Every major peptide clinical trial result in one place. Sample sizes, weight loss percentages, A1c reductions, cardiovascular outcomes, side effect rates, and journal citations, all from published peer-reviewed data.
🔑 Key Takeaways
- This page compiles every major peptide and GLP-1 clinical trial result with specific numbers from peer-reviewed publications. Bookmark it as a reference.
- Weight loss results range from 8% (liraglutide) to 24.2% (retatrutide Phase 2) of body weight across the GLP-1 class
- The SURMOUNT-5 head-to-head trial definitively showed tirzepatide produces 47% more weight loss than semaglutide (20.2% vs 13.7%)
- Three cardiovascular outcome trials show GLP-1 drugs reduce heart attacks and strokes: SELECT (semaglutide, -20%), LEADER (liraglutide, -13%), REWIND (dulaglutide, -12%)
- Non-GLP-1 peptides (BPC-157, TB-500, GHK-Cu, MOTS-c) have limited or no published human clinical trial data. PT-141 and tesamorelin are exceptions with full FDA approval data.
- All data includes sample sizes, durations, exact percentages, side effect rates, and publication references
Last updated: April 2026. Sources cited at the end of each section.
How to Use This Page
This is a reference, not a narrative article. Jump to the drug you need:
- Semaglutide: STEP trials (weight loss), SUSTAIN trials (diabetes), SELECT (cardiovascular), FLOW (kidney), OASIS (oral)
- Tirzepatide: SURMOUNT trials (weight loss), SURPASS trials (diabetes), CVOT (cardiovascular)
- Pipeline GLP-1s: Retatrutide, CagriSema, survodutide, orforglipron, pemvidutide, mazdutide, amycretin
- Older GLP-1s: Liraglutide (SCALE, LEADER), exenatide (EXSCEL), dulaglutide (REWIND)
- Non-GLP-1 peptides: PT-141, tesamorelin, SS-31, tesofensine, BPC-157, TB-500, GHK-Cu, and others
Master Comparison: Weight Loss Across All Drugs
| Drug | Mechanism | Trial | N | Duration | Avg Weight Loss | >=20% Lost | Status |
|---|---|---|---|---|---|---|---|
| Retatrutide 12mg | GLP-1/GIP/Glucagon | Phase 2 | 338 | 48 wk | -24.2% | ~83% >=15% | Phase 3 |
| CagriSema | GLP-1 + Amylin | REDEFINE 1 | 3,417 | 68 wk | -20.4% | Data pending | FDA filed |
| Amycretin 20mg (SC) | GLP-1/Amylin | Phase 1b/2a | 125 | 36 wk | -22.0% | Data pending | Phase 2 |
| Tirzepatide 15mg | GLP-1/GIP | SURMOUNT-1 | 2,539 | 72 wk | -20.9% | 56.7% | Approved |
| Tirzepatide (vs sema) | GLP-1/GIP | SURMOUNT-5 | 751 | 72 wk | -20.2% | Data pending | Approved |
| Mazdutide 9mg | GLP-1/Glucagon | GLORY-2 | ~600 | 48 wk | -20.1% | Data pending | Approved (China) |
| Survodutide 4.8mg | GLP-1/Glucagon | Phase 2 | 387 | 46 wk | -14.9% (completers: -18.7%) | ~55% >=15% | Phase 3 |
| Semaglutide 2.4mg | GLP-1 | STEP 1 | 1,961 | 68 wk | -14.9% | Not reported | Approved |
| Semaglutide (vs tirz) | GLP-1 | SURMOUNT-5 | 751 | 72 wk | -13.7% | Data pending | Approved |
| Pemvidutide 2.4mg | GLP-1/Glucagon | MOMENTUM | 391 | 48 wk | -15.6% | >30% | Phase 2 |
