Elecoglipron results in 40.4% to 88.8% of patients reaching at least 5% weight lossTrial shows weight loss in adults with obesity using elecoglipron

Lancet (London, England) Published June 20, 2026 Study authors: Davies Melanie J, Aroda Vanita R, Rosenstock Julio, Capehorn Matthew, Pedersen Sue D, Morizzo Erika,… PubMed ↗ NCT06579092 ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Note that 40.4% to 88.8% of patients on elecogipron achieved at least 5% weight loss compared to 15.6% on placebo.

This Phase 2 multicenter randomized controlled trial was conducted across several countries including Australia, Canada, Germany, Japan, Taiwan, the United Kingdom, and the United States. The study enrolled 310 adults meeting specific criteria: a body mass index (BMI) of at least 30 kg/m^2 for those with obesity or at least 27 kg/m^2 for those who are overweight. Additionally, participants were required to have at least one weight-related condition and must not have type 2 diabetes.

The study evaluated the efficacy and safety of elecoglipron compared to a placebo over a period of up to 36 weeks. Participants receiving elecoglipron were assigned to various dosing regimens including 5 mg, 15 mg, 50 mg, or 75 mg with different titration schedules. The primary outcome measure was the percent change in bodyweight from baseline and the proportion of patients achieving at least a 5% reduction in weight by week 26.

Regarding the primary outcomes, participants receiving elecogipron showed a mean percent change in bodyweight ranging from -2.6% to -10.5% at week 26. In contrast, the placebo group showed a mean weight reduction of only -0.6%. Furthermore, the proportion of patients achieving the clinically relevant threshold of at least 5% weight loss was significantly higher in the elecoglipron groups (40.4% to 88.8%) compared to the placebo group (15.6%).

Safety and tolerability were monitored throughout the study period. Reported adverse events included nausea, constipation, diarrhea, headache, and vomiting. The safety profile was noted as consistent with the GLP-1 receptor agonist class. Regarding study completion, 231 participants (75%) completed the assigned treatment, while 288 participants (93%) completed the full study duration.

These findings provide preliminary evidence for the efficacy of elecogipron in managing weight. While these results are promising, they must be interpreted with caution as they originate from a Phase 2 dose-ranging study. The clinical meaningfulness of these specific percentages is based on the authors' interpretation of early-phase data rather than long-term established outcomes.

Methodological limitations include the fact that this was a Phase 2 trial, which is designed to establish dosing and preliminary efficacy rather than definitive long-term outcomes. Data regarding long-term outcomes beyond 36 weeks are not reported. Potential biases inherent in early-phase trials may affect the generalizability of these results to broader populations.

For clinical practice, these results support the transition into Phase 3 investigations for elecogipron in patients with obesity or overweight. Clinicians should note that while the weight reduction is statistically evident compared to placebo, the long-term durability and safety beyond 36 weeks remain unknown. Questions remain regarding the optimal titration schedule for maximum efficacy and how these results translate across diverse patient populations with varying comorbidities.

How this fits prior evidence

How this fits prior evidence: This study addresses a gap in pharmacological options for weight management in patients with obesity or overweight. While previous findings noted that white kidney bean extract can reduce weight by 1.62 kg, the current trial provides data on a different mechanism of action. Additionally, while semaglutide has shown improvements in metabolic health for specific populations, this study offers new preliminary evidence for elecogipron as an alternative for general obesity management.

Managing weight is a major challenge for many people living with obesity or being overweight. These conditions are often linked to other health problems, making it important to find effective ways to manage weight and improve overall well-being. This study looked at a new medication called elecoglipron to see if it could help patients achieve meaningful weight loss.

The researchers conducted a Phase 2 clinical trial involving 310 adults. These participants were people who were either overweight or had obesity and also had at least one health condition related to their weight. The study took place in several countries, including the United States, Canada, Germany, Japan, Taiwan, the United Kingdom, and Australia. Participants were given different doses of elecoglipron over a period of 26 weeks, while others received a placebo (a dummy pill with no medicine).

The results showed that people taking elecoglipron lost between 2.6% and 10.5% of their body weight by the end of the 26-week period. In contrast, those who took the placebo only saw a very small change in weight, averaging about 0.6%. Furthermore, a much higher percentage of people taking the medication reached a goal of losing at least 5% of their body weight compared to those who took the placebo. Specifically, between 40.4% and 88.8% of the group taking elecoglipron hit that 5% mark, while only about 15.6% of the placebo group did.

Regarding safety, some participants experienced common side effects such as nausea, constipation, diarrhea, headache, and vomiting. These reactions are similar to what is often seen with other medications in this same class of drugs. Most people in the study were able to complete the treatment, though some chose to stop earlier due to these side effects.

