Novo Nordisk opens the first zenagamtide Phase 3 trial

Novo Nordisk has begun enrolling the first Phase 3 trial of zenagamtide, an experimental drug that has not been approved anywhere. The study, called AMBITION 7, is testing zenagamtide against insulin glargine in 1,778 people with type 2 diabetes who are already taking one to three other diabetes medicines and who face an increased risk of heart and blood vessel disease ^[1].

Two more late-stage studies are now on the public registry. One, listed under ClinicalTrials.gov number NCT07668414, compares zenagamtide with semaglutide — the molecule sold as Ozempic, Wegovy and Rybelsus — in people with excess body weight ^[2]. The other, AMAZE 9, tests zenagamtide tablets in the same population ^[3]. Both are scheduled to begin enrolling in September 2026.

What the trials are set up to measure

AMBITION 7's full registered title describes a study "Investigating How Well Zenagamtide Lowers Blood Sugar and Body Weight Compared to Insulin Glargine in People With Type 2 Diabetes and Increased Risk of Diseases That Affect the Heart and Blood Vessels Treated With 1-3 Other Diabetes Medications" ^[1]. Insulin glargine is a long-acting basal insulin, so the comparison is against a widely used standard option for people whose blood sugar is not controlled on pills or other injectables.

The obesity study registered as NCT07668414 is framed as a direct comparison: how well zenagamtide "Helps People With Excess Body Weight Lose Weight Compared to Semaglutide" ^[2]. Head-to-head trials against an approved drug, rather than against placebo, are the kind that can eventually support marketing claims about relative weight loss — though nothing can be concluded until results are reported and reviewed.

AMAZE 9 is the oral arm of the program, testing "Zenagamtide Tablets" for weight loss ^[3]. A pill version matters because the two most-used incretin drugs in the United States are injections, and oral options have so far been limited.

Several things are not yet known from these registry postings. The sources available do not spell out how zenagamtide works, what doses are being tested, how long each trial runs, where the sites are, or when results are expected. They also do not report any efficacy or safety findings, because none exist yet for Phase 3.

Why it matters for patients

A Phase 3 start is an early milestone, not a product. Late-stage trials typically take years, and drugs can still fail on effectiveness or safety at this stage. Nothing about zenagamtide changes what is available at a pharmacy today.

Still, the shape of this program tells you what Novo Nordisk is aiming at. Running a trial against insulin glargine in type 2 diabetes suggests the company wants evidence that its drug can compete with basal insulin on blood sugar and weight ^[1]. Running a trial against semaglutide in obesity suggests it wants a direct efficacy comparison with its own best-selling molecule ^[2]. And testing tablets suggests an effort to expand beyond weekly injections ^[3].

For people currently weighing options, the practical takeaway is that the field is still moving, and that comparative data — drug versus drug, rather than drug versus placebo — is slowly becoming more common. That kind of evidence is what insurers and guideline writers tend to lean on when deciding what to cover and recommend.

People interested in joining a study can look up the registry entries by their identifiers: NCT07797335 for AMBITION 7 ^[1], NCT07668414 for the semaglutide comparison ^[2], and NCT07720271 for AMAZE 9 ^[3]. Eligibility rules are set by each trial's protocol.

What happens next

AMBITION 7 is enrolling now ^[1]. The two obesity trials are planned to start in September 2026 ^[2][3]. Data readouts have not been announced in the available records, and no regulatory filing date for zenagamtide has been disclosed.