| Orforglipron 36mg | GLP-1 (oral) | ATTAIN-1 | 3,127 | 72 wk | -12.4% | Data pending | Approved |
| Tesofensine 0.5mg | DA/NE/5-HT reuptake | Phase 2 | 203 | 24 wk | -11.3 kg | N/A | Phase 3 |
| Liraglutide 3mg | GLP-1 | SCALE | 3,731 | 56 wk | -8.0% | N/A | Approved |
| AOD-9604 | hGH fragment | Phase 2 | ~300 | 24 wk | -1.8 kg vs placebo | N/A | Abandoned |
Master Comparison: Cardiovascular Outcome Trials
| Trial | Drug | N | Follow-up | MACE Hazard Ratio | 95% CI | Superior? | Publication |
|---|---|---|---|---|---|---|---|
| SELECT | Semaglutide 2.4mg | 17,604 | 39.8 mo | 0.80 | 0.72-0.90 | Yes (P<0.001) | NEJM 2023 |
| LEADER | Liraglutide 1.8mg | 9,340 | 3.8 yr | 0.87 | 0.78-0.97 | Yes (P=0.01) | NEJM 2016 |
| REWIND | Dulaglutide 1.5mg | 9,901 | 5.4 yr | 0.88 | 0.79-0.99 | Yes (P=0.026) | Lancet 2019 |
| SUSTAIN 6 | Semaglutide 0.5/1mg | 3,297 | 2.1 yr | 0.74 | 0.58-0.95 | Yes (P=0.016) | NEJM 2016 |
| SURPASS-CVOT | Tirzepatide | 13,299 | ~3 yr | 0.92 | vs dulaglutide | Non-inferior, not superior | 2025 |
| EXSCEL | Exenatide ER 2mg | 14,752 | 3.2 yr | 0.91 | 0.83-1.00 | Non-inferior only (P=0.06) | NEJM 2017 |
| FLOW | Semaglutide 1mg | 3,533 | ~3.4 yr | 0.76 (kidney) | 0.66-0.88 | Yes (stopped early) | NEJM 2024 |
Semaglutide: STEP Trials (Weight Loss)
| Trial | Population | N | Weeks | Avg Loss | >=5% | >=10% | >=15% | >=20% | Nausea | Diarrhea | Vomiting | Discontinuation (AE) | Journal |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEP 1 | Obesity, no T2D | 1,961 | 68 | -14.9% | 86.4% | 69.1% | 50.5% | NR | 44.2% | ~30% | ~25% | 7.0% | NEJM 2021 |
| STEP 2 | Obesity + T2D | 1,210 | 68 | -9.6% | 68.8% | 45.6% | 25.8% | NR | NR | NR | NR | 4.2% | Lancet 2021 |
| STEP 3 | Obesity + IBT | 611 | 68 | -16.0% | 86.6% | 75.3% | 55.8% | 35.7% | 58.2% | 36.1% | 27.3% | 5.9% | JAMA 2021 |
| STEP 4 | Obesity, withdrawal | 902 | 68 | -17.4%* | 88.7% | 79.0% | 63.7% | 39.6% | 14.0% | 14.4% | 10.3% | 2.4% | JAMA 2021 |
| STEP 5 | Obesity, 2-year | 304 | 104 | -15.2% | 77.1% | 61.8% | 52.1% | 36.1% | NR | NR | NR | NR | Nat Med 2022 |
| STEP 6 | East Asian | 401 | 68 | -13.2% | NR | ~61% | NR | NR | NR | NR | NR | NR | Lancet DE 2022 |
| STEP 8 | vs Liraglutide | 338 | 68 | -15.8% | 87.2% | 70.9% | 55.6% | 38.5% | 61.1% | 27.8% | 25.4% | 3.2% | JAMA 2022 |
| STEP TEENS | Adolescents 12-17 | 201 | 68 | -14.7% | 73% | 62% | NR | 37% | NR | NR | NR | 5% | NEJM 2022 |
*STEP 4: -17.4% is the total loss (0-68 weeks) for the continued-treatment group. The study randomized at week 20 after an open-label run-in. Switchers to placebo regained to -5.0% by week 68.
Source: Wilding et al. NEJM 2021 (STEP 1); Davies et al. Lancet 2021 (STEP 2); Wadden et al. JAMA 2021 (STEP 3); Rubino et al. JAMA 2021 (STEP 4); Garvey et al. Nature Medicine 2022 (STEP 5); Rubino et al. JAMA 2022 (STEP 8); Weghuber et al. NEJM 2022 (STEP TEENS).
