Altimmune's pemvidutide MASH trial is registered as an 1,800-patient Phase 3

Altimmune's liver program has moved to a larger stage. A Phase 3 trial of its drug pemvidutide in MASH — a form of liver disease — has been registered with an enrollment target of 1,800 participants and a status of recruiting. The study is listed under the name PERFORMA.

Pemvidutide is a GLP-1/glucagon dual agonist ^[2]. That means it combines two hormone signals in one drug, unlike semaglutide (Ozempic, Wegovy, Rybelsus), which is a GLP-1, or tirzepatide (Mounjaro, Zepbound), which combines GLP-1 and GIP ^[2]. ObesityIntel notes that pemvidutide's glucagon component "also hits the liver," which it cites as part of the drug's MASH opportunity ^[2].

The registration follows a positive Phase 2b result for pemvidutide in MASH, according to ObesityIntel ^[2]. In obesity, the same drug produced 15.6 percent weight loss at 48 weeks ^[2]. In a Phase 2 trial in alcohol use disorder called RECLAIM, reported on July 28, 2026, pemvidutide met its primary endpoint, with weight down 9.1 percent versus placebo ^[2].

Altimmune remains small next to the companies running the biggest incretin programs. ObesityIntel put its market capitalization at roughly $440 million to $590 million in July 2026, with cash of about $535 million as of April 30, 2026, including $225 million raised that April ^[2]. Its stated bear case for the company is blunt: "Small, speculative, crowded class, binary Phase 3 ahead." ^[2]

An enrollment target of 1,800 is the kind of size that can take years to fill and years more to complete. Altimmune has said its cash is meant to fund the program through a 52-week readout expected in 2029.

Not everything about the trial has been disclosed. The registry entry does not set out, in the summary available, which patients will be enrolled, what doses are being tested, or when the study will finish. Registry listings also change over time, and the public record does not preserve earlier versions of a listing once it is updated ^[1]. ObesityIntel's pipeline tracker still lists pemvidutide in Phase 2 rather than Phase 3 ^[2], a reminder that tracking services and registration databases can lag each other.

Why it matters for patients

Pemvidutide does not appear among the approved drugs in ObesityIntel's tracker. The approved GLP-1 medicines listed there are semaglutide, tirzepatide and Eli Lilly's oral orforglipron, sold as Foundayo ^[2]. That means pemvidutide is not an option anyone can be prescribed today, and the MASH trial will not change that until it reads out and, if successful, is reviewed by regulators.

This trial is also aimed at liver outcomes, not weight management. People taking semaglutide or tirzepatide for obesity or type 2 diabetes are not the population this study is designed to answer questions about. ObesityIntel lists a separate obesity program for pemvidutide at 15.6 percent weight loss over 48 weeks ^[2].

The 1,800-person target matters for a practical reason: a trial that large takes longer to enroll and follow than a small one, and its results are usually meant to support a regulatory filing rather than to explore whether a drug works at all. It also means results, when they come, will reflect a broader group of patients than an early study would.

A drug's mechanism does not guarantee an outcome. Pemvidutide's glucagon component is the reason it is being tested in liver disease in the first place ^[2], but the Phase 3 result has not been reported, and whether it improves liver outcomes at 52 weeks is not yet known.

What happens next

The trial's listed status is recruiting. The 52-week readout Altimmune has pointed to is expected in 2029, and no date for a regulatory submission or approval decision has been disclosed. Until then, the practical picture for patients — what is approved, what insurers cover, and what doctors can prescribe — is unchanged by this registration.