Peptide & experimental
Petrelintide
Long-acting amylin analog, investigational drug · Petrelintide, ZP8396, RO7895515
Petrelintide is a replica of the body’s own satiety hormone amylin, developed by Zealand Pharma and now jointly with Roche. It is injected once a week and acts on a different signal than semaglutide or tirzepatide. In the published phase 2 trial with 493 participants, weight fell by 7.9 to 9.8 percent after 28 weeks, with gastrointestinal complaints close to placebo level. The phase 3 program has been running since September 2026; petrelintide is not yet approved anywhere.
What petrelintide is
Amylin is a hormone that the pancreas releases together with insulin after a meal. It signals satiety to the brain, slows gastric emptying and dampens glucagon. Petrelintide is a chemically stabilized, long-acting variant of human amylin that can be formulated at near-neutral pH and can therefore also be combined with other peptides.
This places petrelintide in the new wave of amylin drugs, alongside cagrilintide, eloralintide and the combined GLP-1/amylin agonist amycretin. The appeal of this class: a second route to satiety that is independent of GLP-1, possibly with less nausea.
How it works
Petrelintide activates the amylin receptors. In two phase 1 trials it was absorbed slowly, had a half-life of about 10 days and behaved dose-proportionally at steady state. This allows once-weekly dosing.
In humans, the chain of action has been measured via weight and tolerability. How the weight loss is split between fat and muscle mass is not stated in the published summaries. Petrelintide is being developed both on its own and as a possible combination partner for other weight-loss peptides.
What is well supported
- Clear weight loss compared with placebo. In ZUPREME 1, 485 treated adults without diabetes lost 7.9 to 9.8 percent of their weight after 28 weeks, compared with 1.7 percent on placebo. All dose groups were 6.2 to 8.1 percentage points below placebo; the primary endpoint was met.
- The curve had not flattened after 28 weeks. Weight continued to fall until week 42, to up to 10.7 percent.
- Little vomiting and diarrhea. Vomiting occurred in 3 percent on petrelintide and in 6 percent on placebo; diarrhea in 7 versus 7 percent, constipation in 7 versus 4 percent. For the drug class of weight-loss injections, this is a remarkably calm profile.
- A satiety signal of its own. Petrelintide does not act via GLP-1. This makes it interesting as an alternative for people who tolerate GLP-1 agonists poorly, and as a combination partner.
What the studies show
ZUPREME 1: the phase 2 trial
Garvey 2026 (Lancet Diabetes Endocrinol) randomized 493 adults with a BMI of at least 30, or at least 27 with high blood pressure or a lipid disorder, at 32 centers in Poland, Romania and the US in a 5 to 1 ratio to petrelintide or placebo, over 42 weeks including dose escalation. After 28 weeks, the mean weight change was minus 7.9 percent in the two lower dose groups and minus 9.3 to 9.8 percent in the higher ones, compared with minus 1.7 percent on placebo. The trial participants weighed 107 kg on average.
The most common adverse event was nausea, in 20 percent versus 6 percent on placebo, mostly mild and during dose escalation. There were no deaths. The trial was funded by Zealand Pharma.
The phase 1 trials
Brændholt Olsen 2026 (Diabetes Obes Metab) describes one trial with single doses and one with multiple doses over up to 16 weeks, both randomized and placebo-controlled. There were no serious adverse events; one participant discontinued because of gastrointestinal complaints. In the second part, nausea occurred in 16.7 to 33.3 percent on petrelintide and in 16.7 percent on placebo. After 16 weeks, weight loss was up to 8.6 percent.
What is being tested in phase 3
In September 2026, Roche started three phase 3 trials: in overweight and obesity with 3,900 planned participants, in type 2 diabetes with 600, and in established cardiovascular disease with 2,500. The primary endpoint in each is the change in weight after 64 weeks; the registry plans completion of the main analyses for October to December 2028, and for 2030 in the cardiovascular trial.
Where the data stop
- Long-term effect. The longest published treatment lasted 42 weeks. Whether the weight is maintained over years and what happens after stopping is open.
- Comparison with GLP-1 drugs. At just under 10 percent after 28 weeks, petrelintide is below the figures from large GLP-1 and combination trials. Those trials, however, ran longer and with different participants; a direct comparison does not exist.
- Type 2 diabetes. The phase 2 trial ZUPREME 2 with 221 participants has been completed; its results have not appeared in a journal.