Semaglutide: SELECT Trial (Cardiovascular Outcomes)
| Endpoint | Semaglutide 2.4mg | Placebo | Hazard Ratio | P-value |
|---|---|---|---|---|
| 3-point MACE (primary) | 6.5% | 8.0% | 0.80 (0.72-0.90) | <0.001 |
| CV death | 2.5% | 3.0% | 0.85 (0.71-1.01) | NS |
| All-cause mortality | 4.3% | 4.7% | 0.81 (not formally tested) | NR |
| Weight loss at end | -9.4% | -0.9% | N/A | N/A |
N=17,604. Mean follow-up 39.8 months. Population: adults with BMI >=27, established CV disease, no diabetes. Source: Lincoff et al. NEJM 2023.
Semaglutide: FLOW Trial (Kidney Outcomes)
| Endpoint | Semaglutide 1mg | Placebo | Hazard Ratio |
|---|---|---|---|
| Major kidney events (primary) | -- | -- | 0.76 (0.66-0.88) |
| All-cause mortality | -- | -- | 0.80 (not formally tested) |
N=3,533. Population: T2D + CKD (eGFR 25-75). Trial stopped early for efficacy. Source: Perkovic et al. NEJM 2024.
Semaglutide: SUSTAIN Trials (Diabetes, Abbreviated)
| Trial | Comparator | N | Weeks | A1c Reduction (1mg) | Weight Loss (1mg) |
|---|---|---|---|---|---|
| SUSTAIN 1 | Placebo | 388 | 30 | -1.55% | -4.53 kg |
| SUSTAIN 2 | Sitagliptin | 1,231 | 56 | -1.6% | -6.1 kg |
| SUSTAIN 3 | Exenatide ER | 813 | 56 | -1.5% | -5.6 kg |
| SUSTAIN 4 | Insulin glargine | 1,089 | 30 | -1.64% | -5.17 kg |
| SUSTAIN 5 | Placebo (+ basal insulin) | 397 | 30 | -1.8% | -6.4 kg |
| SUSTAIN 6 | Placebo (CVOT) | 3,297 | 104 | -1.1% | -4.3 kg |
| SUSTAIN 7 | Dulaglutide | 1,201 | 40 | -1.8% | -6.5 kg |
Sources: Sorli et al. Lancet DE 2017 (S1); Ahren et al. Lancet DE 2017 (S2); Ahmann et al. Diabetes Care 2018 (S3); Aroda et al. Lancet DE 2017 (S4); Rodbard et al. JCEM 2018 (S5); Marso et al. NEJM 2016 (S6); Pratley et al. Lancet DE 2018 (S7).
Tirzepatide: SURMOUNT Trials (Weight Loss)
| Trial | Population | N | Weeks | Dose | Avg Loss | >=5% | >=10% | >=15% | >=20% | Nausea | Diarrhea | Vomiting | Journal |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SURMOUNT-1 | Obesity, no T2D | 2,539 | 72 | 5mg | -15.0% | 85.1% | 68.5% | 48.0% | 30.0% | 25% | 19% | 8% | NEJM 2022 |
| 10mg | -19.5% | 88.9% | 78.1% | 66.6% | 50.1% | 29% | 21% | 11% | |||||
| 15mg | -20.9% | 90.9% | 83.5% | 70.6% | 56.7% | 28% | 23% | 13% | |||||
| SURMOUNT-2 | Obesity + T2D | 938 | 72 | 10mg | -12.8% | 79.2% | 57.2% | 37.5% | 21.4% | NR | NR | NR | Lancet 2023 |
| 15mg | -14.7% | 82.8% | 64.2% | 44.0% | 30.3% | NR | NR | NR | |||||
| SURMOUNT-3 | After lifestyle | 579 | 72 | Max tolerated | -18.4% additional | NR | NR | NR | NR | NR | NR | NR | Nat Med 2024 |
| SURMOUNT-5 | vs semaglutide | 751 | 72 | 10-15mg | -20.2% | NR | NR | NR | 51.6% | NR | NR | NR | NEJM 2025 |
SURMOUNT-5 comparator: semaglutide 2.4mg lost -13.7%, 31.5% achieved >=20%. Treatment difference: 47% more weight loss with tirzepatide.
