Pipeline · Late stage

What's coming after Wegovy & Zepbound.

Foundayo (orforglipron) just graduated from this pipeline on April 1, 2026 — the first new molecular entity to clear the FDA's National Priority Voucher pilot. Ten more candidates remain in Phase 2 or Phase 3 and will determine the GLP-1 standard of care through the end of the decade. Mechanism, trial data, and timing — without the press-release gloss.

10 drugs profiled · 1 just approvedSourced from Phase 2/3 publications and clinicaltrials.govUpdated April 2026

Just approved

Foundayo (orforglipron)graduated from this pipeline on April 1, 2026 — the first small-molecule oral GLP-1.

Read the oral vs injection update

Headline candidatePhase 3

Retatrutide~24% body weight loss in Phase 2

Eli Lilly’s triple agonist activates GLP-1, GIP, and the glucagon receptor — adding a metabolic-rate pathway on top of the appetite suppression that has driven the field. Phase 2 weight loss reached 24.2% at 48 weeks at the highest dose with the curve still descending. TRIUMPH Phase 3 readouts begin early 2026.

Read the full retatrutide profile→

Novo's amylin combination

CagriSema

Cagrilintide (amylin analog) + semaglutide (GLP-1)

2026 to 2027

GLP-1 / glucagon dual

Survodutide

GLP-1 + glucagon dual agonist

Late 2026 (MASH) to 2027

Late stage

Phase 3 candidates

Drugs already in pivotal trials. Most likely to launch within the next 12–24 months.

6 drugs

Eli Lilly

Retatrutide

Triple agonist — GLP-1 + GIP + glucagon

Phase: Phase 3 (TRIUMPH program)
Delivery: Subcutaneous injection, once weekly
Approval (est.): Late 2026 to 2027 (if pivotal data hold)

Phase 2 weight loss

~24% mean body weight at 48 weeks at the highest dose (12 mg) — TRIUMPH-1 Phase 2

What makes it different

First triple agonist in late-stage development. Adding glucagon receptor activity is hypothesized to drive incremental energy expenditure on top of GLP-1/GIP-mediated appetite suppression.

Retatrutide is the most-watched name in the obesity pipeline. The Phase 2 data in 2023 represented the highest weight-loss percentage seen with any incretin drug to date. TRIUMPH Phase 3 trials are running across obesity, T2D, sleep apnea, knee osteoarthritis, and MASH.

Novo Nordisk

CagriSema

Cagrilintide (amylin analog) + semaglutide (GLP-1)

Phase: Phase 3 (REDEFINE program)
Delivery: Subcutaneous injection, once weekly (single combined pen)
Approval (est.): 2026 to 2027

Phase 2 weight loss

~22.7% mean body weight at 68 weeks — REDEFINE-1 (Dec 2024 readout)

What makes it different

Pairs amylin (a hormone that complements GLP-1 by enhancing satiety differently) with semaglutide. The REDEFINE-1 readout came in below the most ambitious analyst expectations (~25%) but was still strongly positive.

CagriSema is Novo Nordisk's leading bet to compete with tirzepatide and retatrutide. Cagrilintide alone showed ~10% weight loss in earlier trials; the combination is meaningful evidence that amylin pathways add real value alongside GLP-1.

Boehringer Ingelheim / Zealand Pharma

Survodutide

GLP-1 + glucagon dual agonist

Phase: Phase 3 (SYNCHRONIZE program for obesity; LIVERAGE for MASH)
Delivery: Subcutaneous injection, once weekly
Approval (est.): Late 2026 (MASH) to 2027

Phase 2 weight loss

~18.7% mean body weight at 46 weeks — Phase 2 (2023)

What makes it different

Dual mechanism focused on glucagon-driven energy expenditure plus GLP-1 satiety. Strong signal in MASH (formerly NASH) liver disease — could be first-to-market in that indication.

Boehringer is leveraging survodutide's glucagon pathway to differentiate from the Lilly and Novo dual-incretin approaches. The MASH liver disease use case may reach market earlier than the obesity indication.

Innovent Biologics / Eli Lilly (China)

Mazdutide

GLP-1 + glucagon dual agonist

Phase: Approved in China (June 2025) — not under FDA review for US
Delivery: Subcutaneous injection, once weekly
Approval (est.): Approved in China; no US filing announced

Phase 2 weight loss

~14.4% body weight at 48 weeks at 9 mg — GLORY-1 Phase 3

What makes it different

First China-developed dual agonist to reach approval. Originated as a Lilly molecule (LY3305677) licensed to Innovent for the Chinese market.

Mazdutide is significant as evidence that the dual-agonist class will see geographic competition. US patients are unlikely to access it directly, but the trial data informs regional standard of care.

Innovent / Sciwind Biosciences

Ecnoglutide

GLP-1 receptor agonist (cAMP-biased)

Phase: Phase 3 in China
Delivery: Subcutaneous injection, once weekly
Approval (est.): China only; no US filing announced

Phase 2 weight loss

~15.4% body weight at 48 weeks — Chinese Phase 2

What makes it different

Biased agonism intended to reduce GI side effects while maintaining efficacy.

Ecnoglutide is one of several Chinese-developed GLP-1s now reaching late-stage trials. The biased-agonism design is an interesting angle but real-world tolerability data is still emerging.