- Body composition and endpoints. Data on the share of fat and muscle mass in the weight loss and on cardiovascular events are not available.
- Products from the gray market. The trial results apply to the investigational drug. What is offered online under this name is not the same tested product.
Status, approval and legal
Petrelintide is an investigational drug and not approved anywhere in the world. In Germany it is not a marketable medicine and is not available outside clinical trials. Based on the timeline of the phase 3 trials, approval is conceivable towards the end of the decade at the earliest.
In sport, as a substance not approved anywhere, petrelintide falls under class S0 of the WADA Prohibited List 2026 and is prohibited at all times. We do not state dosages for non-approved substances.
Safety
Tolerability is petrelintide’s strength in the data so far. In ZUPREME 1, nausea was the most common event, in 20 versus 6 percent, mostly mild and during dose escalation; vomiting and diarrhea were at placebo level. In the phase 1 trials there were no serious adverse events.
Controlled data are so far available for around 400 treated people over up to 42 weeks. Rare side effects and long-term risks cannot be derived from this; that is what the ongoing phase 3 trials are designed for.
BK-Score Supported, with caveats
| Human evidence | 7 | |
|---|---|---|
| Mechanism | 8 | |
| Safety data | 5 | |
| Hype gap | 6 | |
| Track record of use | 2 |
Evidence 7, because a published, placebo-controlled phase 2 trial with 493 participants over 42 weeks is available that met its primary endpoint: 7.9 to 9.8 percent weight loss after 28 weeks compared with 1.7 percent on placebo, up to 10.7 percent by week 42 (Garvey 2026), plus two randomized phase 1 trials (Brændholt Olsen 2026); not 8, because phase 3 only began in September 2026 and the diabetes trial ZUPREME 2 has not been published. Mechanism 8, because amylin is well described as a satiety signal in humans and half-life, dose proportionality and weight effect have been measured for petrelintide; not 9, because data on the composition of the weight loss are missing. Safety 5, because controlled data over 42 weeks in around 400 treated people are available, without deaths and with vomiting and diarrhea at placebo level, but nausea in 20 versus 6 percent, and because long-term and endpoint data are missing. Hype 6, because the trial largely supports the advertised better gastrointestinal tolerability; points deducted because the weight loss is below that of GLP-1 combinations and a direct comparison is missing. Use 2, because the drug occurs only in clinical trials. Direction positive: all dose groups lowered weight considerably more than placebo.
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 petrelintide
What is petrelintide?
Petrelintide is a long-acting analog of the satiety hormone amylin, developed by Zealand Pharma together with Roche. It is injected under the skin once a week and has been in phase 3 since September 2026. It is not yet approved anywhere.
How much weight do people lose with petrelintide?
In the phase 2 trial ZUPREME 1 with 493 participants, weight fell by 7.9 to 9.8 percent after 28 weeks, compared with 1.7 percent on placebo. It continued to fall until week 42, to up to 10.7 percent.
Is petrelintide better tolerated than semaglutide?
A direct comparison is missing. In ZUPREME 1, vomiting and diarrhea were at placebo level, and nausea occurred in 20 versus 6 percent, mostly mild and during dose escalation. This points to a mild profile but does not replace a comparative trial.
What is the difference from cagrilintide?
Both are long-acting amylin analogs. Cagrilintide is being developed mainly in combination with semaglutide as CagriSema and has phase 3 data. Petrelintide was made formulable at near-neutral pH and stands at the start of phase 3 with phase 2 data.
Is petrelintide available in Germany?
No. It is an investigational drug without approval and available only in clinical trials. In sport, as a substance not approved anywhere, it is prohibited at all times under the WADA List 2026 (S0).
Related
- Related topicEloralintide
- Related topicVK2735
- Related topicAmycretin
- Related topicPemvidutide
- Related topicEcnoglutide
- Related topicMazdutide
Sources
- Garvey WT et al., Lancet Diabetes Endocrinol 2026 – ZUPREME 1, phase 2, 493 participants
- Brændholt Olsen M et al., Diabetes Obes Metab 2026 – two randomized phase 1 trials
- Fischer Munch H et al., J Med Chem 2025 – development of petrelintide
- ClinicalTrials.gov NCT06926842 – ZUPREME 2, phase 2 in type 2 diabetes
- ClinicalTrials.gov NCT07843498 – phase 3 in overweight and obesity (Roche)
- WADA – Prohibited List 2026, S0 Non-approved substances
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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.