It is important to remember that this was a Phase 2 trial. This means it is an early stage of testing used to find the right dose and check for safety before larger studies begin. Because it was a smaller study with a shorter follow-up period, we do not yet know how well the drug works over many years or if it remains effective long-term. The results are promising but are not enough to change standard medical practice immediately.

For patients today, this means that elecoglipron shows potential as a new tool for weight management. While it is not yet widely available, the study provides a foundation for larger trials to confirm these findings and determine how the drug works over a longer period of time.

What this means for you:

The medication elecoglipron showed significant weight loss in a Phase 2 trial, but more long-term research is needed.

Study Details

Study typeRct

Sample sizen = 310

EvidenceLevel 2

Follow-up8.3 mo

PublishedJun 2026

PMID42259337

TrialNCT06579092

View Original Abstract ↓

BACKGROUND: Elecoglipron (AZD5004) is an oral small-molecule glucagon-like peptide-1 (GLP-1) receptor agonist administered once daily without food or fluid restriction, in development for weight management in people living with obesity or overweight and type 2 diabetes. We assessed the efficacy, safety, and tolerability of elecoglipron versus placebo in participants with obesity or overweight and at least one weight-related condition without diabetes. METHODS: In this double-blind, randomised, controlled, phase 2 dose-ranging study with a total treatment duration of 36 weeks, adult participants were recruited from medical research centres and hospitals in Australia, Canada, Germany, Japan, Taiwan, the UK, and the USA. Participants were aged 18 years or older living with obesity (BMI ≥30 kg/m) or with overweight (BMI ≥27 kg/m) with at least one weight-related condition and without type 2 diabetes. Eligible participants were randomly assigned in a 2:3:3:3:3:5 ratio to receive 5 mg, 15 mg, 50 mg, 75 mg (weekly titration), or 75 mg (every 2-week titration) of elecoglipron or matching placebo. Elecoglipron was administered as oral once-daily tablets without titration (5 mg and 15 mg) and as three different dose-titration regimens. The daily dose of 50 mg was evaluated using an every-4-weeks dose-escalation schedule, while 75 mg was assessed with weekly or every 2-week dose-escalation schedules. Participants, treating physicians, and sponsor were masked to the treatment allocation. The dual primary endpoints were percent change in bodyweight from baseline and the proportion of patients reaching at least 5% weight loss at week 26. Safety and tolerability were assessed in all participants who received at least one dose of study treatment. This trial is registered at ClinicalTrials.gov (NCT06579092) and is completed. FINDINGS: From Oct 8, 2024, to Feb 18, 2025, 472 individuals were screened for potential study inclusion, 162 did not meet the inclusion criteria, and 310 participants were randomly assigned to the varied elecoglipron groups or placebo. 288 participants (93%) completed the study and 231 (75%) completed the assigned treatment. The mean age of participants was 48·4 years (SD 13·7), 225 (73%) were female, 85 (27%) were male, their mean bodyweight was 106·9 kg (SD 24·1), and their mean BMI was 38·2 kg/m (SD 7·2). At week 26, the estimated mean change from baseline in bodyweight was between -2·6% (5 mg elecoglipron), and -10·5% (75 mg with weekly titration steps) compared with -0·6% with placebo. The estimated proportion of participants reaching weight reductions of at least 5% at week 26 was 40·4-88·8% with elecoglipron versus 15·6% with placebo. Adverse events were reported by 84% (27 of 32) to 98% (48 of 49) of participants across elecoglipron doses compared with 84% (68 of 81) in the placebo group, the most common being nausea, constipation, diarrhoea, headache, and vomiting. INTERPRETATION: Daily oral elecoglipron demonstrated clinically meaningful weight reductions and a safety and tolerability profile consistent with the GLP-1 receptor agonist class in this phase 2 dose-ranging study, supporting phase 3 investigation in people living with obesity or overweight. FUNDING: AstraZeneca.

Elecoglipron results in 40.4% to 88.8% of patients reaching at least 5% weight lossTrial shows weight loss in adults with obesity using elecoglipron

How this fits prior evidence

Study Details

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Elecoglipron results in 40.4% to 88.8% of patients reaching at least 5% weight lossTrial shows weight loss in adults with obesity using elecoglipron

How this fits prior evidence

Study Details

Thiazolidinediones show lower hepatocellular carcinoma risk than DPP-4 inhibitors, GLP-1RAs, insulin, and sulfonylureas in this network meta-analysis

New analysis links diabetes drugs to liver outcomes in millions of patients

Clinical research that matters. Delivered to your inbox.

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