Every GLP-1 Drug in Development, Ranked by How Close It Is to Approval

Search for “new weight loss drug” and you get a wall of headlines that all sound imminent. Almost none of them are. A drug that produces a great trial result in 2026 typically reaches a pharmacy in 2029.

This article sorts the field by one criterion: how close each drug is to an FDA decision, based on what has actually been filed and what the clinical trial registry says. Not by how much weight it produced. Not by how exciting the mechanism is. Just by distance from a prescription pad.

Everything here reflects the state of play on September 14, 2026.

How to read this ranking

A few ground rules, because this is where most pipeline coverage goes wrong.

Filing status beats trial results. A drug that has been submitted to the FDA is closer to your pharmacy than a drug with better numbers that has not been submitted. Regulatory paperwork, manufacturing data and factory inspections are real gates, and drugs get stuck behind them. Retatrutide’s own filing slipped from an expected 2026 submission to the first quarter of 2027 because of manufacturing and quality-control data, not because of anything in its trials.

Primary completion is not a results date. “Primary completion” on ClinicalTrials.gov is when the last participant finishes the main measurement. Topline results usually follow by one to three months. Full publication follows by six to eighteen months.

Tiers are not predictions. Roughly half of drugs entering Phase 3 in metabolic disease never get approved. The FDA can also issue a Complete Response Letter, which sends a company back for more work and adds a year or more.

Do not compare weight-loss percentages across trials. Different trials enroll different people with different starting weights and handle dropouts differently. Where two numbers appear side by side below, treat them as context, not as a scoreboard.

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Tier 1: Under FDA review right now

CagriSema (cagrilintide + semaglutide) — Novo Nordisk

Status: New Drug Application submitted December 18, 2025 for chronic weight management. Under review. No FDA action date published; no advisory committee announced [1].

What it is: A once-weekly injection combining the amylin analog cagrilintide with semaglutide, in one pen.

The numbers: REDEFINE 1 reported 22.7% average weight loss at 68 weeks on the efficacy estimand, about 20.4% on the treatment-regimen estimand.

The complication: REDEFINE 4, an 84-week open-label head-to-head against tirzepatide 15 mg in 809 adults, did not meet its primary endpoint of non-inferiority. CagriSema reached 23.0% versus tirzepatide’s 25.5% on the efficacy estimand, and 20.2% versus 23.6% on the treatment-regimen estimand.

That matters commercially more than regulatorily. A drug does not have to beat the market leader to be approved; it has to be safe and effective against its own trial’s comparator. But payers read head-to-head results, and a drug that loses one has a harder negotiation ahead.

CagriSema is still the only genuinely new obesity drug in front of the FDA.

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Tier 2: Phase 3 finished, filing announced

Retatrutide — Eli Lilly

Status: Biologics License Application planned for the first quarter of 2027, per Lilly’s July 23, 2026 announcement [2].

What it is: A once-weekly triple agonist hitting GIP, GLP-1 and glucagon receptors.

The numbers: TRIUMPH-1 (2,339 randomized participants) reported 28.3% average weight loss at 80 weeks at 12 mg on the efficacy estimand (25.0% on the treatment-regimen estimand), with 45.3% of the 12 mg group losing at least 30% of body weight. In a blinded extension for people starting at BMI 35 or higher, the 12 mg group reached 30.3% at 104 weeks. TRIUMPH-2 (with type 2 diabetes) reached 20.8% at 12 mg; TRIUMPH-3 (BMI 35+ with cardiovascular disease) reached 22.6%.

The catch: Discontinuation for adverse events was 11.3% at 12 mg versus 4.9% on placebo, and 12.5% of the 12 mg group reported dysesthesia, an altered skin sensation that has appeared across the program.

Realistic timeline: A first-quarter 2027 filing plus a 10 to 12 month review points to a decision in late 2027 at the earliest, more likely 2028. That is an estimate; only the filing quarter is company guidance.

One thing most coverage misses: Lilly opened a pre-approval expanded access program for retatrutide, registered as NCT07629401 and listed as Available [12]. It is narrow: adults with a BMI of 35 or higher who have already failed the highest tolerated dose of an approved therapy, who have two or more serious obesity-related complications, and who cannot join a trial. A physician has to request it. It is not a shortcut for the general public, but it is the only legal non-trial route to retatrutide in the United States.

