Gathering the record
Relay is organizing the evidence and source boundaries.
Unimolecular GLP-1 / amylin receptor co-agonist
Zenagamtide, formerly amycretin, combines GLP-1 and amylin receptor agonism in one molecule. Published early human and sponsor-reported Phase 2 results show substantial weight and glucose effects, alongside meaningful gastrointestinal tolerability and discontinuation concerns at higher doses.
60-Second Overview
Start with what it is, why it matters, what research has shown, and what remains unknown. The science follows after the orientation.
Start here. These four answers explain why the compound matters before the page introduces the deeper science.
Zenagamtide, previously called amycretin, is an investigational medicine that combines two appetite-related hormone signals in one molecule: GLP-1 and amylin activity.
Researchers want to learn whether one molecule acting through both signals can change weight and blood sugar more than either approach alone, and whether oral and injectable forms behave differently.
A peer-reviewed 36-week early trial reported large average weight reductions with weekly injection in the groups studied. Sponsor-reported diabetes research also found weight and blood-sugar changes with injected and oral forms, alongside meaningful tolerability and discontinuation concerns at higher exposures.
Phase 3 benefit, long-term tolerability, rare harms, cardiovascular outcomes, and the durability of oral and injectable effects remain unresolved. The two formulations are not interchangeable, and zenagamtide is not approved.
The research depth, routes, studies, and primary sources below explain how Relay knows—and where the evidence stops.
Research context
Published research has investigated this compound using the following study designs.
These records explain what researchers did. They are not instructions, recommendations, or a transferable protocol.
A peer-reviewed early-phase trial investigated the injectable form in adults with overweight or obesity, focusing on weight change, safety, and tolerability.
Reported study administration—not a recommendation.
Research at a glance
Evidence depth, confidence, and route context explain how Relay knows—not what anyone should do.
Published subcutaneous evidence, Phase 2 oral and injectable research, and Phase 3.
Research depth describes how large and mature the overall record is. It does not tell you whether the results were positive.
Strong measured signals coexist with high-dose discontinuation uncertainty.
Confidence describes how reliable and consistent the conclusions are. It can be high for one outcome and low for another.
The strongest evidence type shows what the best-supported conclusions are actually based on.
Human findings are more directly relevant than animal or laboratory results, but they still apply only to the populations and outcomes studied.
Route-specific record
These are exposures used in cited research for a specific route and population—not an instruction for an individual.
Half-life describes how long it takes the measured amount in the body to fall by half. It is not a dosing recommendation.
Evidence can change by administration method. Findings from one route should not automatically be applied to another.
Evidence boundary: The dose groups were small and exploratory despite the 36-week observation period. The findings do not establish Phase 3 benefit, an approved product, or equivalence between injectable and oral formulations. Amounts shown describe cited research exposure—not a dosage recommendation.
Detailed evidence
Start with the strongest supported conclusion and its main uncertainty. Claim-level records below show how the evidence changes by question, population, route, formulation, and study design.
Peer-reviewed randomized 36-week subcutaneous early-phase obesity evidence and a 448-participant Phase 2 diabetes program reported by the sponsor.
This is the strongest supported conclusion in the current human evidence—not a summary of every claim made about the compound.
Phase 3 efficacy and tolerability, dose optimization, high-dose discontinuation, dysesthesia, oral-versus-injectable durability, rare events, and cardiovascular outcomes.
Keeping the main uncertainty visible prevents an early or promising finding from looking more settled than it is.
Questions people bring to the evidence
Research questions—not promises of benefit.
It is not the same as co-injecting two separate products.
The highest exploratory arm reached 24.3%.
Sponsor reporting showed larger effects with the leading subcutaneous regimens.
Upper subcutaneous arms had substantial discontinuation and gastrointestinal events; dysesthesia was also reported.
Pivotal registration is not proof of benefit.
Mechanisms
Zenagamtide is a unimolecular co-agonist of GLP-1 and amylin receptors developed in subcutaneous and oral formulations. A peer-reviewed Phase 1b/2a obesity study reported dose-dependent weight reduction, reaching 24.3% at 36 weeks in the highest exploratory subcutaneous arm. In a 448-participant Phase 2 type 2 diabetes trial, Novo Nordisk reported subcutaneous weight reduction up to 14.6% and oral reduction up to 10.1% at 36 weeks, with HbA1c reductions around 1.7–1.8 percentage points in leading subcutaneous arms. Gastrointestinal events were common, and discontinuation was high in the upper subcutaneous dose groups. Phase 3 programs are underway, but no approved indication exists.
A plausible mechanism can explain why a study was attempted. It does not prove that the compound improves a human outcome.
Studies
Study arms are reported for transparency. They describe what researchers did in a defined record and do not transfer across identities, routes, formulations, or populations.
A later trial phase can ask a more mature question, but it does not guarantee a positive result, regulatory approval, or relevance outside the studied population.
Randomized, placebo-controlled multiple-dose trial
Adults with overweight or obesity
Weight reduction was dose dependent and reached 24.3% in the highest exploratory arm at 36 weeks.
Study administration: Once-weekly subcutaneous amycretin dose-escalation regimens or placebo
Limitations: Small dose cohorts and an exploratory early-phase design limit generalization.
Randomized pivotal obesity trial
Adults with obesity or overweight
Phase 3 is evaluating longer-term efficacy and tolerability.
Study administration: Zenagamtide or comparator
Limitations: No Phase 3 outcomes were available.
Randomized, placebo-controlled subcutaneous and oral dose-ranging trial
Adults with type 2 diabetes
The sponsor reported subcutaneous weight reduction up to 14.6% and oral reduction up to 10.1%, with substantial HbA1c improvement.
Study administration: Weekly subcutaneous or daily oral zenagamtide dose groups or placebo
Limitations: Conference and investor materials are less complete than a peer-reviewed full paper.
Official registry record for the diabetes trial
Adults with type 2 diabetes
The registry confirms the mixed-route Phase 2 design.
Study administration: Subcutaneous or oral amycretin versus placebo
Limitations: Registry information does not independently confirm sponsor-reported effect sizes.
Safety snapshot
High-dose tolerability is a material uncertainty.
Other human evidenceRates and dose relationships require fuller publication and Phase 3 confirmation.
Open sourceThe current record does not support a reliable common-versus-uncommon frequency split.
Evidence boundaryUnder-detected or under-reported events must not be described as rare.
No source-qualified compound-specific warning or contraindication is encoded in the current record.
Evidence boundaryInvestigational — Phase 2 results; Phase 3 initiated Phase 3 efficacy and tolerability, dose optimization, high-dose discontinuation, dysesthesia, oral-versus-injectable durability, rare events, and cardiovascular outcomes.
The current record does not identify a reliable compound-specific pattern of events that caused study discontinuation.
Evidence boundaryThis is an evidence gap, not proof that discontinuations did not occur.
No compound-specific patient-facing urgent-action threshold is established in the current Relay record.
Evidence boundaryRelay does not infer emergency guidance from study discontinuations, mechanism, or incomplete adverse-event reporting.
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