AstraZeneca's oral GLP-1 elecoglipron moves to Phase 3 after 11.8% weight loss

AstraZeneca said on June 8, 2026 that it is advancing elecoglipron, an experimental once-daily oral GLP-1 pill, into an extensive Phase 3 program in obesity and type 2 diabetes, including cardiovascular and kidney outcome trials ^[1]. The announcement followed full Phase 2b results presented at the American Diabetes Association's 2026 Scientific Sessions in New Orleans and published at the same time in The Lancet ^[1].

What the weight-loss trial found

In VISTA, 310 adults with obesity or overweight and at least one weight-related condition, none with type 2 diabetes, took elecoglipron or placebo as a daily tablet along with standard diet and physical activity advice ^[1][2]. At the 75 mg dose reached with weekly dose increases, average body weight fell 10.5% at 26 weeks compared with 0.6% on placebo, one of the trial's dual primary endpoints ^[1]. Weight loss had not leveled off when treatment ended at 36 weeks: 11.8% at 75 mg versus 0.3% for placebo ^[1]. A second 75 mg schedule, with dose increases every two weeks, produced 11.1% at week 36 ^[1].

Participants' mean starting weight was 106.9 kg and mean BMI 38.2; 73% were women and the mean age was 48.4 years ^[2]. The trial ran in Australia, Canada, Germany, Japan, Taiwan, the UK and the USA, and is listed as completed on ClinicalTrials.gov under NCT06579092 ^[2].

On the second primary endpoint, 88.8% of participants on the 75 mg every-two-week schedule lost at least 5% of their body weight by week 26, compared with 15.6% on placebo; 86.1% on the weekly-escalation 75 mg schedule reached that threshold ^[1]. By week 36, 52.0% and 61.9% of those two groups had lost at least 10%, and about 39% of each had lost at least 15%, against 4.5% and 2.7% on placebo ^[1].

Diabetes results

SOLSTICE enrolled 404 adults with type 2 diabetes ^[1]. At 75 mg, HbA1c fell by 1.9 percentage points at 26 weeks versus 0.2 points with placebo, the trial's primary endpoint ^[1]. AstraZeneca said 90% of participants on 75 mg reached an HbA1c below 7% and 85% reached 6.5% or lower ^[1]. Average weight loss was 7.7% with elecoglipron versus 1.7% with placebo at 26 weeks ^[1].

SOLSTICE included an open-label oral semaglutide arm for exploratory comparison, but results from that arm were not reported in these disclosures. No head-to-head comparison of elecoglipron with an approved GLP-1 drug has been reported.

Side effects

Gastrointestinal adverse events were the most common, consistent with the GLP-1 receptor agonist class, and were mostly mild to moderate ^[1]. In VISTA at 75 mg versus placebo, nausea occurred in 55% versus 20%, constipation in 41% versus 6%, diarrhoea in 35% versus 25%, and vomiting in 29% versus 5% ^[1]. In SOLSTICE the same comparison was nausea 37% versus 3%, constipation 29% versus 4%, diarrhoea 21% versus 15% and vomiting 18% versus 1% ^[1]. Discontinuations due to adverse events were infrequent, and no liver safety signals were observed ^[1]. In SOLSTICE, low blood sugar was uncommon and no serious adverse events or discontinuations were attributed to it ^[1]. Phase 2 tolerability data led AstraZeneca to adjust the dose-escalation schedule for Phase 3 ^[1].

Why it matters for patients

Elecoglipron is investigational, so it is not available by prescription while the Phase 3 program runs ^[1]. It is taken as a once-daily tablet without food or fluid restrictions in the trials ^[2], a different format from injected GLP-1 drugs. The weight-loss figures are averages from a 310-person trial with a placebo comparison, not predictions for an individual, and were calculated using an efficacy estimand that reflects participants who followed treatment as directed ^[1].

Gastrointestinal side effects are a common reason people stop GLP-1 medications; in VISTA, more than half of participants on 75 mg reported nausea and more than four in ten reported constipation ^[1]. How elecoglipron compares with Ozempic, Wegovy, Rybelsus, Mounjaro or Zepbound on weight loss, blood sugar or tolerability has not been reported.

What happens next

AstraZeneca said Phase 3 will include the EMBOLD trials in people with obesity or overweight, with and without type 2 diabetes, and the ELUMINATE trials in type 2 diabetes testing elecoglipron alone and in combination with dapagliflozin ^[1]. Additional trials will track longer-term cardiovascular and kidney outcomes ^[1]. Start dates, enrollment targets and completion dates for those trials have not been disclosed ^[1].