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Tier 3: Phase 3 finished, no filing announced

Survodutide — Boehringer Ingelheim / Zealand Pharma

Status: Core Phase 3 program complete. No US filing date published.

The numbers: SYNCHRONIZE-1 reported up to 16.6% average weight loss at 76 weeks on the efficacy estimand, with about a 63% reduction in liver fat and 34% reduction in visceral fat [3]. Its cardiovascular safety trial (5,531 participants) reached primary completion June 1, 2026 with results not yet published.

Why it is here and not higher: Everything needed for a filing appears to be done, but nothing has been announced. Survodutide’s strongest pitch is metabolic organ health rather than maximum weight loss, and it has FDA breakthrough therapy designation in MASH, where its pivotal trials do not finish until 2029 and 2031.

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Tier 4: Phase 3 data expected in 2027

MariTide (maridebart cafraglutide) — Amgen

MARITIME-1 (3,853 participants) and MARITIME-2 (1,105 participants) both have primary completion on January 21, 2027 [4]. MariTide is an antibody-peptide conjugate that activates the GLP-1 receptor and blocks the GIP receptor, which is the opposite of what tirzepatide does at GIP. It is designed for monthly or less frequent dosing, with maintenance schedules being studied at every eight weeks and every three months.

Phase 2 showed up to about 20% weight loss at 52 weeks on the efficacy estimand (16.3% to 19.9% across doses) and 12.3% to 16.2% on the treatment-policy estimand, with no plateau. Those are two analyses of the same trial, not two doses. Amgen redesigned the Phase 3 dose escalation to reduce nausea.

Several MariTide trials were recruiting in September 2026, including MARITIME-CV (12,800 participants), MARITIME-HF (5,056), MARITIME-SWITCH for people moving off weekly drugs (300), and two sleep apnea trials.

VK2735 injection — Viking Therapeutics

VANQUISH-1 (4,500 participants) and VANQUISH-2 (1,100 participants) both have primary completion on July 1, 2027 [5]. Both are 78-week trials of weekly 7.5 mg, 12.5 mg or 17.5 mg against placebo, and both are fully enrolled.

Phase 2 showed up to 14.7% weight loss after just 13 weekly doses with no plateau. Viking is also running a maintenance study of every-other-week and monthly dosing, with results guided for the third quarter of 2026 and not yet published.

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Tier 5: Phase 3 data expected in 2028

This is the crowded tier, and the most competitive year in the field’s history is shaping up to be 2028. Grouped by what they are:

Oral GLP-1 pills

• Aleniglipron (Structure Therapeutics). ACCOMPLISH-1 (3,600 participants) and ACCOMPLISH-2 (1,100) are recruiting, primary completion September 2028 [6]. An open-label extension reported up to 16.2% at 72 weeks with fewer than 5% stopping for side effects, which analysts called comparable to the Wegovy pill and better than Foundayo.
• Elecoglipron (AstraZeneca, licensed from Eccogene). Nine Phase 3 trials are recruiting, including a 4,500-participant obesity master protocol (primary completion July 2028), five diabetes trials, and outcomes trials in heart failure and chronic kidney disease [8]. Roughly 25,000 planned participants across the program.

Amylin drugs

• Eloralintide (Eli Lilly). Five ENLIGHTEN Phase 3 trials are recruiting, primary completion early to mid 2028 [7]. Phase 2 showed up to about 20.1% at 48 weeks, which is unusually high for an amylin drug alone. ENLIGHTEN-6 specifically enrolls people whose weight loss has stalled on a weekly incretin.
• AZD6234 (AstraZeneca). Three SELENE Phase 3 trials started in August 2026, primary completion August 2028. SELENE 3 tests it as an add-on for people already on an incretin.

Weekly dual agonists

• Enicepatide (Roche, formerly CT-388). Three Phase 3 trials recruiting, earliest primary completion first half of 2028.
• Ribupatide (Kailera, from Hengrui’s HRS9531). Three KaiNETIC Phase 3 trials recruiting, primary completion February to March 2028, including a head-to-head against semaglutide [9].

