Zenagamtide (Amycretin): What to Know About Novo's Next Big Bet

If you search for “amycretin” you will find a lot of excitement from 2024 and 2025 and then a confusing gap. The gap is a name change. Amycretin is now called zenagamtide, and it is the drug Novo Nordisk is counting on to carry it past semaglutide.

This is what is actually known about it, what the numbers mean, and how far away it is.

What is zenagamtide?

Zenagamtide is an investigational drug from Novo Nordisk that activates two receptors in one molecule: the GLP-1 receptor and the amylin receptor [1].

To see why that is interesting, it helps to know what amylin is. Amylin is a hormone released by the pancreas at the same time as insulin. It slows how fast the stomach empties, reduces how much glucagon your body puts out after a meal, and signals fullness to the brain through a pathway that is separate from GLP-1’s.

That “separate pathway” part is the whole idea. If GLP-1 and amylin reduce appetite through different routes, then doing both at once should push weight loss further than doing either alone, without simply doubling the nausea.

Almost every major drug company now believes some version of this. What separates them is how they do it:

Approach	Example	How it works
Two drugs mixed in one injection	CagriSema (Novo)	Cagrilintide plus semaglutide
One molecule, both receptors	Zenagamtide (Novo)	Single peptide hits GLP-1 and amylin
Two separate drugs given together	ZYNERGY (Roche)	Petrelintide plus enicepatide
Amylin added on top of an existing drug	SELENE 3 (AstraZeneca), ENLIGHTEN-6 (Lilly)	Amylin for people already on an incretin
Amylin alone	Petrelintide, eloralintide, cagrilintide	No GLP-1 activity at all

Zenagamtide’s single-molecule design is the manufacturing-friendly version. One peptide means one production line, one stability profile, and one dose to titrate instead of two.

Novo is also developing it in two forms: a once-weekly injection and a once-daily tablet. That mirrors what the company did with semaglutide, where Ozempic and Wegovy are injections and Rybelsus and the Wegovy pill are tablets.

What did the zenagamtide results show?

Two datasets have been reported, and both need a caveat attached.

The early study. A Phase 1b/2a trial of the once-weekly subcutaneous injection reported roughly 24.3% average weight loss at 36 weeks at the 60 mg dose [1]. That number is what set off the excitement in 2025. It is also a very small, very early study. Phase 1b/2a trials enroll dozens of people, not thousands, and results at that stage routinely shrink when they are repeated in large populations.

The diabetes study. Phase 2b results for the once-weekly injection in adults with type 2 diabetes were presented at the American Diabetes Association Scientific Sessions in June 2026 (abstract 1730-P). Coverage reported roughly 14.6% weight loss in that population [1][2].

That drop from 24.3% to 14.6% looks alarming out of context, but it mostly is not. People with type 2 diabetes consistently lose less weight on incretin drugs than people without it, across every drug in this class. Semaglutide, tirzepatide, retatrutide and CagriSema all show the same pattern. Comparing a diabetes result to a non-diabetes result is comparing two different questions.

The real caveat is about evidence weight, and it differs for the two numbers. The 24.3% figure is peer-reviewed: the Phase 1b/2a subcutaneous study was published in The Lancet in 2025 (Dahl et al.), reporting a mean body-weight change of −24.3% at 60 mg versus −1.1% on placebo at week 36, in 125 adults [8]. What limits it is size and stage, not publication status — 125 people across escalating dose groups is a long way from a 2,000-person Phase 3, and early-phase effect sizes routinely shrink when repeated at scale.

The 14.6% diabetes figure has not been peer-reviewed. It comes from an ADA conference abstract and company communications, without the journal-level detail on dropouts and side effects. Treat that one as preliminary.

Where do the Phase 3 trials stand?

Novo moved zenagamtide into Phase 3 across two program names: AMAZE for obesity and AMBITION for type 2 diabetes. As of September 14, 2026, these were the registered studies:

AMBITION 7 (NCT07797335) — recruiting [5]

• 1,778 participants with type 2 diabetes and increased cardiovascular risk, already on one to three other diabetes medications
• Compares zenagamtide against insulin glargine
• Started August 24, 2026; primary completion July 31, 2028

AMAZE 7 (NCT07668414) — not yet recruiting [3]

• 650 participants with excess body weight
• Compares zenagamtide against semaglutide, which makes it a head-to-head against Novo’s own drug
• Planned start September 22, 2026; primary completion October 10, 2028

AMAZE 9 (NCT07720271) — not yet recruiting [4]

• 950 participants
• Tests the zenagamtide tablet
• Planned start September 1, 2026; primary completion June 27, 2028

AMAZE 13 (NCT07668401) — not yet recruiting [6]

• 400 participants in Asia
• Planned start January 7, 2027; primary completion January 11, 2029

The AMAZE 7 design deserves a note. Novo is testing zenagamtide directly against semaglutide, its own biggest product. Companies only run that comparison when they expect to win it, and they run it because payers and prescribers increasingly demand head-to-head evidence rather than cross-trial arithmetic.

The AMAZE 9 tablet trial is the other one to watch. If a daily zenagamtide tablet works, Novo would have a pill that hits two receptors, against Lilly’s orforglipron and Structure’s aleniglipron, which each hit one.

When could zenagamtide be approved?

Here is the arithmetic, based entirely on registry dates.

The earliest Phase 3 primary completion in the program is June 27, 2028 (AMAZE 9, the tablet). The obesity injection trial completes October 10, 2028. Topline data usually follow primary completion by one to three months.

Add the normal sequence after that: a few months to a year to assemble and submit the application, then 10 to 12 months for a standard FDA review (or roughly 6 to 8 months for priority review), then one to three months to launch.

