Eloralintide vs Retatrutide: 5-Drug Pipeline Matrix (2026)

Eloralintide vs Retatrutide at a Glance: Status on November 4, 2026

Retatrutide and eloralintide are both Eli Lilly drugs, but they act on different hormone systems. Survodutide (Boehringer Ingelheim) and mazdutide (Innovent in China, with Eli Lilly) share a GLP-1 and glucagon design. CagriSema (Novo Nordisk) is a pairing of two drugs. All five were studied as once-weekly injections under the skin.

How we checked: on November 4, 2026, none of the five drugs' new active ingredients (cagrilintide for CagriSema) returned a Drugs@FDA record, and none appears on FDA's Novel Drug Approvals 2026 page (content current as of October 20, 2026), where the only obesity entry is Foundayo (orforglipron). We also found no FDA approval announcement for CagriSema that day. Novo Nordisk said in February 2026 that a decision is anticipated by late 2026, so this row may change soon. Our GLP-1 medications list tracks what is approved.

How the Five Work

All five copy gut or pancreatic hormones that reduce appetite. They differ in which receptors they switch on. The descriptions below come from each drug's trial papers and stay at the level of drug class. More receptors doesn't mean more weight loss.

Triple agonist: retatrutide

Retatrutide activates GLP-1, GIP and glucagon receptors. Tirzepatide covers the first two; retatrutide adds glucagon. Our guide to how retatrutide works covers each pathway.

Amylin drugs: eloralintide and CagriSema

Its Phase 2 paper describes eloralintide as a selective amylin receptor agonist, which makes it the outlier here: the other four all act on the GLP-1 receptor (CagriSema through semaglutide). CagriSema pairs an amylin analogue, cagrilintide 2.4 mg, with semaglutide 2.4 mg, once weekly.

GLP-1 plus glucagon: survodutide and mazdutide

Survodutide and mazdutide are dual agonists of the GLP-1 and glucagon receptors. Neither acts on GIP or amylin.

Receptor targets at drug-class level. A filled mark means the receptor is targeted. It says nothing about potency or weight loss. Eloralintide is shown as its Phase 2 paper describes it, a selective amylin receptor agonist. None of the five is FDA-approved, and our ClinicalTrials.gov search of every pair involving retatrutide on November 4, 2026 found no trial registered with retatrutide and any of the other four.

What Each Trial Measured: The Eloralintide vs Retatrutide Weight-Loss Matrix

This table covers adults without type 2 diabetes, except GLORY-2, where 16% of participants had it. The like-for-like column comes first: treatment-regimen or treatment-policy figures count people who stopped the drug. The efficacy column estimates the result as if everyone had stayed on it. A dash or "not stated" means the paper we read gives no figure in that column. We did not fill it in.

Read the table with these assumptions:

1. Each number comes from that drug's own trial. Nothing here is a head-to-head, and the table does not rank the drugs.
2. In their Phase 3 papers, Lilly and Boehringer Ingelheim report "treatment-regimen" figures; Novo Nordisk's REDEFINE 1 and 2 papers report "treatment-policy" figures (its REDEFINE 4 announcement uses "treatment-regimen"). They are the closest like-for-like family, not identical definitions. Innovent used treatment-policy for GLORY-1's week-32 primary endpoints, but the GLORY-1 week-48 and GLORY-2 figures shown here carry no estimand label. For the drug arms on this page that print both, the efficacy figure is the higher one.
3. Doses are the highest each trial tested, not equivalent doses.
4. Results are measured at 32 to 80 weeks, and weight loss grows with time.
5. Populations differ: Western and Chinese adults; among the abstracts that print it, mean BMI runs from 31.1 (GLORY-1) to 39.1 (eloralintide Phase 2).
6. Type 2 diabetes trials sit in a separate table below; GLORY-2 stays here because most of its participants did not have diabetes.
7. We show only figures the papers print. We did no subtraction.
8. Company announcements (Lilly toplines, Novo's REDEFINE 4) are company-reported, not peer-reviewed.

For a reference point on an approved drug, tirzepatide 15 mg produced 20.9% weight loss over 72 weeks in SURMOUNT-1 (intention-to-treat). See tirzepatide weight loss.

Why retatrutide has two headline numbers

Lilly's May 2026 topline reported 28.3% weight loss at 12 mg in TRIUMPH-1. The NEJM paper's headline for the same arm is 25.0%. Both are correct. The 28.3% is the efficacy estimand, which estimates the result had everyone stayed on treatment. The 25.0% is the treatment-regimen estimand, which counts people who stopped. The 9 mg and 4 mg arms reached 23.7% and 17.6% on the treatment-regimen count, against 3.9% for placebo. Our retatrutide Phase 3 results page covers the TRIUMPH-1 and TRIUMPH-4 results.

Illustration only, not trial data. When a page quotes one figure for a drug, check which count it uses.

TRIUMPH-1 discussion only. Susan Brian MD, September 30, 2026. She says she is a clinical researcher on retatrutide through her employer and that the video is not sponsored. Her 28% for 12 mg is the efficacy estimand (28.3%); the treatment-regimen figure is 25.0%. Her 30% at 104 weeks comes from an extension group that started with a BMI of 35 or more. Her view that retatrutide will likely beat earlier drugs is a prediction: its obesity head-to-head with tirzepatide (TRIUMPH-5) has not reported. It does not cover the other four drugs, and no other claim on this page comes from the video.