Source: Jastreboff et al. NEJM 2022 (S1); Garvey et al. Lancet 2023 (S2); Wadden et al. Nat Med 2024 (S3); NEJM 2025 (S5).
Tirzepatide: SURPASS Trials (Diabetes, Abbreviated)
| Trial | Comparator | N | Weeks | A1c Reduction (15mg) | Weight Loss (15mg) |
|---|---|---|---|---|---|
| SURPASS-1 | Placebo | 478 | 40 | -2.07% | -9.5 kg |
| SURPASS-2 | Semaglutide 1mg | 1,879 | 40 | -2.46% | -11.2 kg |
| SURPASS-3 | Insulin degludec | 1,444 | 52 | -2.37% | -11.7 kg |
| SURPASS-4 | Insulin glargine | 2,002 | 52 | -2.40% | -11.7 kg |
| SURPASS-5 | Placebo (+ glargine) | 475 | 40 | -2.59% | -10.5 kg |
SURPASS-2 head-to-head: tirzepatide 15mg reduced A1c by -2.46% vs -1.86% for semaglutide 1mg. Weight loss: -11.2 kg vs -5.7 kg. Source: Frias et al. NEJM 2021.
Pipeline GLP-1 Drugs: Trial Data
Retatrutide (Eli Lilly) - GLP-1/GIP/Glucagon Triple Agonist
| Dose | Weight Loss (48 wk) | >=5% | >=10% | >=15% | Nausea |
|---|---|---|---|---|---|
| 1mg | -8.7% | NR | NR | NR | 14% |
| 4mg | -17.1% | NR | NR | NR | NR |
| 8mg | -22.8% | NR | NR | NR | NR |
| 12mg | -24.2% | 100% | 93% | 83% | 60% |
| Placebo | -2.1% | NR | NR | NR | NR |
N=338. Phase 3 TRIUMPH program: 8 trials, >5,800 participants. Readouts expected through 2026. NDA projected late 2026 to Q1 2027. Source: Jastreboff et al. NEJM 2023.
CagriSema (Novo Nordisk) - Semaglutide + Cagrilintide
REDEFINE 1: N=3,417, 68 weeks. CagriSema: -20.4% vs cagrilintide alone -11.5% vs semaglutide alone -14.9% vs placebo -3.0%. Nausea 55%, vomiting 26.1%. FDA filing submitted December 2025. Source: NEJM 2025.
Survodutide (Boehringer Ingelheim) - GLP-1/Glucagon
Phase 2 obesity: N=387, 46 weeks. 4.8mg dose: -14.9% (completers: -18.7%). Also showed 83% MASH improvement at 48 weeks. FDA Breakthrough Therapy designation for MASH. Phase 3 SYNCHRONIZE readouts expected 2026. Source: Lancet DE 2023 (obesity); NEJM 2024 (MASH).
Orforglipron / Foundayo (Eli Lilly) - Oral GLP-1
ATTAIN-1: N=3,127, 72 weeks. 36mg daily: -12.4%. FDA approved April 1, 2026. First non-peptide oral GLP-1 with no food restrictions. Also beat oral semaglutide head-to-head in ACHIEVE-3 (-2.2% vs -1.4% A1c, -9.2% vs -5.3% weight). Source: NEJM 2025.
Pemvidutide (Altimmune) - GLP-1/Glucagon
MOMENTUM Phase 2: N=391, 48 weeks. 2.4mg: -15.6%. Notable: 78.1% of weight loss was fat mass (only 21.9% lean mass), better muscle preservation than most GLP-1s. Also showed 76.4% liver fat reduction in MASH trial (IMPACT). Source: Altimmune press releases 2024-2025.
Amycretin (Novo Nordisk) - GLP-1/Amylin
Phase 1b/2a subcutaneous: N=125. 20mg (36 weeks): -22.0%. Oral formulation: -13.0% at 12 weeks (Phase 1). Phase 3 planned Q1 2026. Projected approval ~2030. Source: The Lancet 2025.