Long-acting and monthly

• Berobenatide (Pfizer, formerly Metsera’s MET-097i). US Phase 3 (954 participants) recruiting, primary completion May 4, 2028 [10]. Separate once-monthly and once-weekly programs are running in Japan. Pfizer shares fell on Phase 2b data in February 2026; specific figures remain unverified from primary sources.

GLP-1 plus amylin in one molecule

• Zenagamtide (Novo Nordisk, formerly amycretin). AMBITION 7 in type 2 diabetes is recruiting; AMAZE 7 (versus semaglutide) and AMAZE 9 (tablets) were opening in late 2026. Primary completion mid-2028 to early 2029 [11].

Liver disease

• Pemvidutide (Altimmune). PERFORMA Phase 3 in MASH recruiting, primary completion December 2028.

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Tier 6: Phase 3 starting, no data before 2029

• Petrelintide (Zealand Pharma / Roche). A weekly amylin analog whose pitch is tolerability, not peak weight loss: Phase 2 showed up to 10.7% at 42 weeks with side effects described as near placebo. Phase 3 in chronic weight management was announced for the second half of 2026.
• Oral VK2735 (Viking Therapeutics). Phase 3 guided to start in the fourth quarter of 2026. Phase 2 showed up to 12.2% after 13 weeks.
• ZYNERGY (Roche). A Phase 2 combination of petrelintide with enicepatide, 486 participants, planned start September 30, 2026.

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Tier 7: Phase 1 and Phase 2

These are real programs, but nobody reading this will get a prescription for any of them before the 2030s.

• PF-08653945 (Pfizer amylin, formerly MET-233i), in the SOLIS-1 combination Phase 2
• Macupatide (Eli Lilly), being tested alone and with eloralintide
• ACCG-2671 (Structure Therapeutics), an oral amylin in first-in-human testing
• UBT251 (Novo Nordisk, licensed from United Biotechnology), a GLP-1/GIP/glucagon triple agonist. United Laboratories and Novo Nordisk reported positive Chinese Phase 2 topline on about September 3, 2026: 19.7% mean weight loss and a 17.5 kg reduction at 24 weeks on 6 mg once weekly against 2.0% on placebo in 205 participants, with improvements in waist circumference, glucose and blood pressure. United Laboratories has dosed the first participant in a 600-participant Chinese Phase 3, and Novo has guided a type 2 diabetes Phase 2 start for the second half of 2026 [13][14]. (updated 2026-09-14)
• ARO-INHBE (Arrowhead), an RNA-interference drug silencing a liver gene linked to fat distribution
• Bimagrumab (Eli Lilly) and trevogrumab (Regeneron), muscle-preservation add-ons rather than weight-loss drugs
• AZD9550 (AstraZeneca), a GLP-1 and glucagon agonist tested mainly as a combination partner
• VK3019 (Viking), with no registered trial found

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Not on a US path at all

Several drugs get searched constantly by Americans and are not coming here on any announced timeline.

Mazdutide is approved and marketed in China for weight management (June 2025) and type 2 diabetes (September 2025), with up to 20.1% weight loss in GLORY-2. Eli Lilly holds the rights outside China and has started no US Phase 3 program.

Ecnoglutide is approved in China for type 2 diabetes (January 2026) and weight management (March 2026). Verdiva Bio holds ex-China rights and is developing a weekly oral version in early trials.

HRS-7535, an oral small-molecule GLP-1 from Hengrui’s Suncadia unit, has completed multiple Phase 3 trials in China with no US registrational program.

Bofanglutide (GZR18) from Gan and Lee is in Phase 3 in China and Latin America, notable for every-two-weeks dosing.

For US readers, the important point about all four is the same: a drug approved in another country is not “almost approved” here. The FDA reviews its own application on its own data, and no application has been submitted for any of these.

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Already approved (for reference)

Two products people still call “pipeline” are on the market:

• The Wegovy pill (oral semaglutide 25 mg), FDA approved December 22, 2025, launched January 2026. 16.6% average weight loss at 64 weeks in OASIS 4 among people who stayed on treatment. It passed 3 million US prescriptions in just over five months.
• Wegovy HD (semaglutide 7.2 mg), FDA approved March 19, 2026, 54 days after filing under the FDA’s national priority voucher pilot. 20.7% average weight loss at 72 weeks in STEP UP. The FDA noted more altered skin sensation at this dose than at 2.4 mg.