Type 2 diabetes results

People with type 2 diabetes usually lose less weight on these drugs than people without it, so these rows stay out of the table above.

Eloralintide alone was tested in three arms of Lilly's completed EloraTZP Phase 2 in type 2 diabetes (NCT06603571); we have not read figures for those arms. For mazdutide in Western adults, we found no completed type 2 diabetes obesity trial with results.

Side Effects and Tolerability, as Each Trial Reported Them

Digestive side effects lead every list. But the trials measured them differently. "Nausea" is one symptom; "any GI event" counts nausea, diarrhea, vomiting and more. A higher any-GI-event rate does not mean more nausea, so this table names the metric in every row and cannot be read across.

Two details are easy to misread. Eloralintide's 6 mg arm had more nausea (64%) than its 9 mg arm (33%). The abstract does not say why, and the arms were small (28 and 54 people), so it is not a dose pattern to rely on. And the mazdutide doses in the table above vary fourfold, from 4 mg (GLORY-1) to 16 mg (US Phase 2).

Retatrutide also raised heart rate in Phase 2. The increase depended on dose and peaked at week 24: +9.2 beats per minute at 12 mg vs +0.8 on placebo, falling to +6.7 vs +0.9 by week 36. Heart-rate results for the other four are not compared here. More detail is in retatrutide side effects.

Head-to-Head Evidence, and What Is Only Indirect

Head-to-head trials covered here

REDEFINE 4 is the one finished obesity trial we found that was built to compare one of these drugs with tirzepatide, and it tested CagriSema, not retatrutide. Other finished comparisons are not shown in this table, such as REDEFINE 1's semaglutide 2.4 mg arm and two completed type 2 diabetes trials: CagriSema vs tirzepatide (NCT06221969) and mazdutide vs semaglutide in Chinese adults (NCT06184568).

Note that tirzepatide's 23.6% in REDEFINE 4 (84 weeks, treatment-regimen) is a different number from its 20.9% in SURMOUNT-1 (72 weeks). Different trial, different length.

No head-to-head with retatrutide

As of November 4, 2026, we found no study on ClinicalTrials.gov listing retatrutide together with eloralintide, survodutide, mazdutide or cagrilintide as interventions, searching every pair by name and code name. So we found no comparison or combination trial registered there. The search does not cover unregistered studies, Chinese-only registries or animal work.

What the 2026 indirect comparisons say

Three 2026 network meta-analyses compared these drugs statistically across separate trials, and a fourth review summarized them without pooling. None is a head-to-head, and each uses its own time point and comparator, so their numbers cannot be merged.

• BMJ Medicine (58 trials, adults without diabetes): placebo-subtracted loss of 22.10% for retatrutide, 19.28% for tirzepatide and 17.32% for CagriSema, with confidence intervals that overlapped for several comparisons. Low-certainty evidence pointed to more discontinuation with retatrutide and better tolerability with mazdutide.
• Annals of Internal Medicine (systematic review, 38 trials): retatrutide 22.1% placebo-subtracted. The authors said heterogeneity precluded pooling, so this is not a statistical comparison.
• BMJ (262 trials): at one year against lifestyle change, tirzepatide 14.9% and CagriSema 14.8%; mazdutide and retatrutide fell in a 13.1% to 14.6% range at very low to low certainty.
• Endocrinology, Diabetes & Metabolism (six amylin trials): high-dose eloralintide 18.01% and CagriSema 17.18% vs placebo. The authors called the findings preliminary.

Survodutide appears in none of the four abstracts we read.

What Reads Out Next

Dates below are registry estimates or company statements, and they slip. Our retatrutide clinical trials guide has more on the TRIUMPH program.

On September 30, 2026, Lilly reported Phase 2 results for EloraTZP, a combination of eloralintide and tirzepatide. That is a different product from eloralintide alone, and its numbers are not used on this page.

Can You Get Any of These Drugs?

Not through any FDA-approved route. Mazdutide is approved by China's NMPA, for weight management (June 2025) and type 2 diabetes (September 2025). That's an approval, not proof it's sold, and it doesn't apply in the US.

The FDA says retatrutide and cagrilintide cannot be used in compounding under federal law. It has also warned companies that illegally sold unapproved drugs containing retatrutide, survodutide or mazdutide, among others. Eloralintide is not named on that FDA page, but it is not approved either. See compounded retatrutide and is retatrutide FDA approved.

Lilly plans an FDA filing for retatrutide in early 2027; FDA's usual review times would put a decision in late 2027 or 2028 (our estimate, not Lilly's). The retatrutide FDA timeline has the detail.

How to Read This Matrix

These questions help you judge any pipeline comparison you read, here or elsewhere. They are not a way to choose a treatment.

1. Same population? Diabetes, starting BMI and ethnicity all shift results.
2. Same estimand? An efficacy figure beside a treatment-regimen figure flatters one drug.
3. Same length and dose? A 48-week result and an 80-week result are not comparable.
4. Peer-reviewed or company-reported? Toplines and final papers can print different figures, as TRIUMPH-1's discontinuation rates show.
5. Approved, filed or in Phase 3? Approved drugs can be prescribed; unapproved ones reach people mainly through clinical trials.

If one of these drugs interests you, a clinician can tell you whether a trial is recruiting near you.

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