Survodutide cuts visceral fat by 34%, liver fat by 63% in phase 3 trials | ADA 2026

Two phase 3 trials of survodutide presented Sunday at the American Diabetes Association (ADA) 2026 Scientific Sessions in New Orleans showed that Boehringer Ingelheim's investigational glucagon/GLP-1 dual agonist reduced visceral and liver fat alongside significant body weight loss in adults living with obesity or overweight. Results from SYNCHRONIZE-1 and SYNCHRONIZE-MASLD were published simultaneously in The New England Journal of Medicine and Nature Medicine, respectively.

SYNCHRONIZE-1: Weight loss driven by fat, not muscle

SYNCHRONIZE-1 was a 76-week, double-blind, placebo-controlled trial enrolling 725 adults with obesity or overweight without type 2 diabetes. The trail met its main end points, with survodutide producing up to 16.6% mean weight loss from baseline using the efficacy estimand, compared with 3.2% in the placebo arm.

A prespecified body composition substudy using MRI showed that survodutide at the highest dose achieved a relative reduction of up to 34% in visceral fat. Lean mass accounted for no more than 10.8% of change in total tissue mass, indicating weight loss was driven primarily by fat reduction rather than muscle loss. Liver fat fell by up to 63.1% from baseline in the same substudy.

"For people living with obesity, weight loss is only one part of the story," Lee Kaplan, M.D., Ph.D., director of the Obesity and Metabolism Institute in Boston and chair of the SYNCHRONIZE program executive committee, said. "These data reveal that the glucagon/GLP-1 dual agonism of survodutide offers a promising approach for people with obesity and for those with obesity-associated metabolic liver diseases, including MASLD and MASH."

SYNCHRONIZE-MASLD: Liver fat normalization in 6 of 10 patients

SYNCHRONIZE-MASLD was a 48-week, double-blind, placebo-controlled trial enrolling 218 adults with obesity or overweight and metabolic dysfunction-associated steatotic liver disease (MASLD) with evidence of inflammation and/or fibrosis, with and without type 2 diabetes. Participants received a weekly 6.0 mg injection of survodutide or placebo.

The trial met both co-primary end points. Using the efficacy estimand, 84.2% of participants in the survodutide group showed at least a 30% relative reduction in liver fat, compared with 24.3% in the placebo arm. Survodutide also produced a relative body weight reduction of up to 12.2% versus 1.0% on placebo. A secondary end point showed 61% of survodutide-treated participants reached liver fat normalization — defined as liver fat content below 5% — at week 48, compared with 5.7% on placebo. Positive trends were also observed in alanine transaminase (ALT) levels, a marker of hepatic inflammation.

Gastrointestinal events were the most commonly reported adverse events across both trials, consistent with the GLP-1 drug class. Nausea, vomiting, diarrhea, and constipation occurred more frequently with survodutide than placebo. Discontinuation rates due to gastrointestinal events reached 19% in the survodutide arm versus 2.9% on placebo in SYNCHRONIZE-1. No new safety signals were identified in either trial.

Additional upcoming phase 3 trials include the SYNCHRONIZE-HERA study, which will evaluate survodutide in women's health; ELEVATE-LIVER, which will assess cardiac function in people with MASLD or early MASH; and SYNCHRONIZE-START, which will examine real-world titration approaches, including switching from GLP-1 receptor agonists. Two ongoing phase 3 trials — LIVERAGE and LIVERAGE-Cirrhosis — are investigating survodutide in patients with advanced fibrosis and compensated MASH cirrhosis, respectively.

“Obesity is a complex disease linked to how the body manages metabolism,” Shashank Deshpande, Chairman of the Board of Managing Directors and Head of Human Pharma at Boehringer Ingelheim, said. “Excess visceral fat, which is found primarily around the abdomen, is a known contributor to metabolic dysfunction and is closely connected to impaired liver function. By tackling obesity alongside visceral fat and liver fat, survodutide has the potential to redefine what a targeted weight management therapy can achieve, as we aim to address key drivers of metabolic dysfunction often associated with obesity."