Survodutide reduces liver fat in 84% of patients in phase 3 trial

Patients with liver disease who were treated with survodutide in a phase 3 trial saw a reduction in liver fat, according to data presented at the American Diabetes Association (ADA) 2026 Scientific Sessions held in June 2026 and published in Nature Medicine.

About 84.2% of the patients in the SYNCHRONIZE-MASLD who had metabolic dysfunction-associated steatotic liver disease (MASLD) and who were treated with survodutide experienced at least a 30% relative reduction in liver fat compared with 24.3% of patients in the placebo arm. Additionally, about 61% of survodutide-treated patients reached liver fat normalization at week 48, compared with 5.7% who received placebo.

MASLD is a condition where excess fat builds up in the liver. It is not caused by alcohol use. The disease tends to develop in people who are obese or who have diabetes, high cholesterol, or high triglycerides. In the United States, about 100 million people are estimated to have MASLD, which can lead to a more serious stage of the disease called metabolic dysfunction-associated steatohepatitis (MASH).

Developed by Boehringer Ingelheim, survodutide is a dual GLP-1 and glucagon receptor agonist. Both glucagon and GLP-1 receptors play a role in controlling metabolic functions. Researchers in the Nature Medicine paper suggest that survodutide may increase fatty acid oxidation, which enhances liver fat clearance.

SYNCHRONIZE-MASLD was a placebo-controlled trial that enrolled 218 adults with obesity or overweight and 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.

“Improvements in LFC [liver fat content], body weight and multiple markers of liver and cardiometabolic health with survodutide treatment in participants with early-stage MASLD suggest that this therapeutic agent has important benefits for reducing liver inflammation and cardiometabolic risk and underscore its potential for improving long-term outcomes in people with obesity and metabolic liver disease,” researchers wrote in Nature Medicine. Researchers were led by Lee Kaplan, M.D., Ph.D., director of the Obesity and Metabolism Institute in Boston.

The most frequently reported adverse events with survodutide were gastrointestinal, including nausea, vomiting, diarrhea, and constipation, which occurred more frequently with survodutide patients. Adverse events commonly occurred during dose escalation and were generally mild to moderate.

An ongoing phase 3 trial, LIVERAGE, is assessing survodutide as a treatment for patients with MASH who have moderate-to-advanced liver fibrosis. The trial will enroll an estimated 1,800 patients and is expected to be completed in 2031. Primary outcomes include the resolution of MASH without worsening fibrosis, improvement in fibrosis and time to first occurrence of cirrhosis, all-cause mortality, liver transplant or liver decompensation. Patients will be studied for up to seven years.

Another ongoing trial is testing survodutide in people who have MASH and cirrhosis. This phase 3 trial will enroll 1,590 patients with completion expected mid-2029. The primary outcome is time to first occurrence of all-cause mortality, liver transplant or liver decompensation.

Boehringer Ingelheim plans to conduct an additional trial, ELEVATE-LIVER, which will assess the impact of survodutide in the preservation of cardiac function and structure in people living with MASLD or early MASH.