Mazdutide (Innovent/Lilly China) - GLP-1/Glucagon
GLORY-1: N=610, 48 weeks. 6mg: -14.01%. GLORY-2 (9mg): -20.1%. Beat semaglutide head-to-head in DREAMS-3 (-10.29% vs -6.00% weight, -2.03% vs -1.84% A1c). Approved in China June 2025. Source: NEJM 2025.
Older GLP-1 Trials
Liraglutide (Saxenda/Victoza)
SCALE Obesity: N=3,731, 56 weeks. 3mg daily: -8.0%. >=5% loss: 63.2%, >=10%: 33.1%, >=15%: 14.4%. Nausea 40.2%, diarrhea 20.9%, vomiting 16.3%. Source: Pi-Sunyer et al. NEJM 2015.
LEADER CVOT: N=9,340, 3.8 years. Liraglutide 1.8mg: MACE HR 0.87 (P=0.01). CV death HR 0.78 (P=0.007). All-cause mortality HR 0.85 (P=0.02). Source: Marso et al. NEJM 2016.
Dulaglutide (Trulicity)
REWIND CVOT: N=9,901, 5.4 years (longest GLP-1 CVOT). Dulaglutide 1.5mg: MACE HR 0.88 (P=0.026). All-cause mortality HR 0.90 (P=0.067, NS). Source: Gerstein et al. Lancet 2019.
Exenatide (Byetta/Bydureon)
EXSCEL CVOT: N=14,752, 3.2 years. Exenatide ER 2mg: MACE HR 0.91. Non-inferior (P<0.001), but superiority NOT met (P=0.06). Source: Holman et al. NEJM 2017.
Non-GLP-1 Peptide Trial Data
PT-141 / Bremelanotide (Vyleesi) - FDA Approved
Phase 3 (RECONNECT): N=1,267 premenopausal women with HSDD. 1.75mg SubQ PRN. FSFI desire domain: +0.35 (P<0.001). FSDS-DAO distress score: -0.33 (P<0.001). Nausea: ~40%. FDA approved June 2019. Source: Kingsberg et al. Obstet Gynecol 2019.
Tesamorelin (Egrifta) - FDA Approved
Phase 3 (pooled): N=806 HIV+ patients with lipodystrophy. 2mg daily SubQ. Visceral fat reduction: -15.4% at 26 weeks, -17.5% at 52 weeks. Triglycerides: -12.3%. IGF-1 increased ~80%. FDA approved November 2010. Source: Falutz et al. JAMA 2007; JCEM 2010.
SS-31 / Elamipretide - FDA Accelerated Approval
Barth syndrome: N=12 (rare disease). 6-minute walk test improved +96.1 meters (P=0.003). FDA accelerated approval September 2025 for Barth syndrome. Source: FDA approval package 2025.
Tesofensine - Phase 3
Phase 2: N=203, 24 weeks. 0.5mg oral daily: -11.3 kg weight loss (9.2% placebo-subtracted). Mechanism: dopamine/norepinephrine/serotonin triple reuptake inhibitor. Published in Lancet 2008. Phase 3 ongoing (Saniona). Source: Astrup et al. Lancet 2008.
Thymosin Alpha-1 (Zadaxin) - Approved Internationally
Hepatitis B meta-analysis: 7 RCTs, N=535. HBeAg seroconversion: 47% vs 29.5% (OR 2.13). HBV DNA clearance: 58.6% vs 30.7%. Approved in 30+ countries (not FDA-approved). Source: Zhang & Wang meta-analysis.
Kisspeptin-54 - Phase 2
IVF oocyte maturation trigger: N=60. 95% oocyte maturation rate. 0% OHSS rate (vs 5-10% with hCG trigger). 45% live birth rate per transfer. Source: Abbara et al. 2015-2020 trials.
BPC-157 - Preclinical Only
Human data: 2 subjects total in published literature (2025 pilot safety study, IV infusion 10-20mg, no adverse effects on biomarkers). No published human efficacy data. Extensive non-human data across tendon, ligament, muscle, gut, nerve, and bone healing models. Typical doses studied: 6-50 mcg/kg daily.
