low risk of bias.
Innovent Biologics. NMPA approval for chronic weight management, 27 June 2025; NMPA approval for type 2 diabetes, 19 September 2025; 9 mg supplementary application accepted, 25 November 2025. Company releases. — the approval dates, indications and strengths.
GLORY-3, NCT06884293 — mazdutide 9 mg versus semaglutide 2.4 mg in overweight adults with MAFLD, co-primary liver fat and body weight. Running, no results. The trial that answers the weight-independent liver question.
GLORY-OSA, NCT06931028 — phase 3 in moderate-to-severe obstructive sleep apnoea, primary endpoint AHI at week 48. The source of the only fully specified 9 mg escalation schedule.
Health Canada. Think twice before injecting peptides bought online. Public advisory, 9 April 2026. — the “research use only labelling does not make these products legal” wording.
US Food and Drug Administration. Certain bulk drug substances for use in compounding that may present significant safety risks. — the Category 2 list, checked directly. Mazdutide does not appear.

Listed rather than hidden, what we could not check. Every major publisher full text was blocked to us — NEJM, JAMA, Nature, Lancet, ScienceDirect and Wiley all returned 403 or a challenge page, and the main biomedical archive served CAPTCHAs throughout. Abstracts were recovered through an open API; no paper body and no supplementary appendix was read in the original. The consequences are named where they fall: the molecular weight is unresolved and none is printed; the GLORY-2 escalation schedule is absent and not reconstructed; heart-rate data at 9 mg is missing; per-event gastrointestinal rates for GLORY-1 and for the US phase 2 are not reproduced because only the qualitative statements were retrievable; and the provenance of the company's “20.1%” figure could not be reconciled with either published estimand. We worked from Innovent's announcements rather than NMPA primary documents or the Chinese package insert, which we could not obtain. One published paper cites a registry number (NCT01904913) that does not match its own programme and is almost certainly a typographical error for NCT04904913; we have flagged it rather than silently correcting it. And the absence of a cardiovascular outcome trial is an absence from the searches we could run, not a certified negative from a complete registry sweep.