And one persistent question with a boring answer: there is no higher-dose Zepbound program. No registered Eli Lilly study of tirzepatide above the approved 15 mg maximum was found as of September 14, 2026. Lilly’s late-stage work runs the other direction, toward stepping people down to lower doses and to pills for maintenance. Its higher-efficacy answer is retatrutide, not a bigger tirzepatide.

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What this ranking actually tells you

Three takeaways worth more than any individual name.

First, 2028 is the bottleneck year. At least nine late-stage programs read out in 2028. Whatever the obesity market looks like in 2030 will largely be decided by data that arrives that year.

Second, the fight has moved from “more weight loss” to “easier to stay on.” Look at what is actually being tested: amylin drugs for tolerability, monthly dosing for convenience, pills for people who will not inject, maintenance and step-down studies, and add-on trials for people already taking something. Three separate Phase 3 programs (SELENE 3, ENLIGHTEN-6, MARITIME-SWITCH) are aimed specifically at people who are already on a GLP-1 drug. That is new.

Third, none of this helps you this year. If you are managing weight or a metabolic condition now, the useful conversation is about what is approved and covered today, not about a drug whose trial finishes in 2028. Talk to a healthcare provider about the options that exist.

If you want access to something investigational, there are two legal doors: a clinical trial, or in rare qualifying cases an expanded access program. Everything sold online under these drug names is neither.

Sources

1. Novo Nordisk, “Novo Nordisk files for FDA approval of CagriSema” — https://www.prnewswire.com/news-releases/novo-nordisk-files-for-fda-approval-of-cagrisema-the-first-once-weekly-combination-of-glp1-and-amylin-analogues-for-weight-management-302645862.html
2. Eli Lilly, “Lilly’s triple agonist retatrutide successful in two additional Phase 3 obesity trials” — https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-successful-in-two-additional-phase-3-obesity-trials-delivering-significant-improvements-in-weight-and-a1c-302832674.html
3. Boehringer Ingelheim, SYNCHRONIZE-1 Phase III results — https://www.boehringer-ingelheim.com/us/human-health/metabolic-diseases/results-phase-iii-synchronize-1-obesity-trial
4. ClinicalTrials.gov, NCT06858839 (MARITIME-1) — https://clinicaltrials.gov/study/NCT06858839
5. ClinicalTrials.gov, NCT07104500 (VANQUISH-1) — https://clinicaltrials.gov/study/NCT07104500
6. ClinicalTrials.gov, NCT07654361 (ACCOMPLISH-1) — https://clinicaltrials.gov/study/NCT07654361
7. ClinicalTrials.gov, NCT07321886 (ENLIGHTEN-1) — https://clinicaltrials.gov/study/NCT07321886
8. ClinicalTrials.gov, NCT07667803 (Embold, elecoglipron) — https://clinicaltrials.gov/study/NCT07667803
9. ClinicalTrials.gov, NCT07284875 (KaiNETIC-1, ribupatide) — https://clinicaltrials.gov/study/NCT07284875
10. ClinicalTrials.gov, NCT07595549 (berobenatide Phase 3) — https://clinicaltrials.gov/study/NCT07595549
11. ClinicalTrials.gov, NCT07668414 (AMAZE 7, zenagamtide) — https://clinicaltrials.gov/study/NCT07668414
12. ClinicalTrials.gov, NCT07629401 (retatrutide expanded access) — https://clinicaltrials.gov/study/NCT07629401
13. RTTNews, “Novo Nordisk And United Lab Reports Positive Results From Chinese Phase 2 Trial Of UBT251 In Obesity,” September 2026 — https://www.rttnews.com/3624314/novo-nordisk-and-united-lab-reports-positive-results-from-chinese-phase-2-trial-of-ubt251-in-obesity.aspx
14. FLCube, “United Laboratories / Novo Nordisk report positive Phase II data for UBT251” — https://flcube.com/united-laboratories-novo-nordisk-report-positive-phase-ii-data-for-ubt251-triple-glp-1-gip-gcg-agonist-achieves-19-7-weight-los