Zealand Pharma and Roche's once-weekly amylin analog for obesity, aimed at weight loss with less nausea than GLP-1 drugs. In phase 3.
Also called ZP8396, ZUPREME trials, Zealand Pharma amylin analog, Roche amylin analog
When Petrelintide's status or evidence changes, it's in the next morning's email.
Petrelintide is a long-acting copy of human amylin, the hormone the pancreas releases with insulin after meals to signal fullness. It is not a GLP-1 drug. Zealand Pharma built it to stay stable at near-neutral pH so it can later be mixed with other drugs, and Roche co-develops it under a 2025 deal. It is injected once a week.
In the phase 2 ZUPREME 1 trial, 493 adults with obesity and no diabetes took one of five doses or placebo. At 28 weeks weight fell 7.9% to 9.8% versus 1.7% on placebo, and it reached up to 10.7% by week 42 with weight still falling. Nausea hit 20% versus 6% on placebo, mostly mild and during dose increases; vomiting was 3%, lower than on placebo. In ZUPREME 2, Zealand Pharma reported that 220 people with type 2 diabetes lost up to 9.2% at 28 weeks versus 2.0%; that trial has not been published yet.
That is less weight loss than semaglutide or tirzepatide give in their trials, and the selling point is tolerability, not size of effect. Petrelintide is not approved anywhere. Three phase 3 trials (ZUPREME 3, 4 and 5, about 7,000 people) started in late September 2026, and a phase 2 trial pairing it with Roche's GLP-1/GIP drug enicepatide (CT-388) is planned.
What it binds to, and what happens inside the body after that, step by step.
Petrelintide activates amylin receptors, which sit in brainstem areas that tell you a meal is enough. This makes people feel full sooner, so they eat less, and it slows stomach emptying. Because it does not act on the GLP-1 receptor, it is being tested both alone and with GLP-1 drugs.
Human results and animal results are kept apart below. A result in rats tells you a mechanism is plausible. It does not tell you what happens in a person.
One published phase 2 RCT in 485 treated people with obesity shows about 8% to 10% weight loss with mainly mild nausea, and a second phase 2 trial in type 2 diabetes has topline results only. Two phase 1 trials established a half-life of about 10 days. No phase 3 results exist yet, and there are no head-to-head trials against GLP-1 drugs.
493 adults with obesity or overweight with a weight-related condition, no diabetes, 42 weeks
Weight fell 7.9% to 9.8% at 28 weeks vs 1.7% on placebo, and up to 10.7% at 42 weeks; nausea 20% vs 6%, vomiting 3% vs 6%.
Read the study220 US adults with overweight or obesity and type 2 diabetes, 28 weeks
Weight fell 7.4% to 9.2% vs 2.0% on placebo; HbA1c fell 0.61 to 0.88 points more than placebo; 1.9% stopped for GI side effects vs 1.7%.
Read the studyAdults with normal weight, overweight or obesity
Half-life was about 10 days and weight fell up to 8.6% after 16 weeks; nausea 16.7% to 33.3% vs 16.7% on placebo.
Read the study493 adults in the ZUPREME 1 trial
Stopping for side effects was 4.8% on the most effective dose vs 4.9% on placebo; no vomiting on that dose.
Read the studyNo preclinical studies are listed as key studies here. The human data above carries the evidence.
When a new Petrelintide study in people is published, the daily email covers it.
These are questions the published research has not answered.
No product containing Petrelintide is approved as a medicine by the FDA.
Phase 3 (ZUPREME 3 in obesity without diabetes, ZUPREME 4 with type 2 diabetes, ZUPREME 5 with established cardiovascular disease), started September 30, 2026. No marketing application has been filed. Co-developed by Zealand Pharma and Roche. WADA: not named on the 2026 Prohibited List, but with no approval anywhere it falls under S0 (non-approved substances), prohibited at all times. This is our reading of the S0 rule, not a WADA ruling on petrelintide by name.
When the FDA or WADA changes Petrelintide's status, it's in the next morning's email.
How much of Petrelintide is left after a single dose
Simple first-order model from the published half-life. Real clearance varies with dose, route, kidney and liver function and formulation. This is not a dosing schedule.
This table records the doses that trials and approved labels used, with the source for each row. It is a record of research, not a recommendation, and it is open to free members.
Which symptoms are expected and which mean stop and get help: side effects and red flags.
Tap a claim to see what the studies found.
ZUPREME 1 averaged up to 10.7% at 42 weeks. Tirzepatide gave about 20% in its own trials. They have not been compared directly, but the gap is large.
Vomiting, diarrhea and constipation were close to placebo, but nausea was 20% vs 6% in ZUPREME 1.
It is an amylin analog and acts on amylin receptors, not the GLP-1 receptor.
Only Zealand and Roche supply the clinical product. Online vials have no verified identity, purity, sterility or dose.
These pairings come up often. Almost none have been tested together in a trial, and the evidence note on each says so plainly.
Roche plans to pair the amylin analog with its GLP-1/GIP drug, the same idea as CagriSema.
EvidencePlanned phase 2 trial (NCT07589686, about 486 people); no results yet.
No approved product exists. Trial product is a solution handled under the sponsor's protocol; storage claims for research-chemical powders are vendor statements.
No public label or stability data.
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