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This article summarizes published scientific research for educational purposes only. Level Up Peptides products are intended exclusively for laboratory research by qualified researchers and are not for human or veterinary use. Discussion of published animal or human studies does not recommend those uses or establish the safety or effectiveness of any product sold on this website. This article does not provide medical advice, dosing guidance, or administration instructions.
SUMMARY
Amycretin, now called zenagamtide, is an investigational peptide developed to engage multiple receptors involved in metabolic regulation. Published research includes early human studies and phase 2 trials evaluating blood-glucose control, bodyweight, and adverse events. The findings support further investigation, but their interpretation depends on the population, formulation, study duration, and analysis used. Clinical trial results concern the investigational formulations tested and do not establish equivalence with separately supplied research materials. [1–4]
WHAT IS AMYCRETIN?
Amycretin and zenagamtide refer to the same development compound. Earlier publications use amycretin, while the 2026 phase 2 papers use zenagamtide.
It is a single peptide molecule with activity at GLP-1, amylin, and calcitonin receptors. Much of the development literature describes it through its combined GLP-1 and amylin activity. An agonist is a substance that activates a receptor, allowing researchers to investigate the biological responses associated with that signaling pathway. [3,4]
The oral and subcutaneous formulations have been studied separately. Their findings should be connected to the formulation and conditions actually tested.
WHAT DID THE EARLY ORAL STUDY EXAMINE?
A first-in-human study published in 2025 enrolled 144 participants across several study parts. Its main focus was safety and tolerability, with additional measurements of drug exposure. Changes in bodyweight were exploratory outcomes in the longer study portion. [1]
Reported treatment-emergent adverse events were mild or moderate in severity, and gastrointestinal events were the most common. Their frequency increased with higher exposure. These observations describe the study’s limited sample and observation period; they cannot establish that uncommon or longer-term risks are absent. [1]
WHAT DID THE EARLY SUBCUTANEOUS STUDY FIND?
A separate phase 1b/2a study randomized 125 participants with overweight or obesity to amycretin or placebo. Different groups were observed over different treatment periods, extending to 36 weeks. Investigators reported greater estimated bodyweight reductions with amycretin than with placebo. [2]
The largest reported estimate was a 24.3% reduction from baseline at week 36 in one study group, compared with 1.1% in its placebo comparison. This was an estimate from a small early-phase group, not an outcome achieved by every participant. [2]
Gastrointestinal adverse events were common. The study also had substantial participant withdrawal, including many discontinuations attributed to reasons other than adverse events. These features matter because missing observations and the methods used to analyze them affect how confidently results can be generalized. [2]
WHAT DID THE 2026 PHASE 2 STUDIES ADD?
Two publications reported oral and subcutaneous zenagamtide findings from a phase 2 research program in adults with type 2 diabetes. The primary outcome was change in HbA1c, a blood measurement used to assess longer-term glucose control, over 36 weeks. Participants were already receiving specified background diabetes medications. [3,4]
The subcutaneous report included 262 randomized participants. Estimated HbA1c reductions were greater with zenagamtide than with placebo across the tested groups. Gastrointestinal events predominated, and serious adverse events were reported in both active-treatment and placebo groups. A reported serious event does not automatically establish that the investigational compound caused it. [3]
The oral report included 186 randomized participants. It also found greater estimated HbA1c reductions with zenagamtide than with placebo. Gastrointestinal adverse events were the most common, and serious adverse events were reported in active-treatment groups. [4]
The principal efficacy analyses used observations collected while participants remained on treatment without rescue medication. This is important context: such estimates answer a different question from the average outcome that might occur regardless of treatment discontinuation or additional therapy. [3,4]
CAN RESULTS FROM DIFFERENT TRIALS BE COMPARED DIRECTLY?
Comparisons require caution. Participants with overweight or obesity are not interchangeable with participants who also have type 2 diabetes. Study duration, background medications, formulation, participant withdrawal, and statistical methods can all influence reported outcomes.
A larger percentage change in one study does not, by itself, prove superiority over another compound or formulation. That conclusion generally requires an appropriately designed direct comparison.
HOW FAR HAS DEVELOPMENT PROGRESSED?
As of October 2026, Novo Nordisk’s development pipeline lists zenagamtide in phase 3 programs. This describes its development stage; it does not mean that phase 3 benefits or long-term outcomes have already been established. [5]
The clinical studies discussed here were funded by Novo Nordisk. Sponsor funding should be considered alongside study design, transparency, participant retention, and the complete results when assessing the evidence. [1–4]
WHAT REMAINS UNCERTAIN?
Longer observation and larger studies are needed to clarify durability, uncommon adverse events, and outcomes beyond changes in bodyweight or HbA1c. Evidence from selected trial populations also may not apply equally to people excluded from those studies.
Published clinical findings do not verify the identity, composition, stability, or biological activity of a separately supplied laboratory material. Those questions require material-specific documentation and analytical testing. This article presents the development literature for research education, not as a recommendation for personal use.
REFERENCES
Study descriptions below are shortened for readability. Each link identifies the original source.
[1] Gasiorek A, Heydorn A, Gabery S, et al. First-in-human phase 1 trial of oral amycretin: safety, tolerability, pharmacokinetics, and pharmacodynamics. The Lancet. 2025;406:135–148.
https://doi.org/10.1016/S0140-6736(25)01176-6
[2] Dahl K, Toubro S, Dey S, et al. Subcutaneous amycretin: results from a phase 1b/2a randomized controlled study. The Lancet. 2025;406:149–162.
https://doi.org/10.1016/S0140-6736(25)01185-7
[3] Mora P, Aroda VR, Asong M, et al. Subcutaneous zenagamtide in type 2 diabetes: a randomized, placebo-controlled phase 2 trial. The Lancet. 2026;408:621–635.
https://doi.org/10.1016/S0140-6736(26)01248-1
[4] Mora P, Aroda VR, Asong M, et al. Oral zenagamtide in adults with type 2 diabetes: a randomized, placebo-controlled phase 2 trial. The Lancet. 2026;408:607–620.
https://doi.org/10.1016/S0140-6736(26)01247-X
[5] Novo Nordisk. Research and development pipeline. Development-status source, accessed October 2026.
https://www.novonordisk.com/science-and-technology/r-d-pipeline.html