Peptide & Experimental

Pemvidutide

Dual GLP-1 and glucagon receptor agonist, investigational drug · Pemvidutide, ALT-801

Pemvidutide is a once-weekly peptide from Altimmune that activates the glucagon receptor in addition to the GLP-1 receptor and therefore acts directly on the liver. Its strength lies in liver fat: after 24 weeks it fell by up to 76 percent, and in the phase 2b trial IMPACT the fatty liver inflammation MASH resolved in more than half of those treated. Fibrosis did not improve significantly over this period. Phase 3 in MASH has been running since July 2026; pemvidutide is not approved anywhere.

What pemvidutide is

Pemvidutide belongs to the dual GLP-1 and glucagon agonists, like survodutide and mazdutide, which is approved in China. GLP-1 dampens appetite, glucagon acts mainly on the liver. Pemvidutide is injected once a week.

Altimmune is developing the substance primarily against the metabolic fatty liver inflammation MASH, that is, a fatty liver with inflammation and beginning scarring. Alongside this, trials are running in obesity, alcohol use disorder and alcohol-related liver disease.

How it works

Via the GLP-1 receptor, pemvidutide lowers appetite and thus weight. Via the glucagon receptor, it stimulates fat burning in the liver and inhibits the new formation of fat. The idea: a stronger effect on liver fat than weight loss alone would explain.

In humans this has been measured via liver fat on MRI, liver enzymes and inflammatory markers. After 12 weeks, liver fat fell by up to 68.5 percent, while weight fell by at most 4.3 percent. What share is due to the direct liver effect has not been conclusively separated.

What is well supported

Liver fat falls sharply and quickly. After 12 weeks, liver fat decreased by 46.6 to 68.5 percent, compared with 4.4 percent on placebo. At the middle dose, 94.4 percent achieved a reduction of at least 30 percent, and in 55.6 percent liver fat normalized.
The effect grows over time. After 24 weeks, the reduction was 56.3 to 76.4 percent compared with 14.0 percent on placebo; weight fell by 6.2 percent.
MASH resolves. In the phase 2b trial IMPACT with tissue biopsies, the inflammation disappeared without worsening of fibrosis in 58 and 52 percent of those treated, compared with 20 percent on placebo. This is one of the two primary endpoints.
Well tolerated without dose titration. In IMPACT, pemvidutide was given without stepwise escalation. 0 and 1 percent discontinued because of side effects, compared with 2 percent on placebo.

What the studies show

Harrison 2025: liver fat after 12 weeks

The randomized, placebo-controlled trial (J Hepatol) enrolled 94 people with a BMI of at least 28 and at least 10 percent liver fat, 29 percent of them with type 2 diabetes. All three dose groups lowered liver fat significantly: by 46.6, 68.5 and 57.1 percent, compared with 4.4 percent on placebo. The strongest effects on weight (minus 4.3 percent), the liver enzyme ALT and the MRI marker cT1 were seen at the middle dose. No serious adverse events occurred.

Browne 2025: the extension to 24 weeks

64 participants continued treatment in their dose group for a further 12 weeks (JHEP Rep). Liver fat now fell by 56.3 to 76.4 percent compared with 14.0 percent on placebo; at the middle dose, 84.6 percent achieved a halving and 53.8 percent normal values.

IMPACT: tissue biopsies after 24 weeks

Noureddin 2025 (Lancet) randomized 212 patients with biopsy-confirmed MASH and moderate to advanced fibrosis (F2 or F3) at 83 centers in the US and Australia. Resolution of MASH without worsening of fibrosis was achieved in 24 of 41 (58 percent) and 45 of 85 (52 percent) of those treated, compared with 18 of 86 (20 percent) on placebo, both p less than 0.0001.

The second primary endpoint, an improvement in fibrosis by at least one stage, was missed: 33 and 36 percent compared with 28 percent, not significant. IMPACT runs for 48 weeks in total; according to the authors, longer trials are planned.

The meta-analysis

Rajab 2026 pooled the randomized trials: after 12 weeks, liver fat, body weight and blood pressure fell; after 24 weeks, liver enzymes and the fibrosis marker ELF improved. Safety was comparable to placebo apart from more frequent, mild to moderate nausea. The authors call for larger and longer trials on fibrosis.

