Obesity and MASH treatment
Amount
1.2-2.4 mg
Frequency
Once weekly
Duration
48 weeks (Phase 2b)
Route
SCSchedule
Once weekly
Timing
No dose titration required; patients start directly on target dose unlike most GLP-1 agonists
Duration
Ongoing (long-term use intended)
Repeatable
Yes
Liver function tests (ALT, AST)
When: Baseline
Why: Baseline hepatic function for MASH monitoring
Fasting glucose and HbA1c
When: Baseline
Why: Baseline glycemic status
Liver function tests and MRI-PDFF
When: 24 weeks
Why: Assess liver fat reduction and MASH improvement
Lipid panel
When: 48 weeks
Why: Monitor metabolic improvements
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Pemvidutide (ALT-801) is a 29-amino acid dual GLP-1/glucagon receptor agonist developed by Altimmune. It features a C18 fatty diacid modification enabling once-weekly subcutaneous dosing. Unlike GLP-1-only agonists, pemvidutide's balanced dual mechanism simultaneously reduces appetite, increases energy expenditure, and directly promotes liver fat oxidation.
Pemvidutide activates both the GLP-1 receptor and glucagon receptor with approximately equal (1:1) potency. The GLP-1 component suppresses appetite and improves glucose homeostasis, while glucagon receptor activation increases hepatic fat oxidation, energy expenditure, and promotes weight loss through complementary metabolic pathways. This dual mechanism provides particular benefit for liver steatosis and MASH.
Pemvidutide has been evaluated in two major Phase 2b programs. The IMPACT trial assessed MASH resolution and liver outcomes, while the MOMENTUM trial focused on weight loss. Key results include 59.1% MASH resolution at 1.2 mg, 54.7% liver fat reduction at 1.8 mg, and 15.6% weight loss at 2.4 mg. The compound does not require dose titration, a notable advantage over most GLP-1 agonists.
Pemvidutide is an investigational drug not approved by any regulatory authority. All data come from Phase 2b trials with limited sample sizes. Long-term safety and efficacy data are not yet available.
Pemvidutide Phase 2b IMPACT Trial in MASH, published in American Association for the Study of Liver Diseases (AASLD) (Altimmune investigators, 2025):
Pemvidutide Phase 2b MOMENTUM Trial in Obesity, published in Conference presentation (Altimmune) (Altimmune investigators, 2025):
We summarize new studies, safety updates, and dosing insights โ delivered biweekly.
See real-world usage patterns alongside the clinical evidence above. Community-sourced, not clinically verified.
0View community protocolsCotadutide (MEDI0382): dual GLP-1/glucagon receptor agonist by AstraZeneca. Reached phase 2b for T2D and NASH before discontinuation in April 2023 in favor of weekly successor AZD9550.
Mazdutide: Dual GLP-1/glucagon agonist approved in China for obesity. Covers up to 20% weight loss in trials, mechanism, dosing, and side effects.
Retatrutide: Triple GIP/GLP-1/glucagon agonist with up to 24% weight loss. Covers mechanism, Phase 2/3 trial data, dosing, and side effects.
Semaglutide: FDA-approved GLP-1 agonist for weight loss and diabetes. Covers STEP/SUSTAIN trials, Ozempic vs Wegovy dosing, and cardiovascular benefits.
This website is for educational and informational purposes only. The information provided is not intended to diagnose, treat, cure, or prevent any disease. Always consult with a qualified healthcare professional before using any peptide or supplement.
Pemvidutide and survodutide are both GLP-1/glucagon dual agonists being developed for obesity and MASH, but survodutide is further ahead in clinical development with more advanced Phase 3 programs, higher-tier regulatory designations (Breakthrough Therapy vs Fast Track), and greater weight loss in Phase 2 (18.7% vs 15.6%). However, pemvidutide differentiates itself through favorable lean mass preservation and expanding into alcohol use disorder, a novel indication for this drug class. Survodutide is backed by the larger Boehringer Ingelheim/Zealand Pharma partnership and is likely to reach market first.
Tirzepatide is the clear choice for anyone seeking an available, proven treatment โ it is FDA-approved, backed by over 14,000 clinical trial participants, and delivers up to 22.5% weight loss. Pemvidutide, while still investigational, differentiates itself through its glucagon component that directly targets liver fat (59.1% MASH resolution in Phase 2b), favorable lean mass preservation (78.1% of weight loss from fat), and no requirement for dose titration. For MASH specifically, pemvidutide's mechanism may offer a more targeted approach. However, pemvidutide lacks Phase 3 data and is not available outside of clinical trials.
Research review of GLP-1 and multi-receptor agonists for MASH (metabolic dysfunction-associated steatohepatitis), including survodutide, pemvidutide, mazdutide, semaglutide, and tirzepatide liver-specific clinical data.
A research review of triple and quadruple receptor agonists for obesity, from retatrutide's record-breaking 28.7% weight loss to bioglutide's quad-agonist approach, and why adding glucagon matters.
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