That puts the realistic earliest US availability at 2029 or 2030. This is an estimate built from registry dates and typical FDA timelines. Novo Nordisk has not published a filing or launch date for zenagamtide.

It is also worth being honest that these dates slip. Primary completion dates on ClinicalTrials.gov are projections, and large obesity trials routinely move by months.

Can you join a zenagamtide trial?

Partly, as of September 14, 2026.

Open now: AMBITION 7 (NCT07797335) is recruiting. It requires type 2 diabetes, increased cardiovascular risk, and current treatment with one to three other diabetes medications. It is the only zenagamtide study listed as recruiting.

Opening soon: AMAZE 7 and AMAZE 9 were listed as not yet recruiting with planned starts in September 2026. Studies in that state typically begin posting individual sites within weeks of the planned start, and keep adding sites for months afterward. If nothing is near you today, check again.

How to look: Search “zenagamtide” at ClinicalTrials.gov, and also search “amycretin,” since older records and third-party pages still use the code name. Novo Nordisk’s own trial finder is at novonordisk-trials.com [7].

Before enrolling in anything, read the full informed consent document, take it home, and go through it with your own healthcare provider. In a trial like AMAZE 7 you might be randomized to semaglutide rather than zenagamtide, and in AMBITION 7 you might be randomized to insulin glargine. Those are real treatments, not placebo, but they are not what most people searching for this drug are hoping to receive.

What about the drug sold online as amycretin?

There is none, and anything marketed that way is a problem.

Zenagamtide is not approved in any country, and Novo Nordisk does not supply it outside its clinical trials. Any vial or powder sold as “amycretin” or “zenagamtide,” including products labeled “research use only,” comes from an unregulated source. Nobody has verified its identity, purity, sterility or dose.

The peptide gray market is particularly aggressive with drug names that generated big headlines and have no approved product to compare against. Amycretin’s 24.3% figure from 2025 made it exactly that kind of target. If a seller is offering it, they are not selling you what Novo Nordisk studied, because that supply does not leave Novo’s trials.

The only lawful way to receive zenagamtide in the United States is inside a registered clinical trial.

How does zenagamtide fit into Novo Nordisk’s plans?

This is the strategic context that explains the urgency.

Novo Nordisk’s position has gotten harder. CagriSema, its combination product, was filed with the FDA in December 2025 and is still under review, but its head-to-head trial against tirzepatide (REDEFINE 4) failed to show non-inferiority: 23.0% versus 25.5% on the efficacy estimand. Wegovy HD (semaglutide 7.2 mg) was approved in March 2026 and reached 20.7% in STEP UP, which narrows the gap with tirzepatide without closing it. Meanwhile, Lilly’s retatrutide reported 28.3% in TRIUMPH-1 and is headed for a filing in the first quarter of 2027.

Zenagamtide is Novo’s answer to that problem, and it is a genuinely different answer: not a bigger dose of an old drug, and not two drugs mixed together, but a new single molecule with a second mechanism built in. The company is also hedging with UBT251, a triple agonist licensed from China’s United Biotechnology, now in Novo-run Phase 2 studies.

If zenagamtide delivers in Phase 3, Novo is back in the efficacy race with a molecule it owns outright. If it does not, the company’s next credible shot is several years further out.

The honest bottom line

Zenagamtide is one of the more interesting molecules in development, for a real reason: a single peptide that does two hormones’ jobs is a cleaner solution than any combination product, and the early weight-loss signal was unusually strong.

It is also several years from anyone’s pharmacy. Its strongest number comes from a peer-reviewed but very small early-phase study, its diabetes number is still only a conference abstract, and the Phase 3 program is only just opening.

Three things to watch:

1. Peer-reviewed publication of the Phase 2b diabetes data, which will show the dropout and side-effect details the ADA abstract did not. The Phase 1b/2a obesity data are already published in The Lancet [8].
2. Whether AMAZE 7 and AMAZE 9 actually start on schedule in late 2026.
3. The AMAZE 7 head-to-head against semaglutide, which is the honest comparison the cross-trial numbers cannot give you.

None of that changes what is available to you this year. If you are managing weight or type 2 diabetes now, the conversation to have is about approved options with a healthcare provider, not about a drug whose pivotal results arrive in 2028.

Sources

1. Novo Nordisk, “Novo Nordisk advances cardiometabolic pipeline with new data featuring CagriSema and zenagamtide at the American Diabetes Association’s 2026 Scientific Sessions” — https://www.prnewswire.com/news-releases/novo-nordisk-advances-cardiometabolic-pipeline-with-new-data-featuring-cagrisema-and-zenagamtide-at-the-american-diabetes-associations-2026-scientific-sessions-302783110.html
2. Fierce Biotech, “Novo Nordisk expands pivotal amycretin program after dual agonist shines in diabetes” — https://www.fiercebiotech.com/biotech/novo-nordisk-expands-pivotal-amycretin-program-after-dual-agonist-shines-diabetes
3. ClinicalTrials.gov, NCT07668414 (AMAZE 7) — https://clinicaltrials.gov/study/NCT07668414
4. ClinicalTrials.gov, NCT07720271 (AMAZE 9, tablets) — https://clinicaltrials.gov/study/NCT07720271
5. ClinicalTrials.gov, NCT07797335 (AMBITION 7) — https://clinicaltrials.gov/study/NCT07797335
6. ClinicalTrials.gov, NCT07668401 (AMAZE 13) — https://clinicaltrials.gov/study/NCT07668401
7. Novo Nordisk clinical trial finder — https://www.novonordisk-trials.com/
8. Dahl D, Toubro S, Dey S, et al., “Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study,” The Lancet, 2025 — https://pubmed.ncbi.nlm.nih.gov/40550231