Where the data stop

Fibrosis. What matters for the course of a fatty liver is scarring. Here pemvidutide showed no significant benefit after 24 weeks.
Hard endpoints. Whether cirrhosis, liver failure or transplants become less frequent is open. The phase 3 trial is assessing this over about 60 months.
Weight loss. The obesity trial MOMENTUM with 391 participants over 48 weeks has been completed; its results have neither appeared in a journal nor been posted in the registry. Statements on weight and muscle preservation therefore do not rest on peer-reviewed data.
Comparison with survodutide and others. There are no head-to-head comparisons with survodutide, mazdutide or the thyroid hormone receptor agonist resmetirom.
Products from the gray market. The trial data apply to the investigational drug, not to products of unclear origin.

Status, approval and legal

Pemvidutide is an investigational drug and is not approved anywhere in the world. In Germany it is not a marketable medicine. The phase 3 trial in non-cirrhotic MASH has been recruiting since July 30, 2026 with 1,800 planned participants; it assesses tissue findings after 52 weeks and clinical events over about 60 months.

In sport, pemvidutide, as a substance approved nowhere, falls under class S0 of the WADA Prohibited List 2026 and is prohibited at all times. We do not state dosages for unapproved substances.

Safety

In IMPACT, 78 and 81 percent of those treated reported adverse events, compared with 67 percent on placebo, mostly mild or moderate. Discontinuations because of side effects remained rare at 0 and 1 percent, even though treatment was started without dose titration. Nausea was the most frequent difference from placebo.

Published controlled data so far cover at most 24 weeks, in about 270 treated people in total. That is not enough for long-term risks and rare events.

BK-Score Supported, with caveats

Human evidence		6
Mechanism		8
Safety data		5
Hype gap		4
Track record of use		2

Evidence 6, because several published randomized trials are available: liver fat minus 46.6 to 68.5 percent after 12 weeks in 94 participants (Harrison 2025), minus 56.3 to 76.4 percent after 24 weeks (Browne 2025) and the phase 2b trial IMPACT with 212 patients, in which MASH resolved in 58 and 52 compared with 20 percent (Noureddin 2025); not 7, because the second primary endpoint, fibrosis improvement, was missed after 24 weeks and the obesity trial MOMENTUM with 391 participants is unpublished. Mechanism 8, because the dual GLP-1 and glucagon agonism has been measured in humans via liver fat, liver enzymes and weight; it remains open what share the direct liver effect has compared with weight loss. Safety 5, because controlled data over up to 24 weeks in about 270 treated people are available, with few discontinuations (0 and 1 compared with 2 percent), but more adverse events than on placebo (78 to 81 compared with 67 percent) and without long-term or endpoint data. Hype 4, because the substance is also being developed as a weight-loss drug, but the weight and body composition data from the obesity trial have not been published in peer-reviewed form, and because the fibrosis endpoint was missed. Use 2, because the substance is used only in trials. Direction mixed: clear effect on liver fat and inflammation, fibrosis not significantly improved after 24 weeks.

The score rates the state of knowledge, not the substance. “Safety data 9” means well studied – not harmless.
Subjective assessment by Biohacking Kompakt based on published scoring rules – not a scientific rating and not a medical recommendation. Rules and all ratings (German)

Frequently asked questions about pemvidutide

What is pemvidutide?

Pemvidutide is a dual GLP-1 and glucagon receptor agonist from Altimmune that is injected once a week. It is being developed mainly against the fatty liver inflammation MASH and is not yet approved anywhere.

Does pemvidutide work against fatty liver?

On liver fat, clearly: after 24 weeks it fell by up to 76.4 percent. In the phase 2b trial IMPACT, MASH resolved in 52 to 58 percent of those treated, compared with 20 percent on placebo. Fibrosis did not improve significantly after 24 weeks.

Can you lose weight with pemvidutide?

In the liver trials, weight fell by up to 6.2 percent after 24 weeks. The actual obesity trial MOMENTUM has been completed, but its results have not been published in peer-reviewed form.

What is the difference from survodutide?

Both activate GLP-1 and glucagon receptors. Survodutide has published phase 3 data on weight and fatty liver. Pemvidutide has phase 2 data with tissue biopsies and has been in phase 3 in MASH since July 2026. A head-to-head comparison is lacking.

Is pemvidutide available in Germany?

No. It is an investigational drug without approval and available only in clinical trials. In sport it is prohibited at all times under the WADA list 2026 (S0).

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Sources

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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-10-07.