TB-500 (Thymosin Beta-4) - Limited Human Data
Phase 2 wound healing trials in pressure ulcers, venous ulcers, and epidermolysis bullosa showed accelerated repair. Ophthalmology trials in dry eye showed improvements lasting beyond treatment. Specific efficacy numbers not published in accessible sources.
GHK-Cu - Preclinical
Wound healing in rats: 64.5% vs 28.2% wound reduction (P<0.05). Performed comparably to 5% minoxidil for hair density in a 2000 comparative study. In vitro: stimulates collagen I, III, and glycosaminoglycan synthesis. No rigorous human clinical trials.
MOTS-c - Preclinical Only
No human clinical trials. Mouse data shows exercise-mimetic metabolic effects: improved insulin sensitivity, increased energy expenditure, reduced fat accumulation. Mitochondria-derived peptide.
Epithalon - In Vitro Only
In vitro telomerase activation: ~10 additional cell divisions in cultured fibroblasts. No published human clinical trials.
AOD-9604 - Failed
Phase 2 (Metabolic Pharmaceuticals): ~300 subjects, 24 weeks. Only 1.8 kg advantage over placebo. Clinical development abandoned 2007. Now sold as a peptide supplement despite failed clinical data.
Side Effect Comparison Across GLP-1 Class
| Drug (max dose) | Nausea | Diarrhea | Vomiting | Constipation | Discontinuation (GI) |
|---|---|---|---|---|---|
| Semaglutide 2.4mg | 44% | 30% | 25% | 24% | 4.5% |
| Tirzepatide 15mg | 28% | 23% | 13% | 11% | 6.2% |
| CagriSema | 55% | NR | 26% | 31% | 5.9% |
| Retatrutide 12mg | 60% | 20% | 26% | NR | Low |
| Survodutide 4.8mg | 66% | 49% | 41% | NR | NR |
| Liraglutide 3mg | 40% | 21% | 16% | 20% | NR |
| Orforglipron 36mg | NR | NR | NR | NR | 5.3-10.3% |
Publication References
All data on this page is sourced from peer-reviewed publications. Key citations:
- Wilding JPH et al. "Semaglutide for weight management." NEJM 2021; 384:989-1002 (STEP 1)
- Jastreboff AM et al. "Tirzepatide for obesity." NEJM 2022; 387:205-216 (SURMOUNT-1)
- Jastreboff AM et al. "Retatrutide Phase 2." NEJM 2023 (Retatrutide)
- Lincoff AM et al. "Semaglutide and cardiovascular outcomes." NEJM 2023 (SELECT)
- Perkovic V et al. "Semaglutide and kidney outcomes." NEJM 2024 (FLOW)
- Marso SP et al. "Liraglutide and cardiovascular outcomes." NEJM 2016 (LEADER)
- Marso SP et al. "Semaglutide and cardiovascular outcomes." NEJM 2016 (SUSTAIN 6)
- Gerstein HC et al. "Dulaglutide and cardiovascular outcomes." Lancet 2019 (REWIND)
- Holman RR et al. "Exenatide and cardiovascular outcomes." NEJM 2017 (EXSCEL)
- Pi-Sunyer X et al. "Liraglutide for weight management." NEJM 2015 (SCALE)
- Frias JP et al. "Tirzepatide vs semaglutide." NEJM 2021 (SURPASS-2)
- NEJM 2025 (SURMOUNT-5, CagriSema REDEFINE, Orforglipron ATTAIN)
- Astrup A et al. "Tesofensine for weight loss." Lancet 2008
- Kingsberg SA et al. "Bremelanotide for HSDD." Obstet Gynecol 2019
- Falutz J et al. "Tesamorelin for HIV lipodystrophy." JAMA 2007
Medical Disclaimer: This page compiles published clinical trial data for informational purposes only. It does not constitute medical advice. Clinical trial results represent population averages; individual responses vary. Consult a licensed healthcare provider before starting any medication. Data is current as of April 2026 and will be updated as new trial results are published.