Novo Nordisk

Oral semaglutide 25 mg / 50 mg (high-dose)

GLP-1 receptor agonist (oral peptide)

Phase: Phase 3 complete (OASIS); FDA review expected 2025–2026
Delivery: Oral tablet, once daily — same empty-stomach ritual as Rybelsus
Approval (est.): Possible 2026

Phase 2 weight loss

~15.1% body weight at 68 weeks (OASIS-1, oral 50 mg) — first oral GLP-1 to approach Wegovy-class results

What makes it different

Same molecule as Wegovy, but as a daily pill. Provides a non-injection pathway for the existing semaglutide infrastructure.

The empty-stomach dosing ritual remains. If approved as an obesity indication, the brand will not be Rybelsus — Novo is expected to launch under a new name.

Mid stage

Phase 2 candidates

Drugs with positive Phase 2 readouts that are likely to advance — but launches are 2–4 years out at the earliest.

2 drugs

Altimmune

Pemvidutide

GLP-1 + glucagon dual agonist

Phase: Phase 2 (obesity); Phase 2 (MASH)
Delivery: Subcutaneous injection, once weekly
Approval (est.): 2028 or later

Phase 2 weight loss

~15.6% body weight at 48 weeks — MOMENTUM Phase 2

What makes it different

Lipid-side-chain modification designed for once-weekly dosing. Strong MASH liver-fat reduction signal.

A smaller-cap competitor but with a credible Phase 2 readout. Altimmune is exploring partnership paths to fund Phase 3.

Eli Lilly

Eloralintide

Long-acting amylin agonist

Phase: Phase 2
Delivery: Subcutaneous injection, once weekly
Approval (est.): 2028 or later

Phase 2 weight loss

Phase 2 readouts pending early 2026

What makes it different

Lilly's amylin entry — answer to Novo's cagrilintide. May be paired with tirzepatide or retatrutide in future combinations.

Less talked-about than retatrutide but strategically meaningful for Lilly's combination roadmap. Amylin pathways do not produce GI side effects to the degree GLP-1 does.

Early stage

Phase 1 / 2 candidates worth watching

Earlier in development. Long timelines, but mechanism or design differentiates them enough that they're worth tracking now.

1 drug

Novo Nordisk

Amycretin

Dual amylin + GLP-1 single molecule

Phase: Phase 1/2
Delivery: Both oral and subcutaneous formulations in development
Approval (est.): Not before 2029

Phase 2 weight loss

~13.1% mean body weight at 12 weeks (Phase 1, oral) — exceptionally fast onset

What makes it different

A single molecule that activates both the amylin and GLP-1 receptors, simplifying what CagriSema does as a two-component pen.

Phase 1 weight loss curves did not plateau by week 12 — the fastest onset of any incretin drug studied. Long-term efficacy data is the key open question.

Outlook

The ceiling moves again

The trajectory the field has been on is a roughly 5-percentage-point jump in achievable mean weight loss every two-to-three years: Saxenda (~7%) to Wegovy (~15%) to Zepbound (~21%) to retatrutide (~24% in Phase 2). At the same time, the cohort of patients reaching 30%+ body weight loss expanded from near-zero with first-generation drugs to a meaningful fraction of SURMOUNT participants.

The next inflection point is convenience. Orforglipron is positioned to bring injection-grade efficacy to a daily oral. If Lilly’s economics on small-molecule manufacturing pan out, the price floor of the GLP-1 class — currently anchored by branded peptides at $1,000+ list — could be meaningfully reset.

For payers, the SELECT cardiovascular trial fundamentally changed the conversation. Future drugs will be judged not only on weight loss but on cardiovascular, kidney, sleep apnea, and liver outcomes. Each new indication unlocks a new payer cohort.

FAQ

Common questions about the GLP-1 pipeline

We answer what we hear most often from readers. Have one we haven’t covered? Send it our way.

Orforglipron (Lilly's oral non-peptide GLP-1) is the closest — Phase 3 read out in 2024 and 2025, with FDA filing in 2025 and a decision expected in 2026. Retatrutide and CagriSema are next, both in late Phase 3 with potential approvals in 2026–2027.

Each receptor pathway controls a partly different metabolic process. GLP-1 works mostly on appetite and insulin secretion. GIP adds another appetite pathway and amplifies insulin response. Glucagon (added in retatrutide) increases energy expenditure and lipid utilization. Combining receptors gives larger combined effects than maxing out any one alone — and head-to-head trials have confirmed this pattern.

List prices may not drop sharply, but the patient out-of-pocket picture should improve. More competition, generic liraglutide already on market, and the early-2026 Inflation Reduction Act effects on Medicare drug negotiation all push downward on net pricing. Manufacturing economics for small-molecule oral candidates like orforglipron also support lower production costs over time.

Yes. Bimagrumab (a myostatin inhibitor) is being studied in combination with semaglutide to preserve lean mass during weight loss. Setmelanotide, a melanocortin-4 receptor agonist, is approved for specific genetic obesity indications. And several amylin-pathway drugs (cagrilintide, amycretin, eloralintide) are progressing — amylin works adjacent to GLP-1 with a different side-effect profile.