CT-388
InvestigationalA dual GLP-1/GIP receptor agonist (INN enicepatide; also RO7795068) acquired by Roche through the $2.7 billion Carmot Therapeutics acquisition in 2024. The published Phase 1 trial (NCT04838405) showed 4.7-8.0% mean weight loss vs 0.5% placebo over 4 weeks; a more widely reported ~18.8% placebo-adjusted figure at 24 weeks comes from an unpublished Phase 1 extension reported via press release. Phase 2 obesity and T2D trials are completed or ongoing and Phase 3 began in 2026, positioning it as a competitive obesity therapeutic with a mechanism similar to tirzepatide.
RG-6912
6 human studies
- Preclinical
- 25%
- Clinical
- 75%
Based on 8 cited sources
clinically demonstrated · low confidence
Demonstrated effect magnitude — not a recommendation or safety claim.
Research Depth 55: one published CT-388 Phase 1 double-blind placebo-controlled RCT (NCT04838405, PMID 41319798) at the small early-phase tier (1A 25, single RCT n<50; 1B 9 some-concerns sponsor-run early study; 1C 3 total N well under 50; 1D 12 direct population/route/outcome match — SC, overweight/obese, bodyweight; 1E 6 substantial multi-model preclinical program in mice and monkeys incl. MASH pathology). The widely-cited 18.8% placebo-adjusted weight loss at 24 weeks is from an unpublished Phase 1b (press-release/conference, no PubMed primary), so it does not raise the human-tier band. Mechanism 76: GLP-1R/GIPR are named validated targets with functional (cAMP-biased) agonism confirmed for CT-388 and class-level knockout confirmation (Samms 34003802; El 37277609) (2A 30 binding+functional, exact Ki undisclosed); incretin pathway largely mapped (2B 22); dose-response across human 0.5-12 mg plus in-vivo mouse/monkey models (2C 14); confirmed in mammalian in vivo (2D 10). Plausibility 85: mechanism->surrogate(weight/glucose)->clinical-weight-loss chain demonstrated in the RCT itself (3A 30); fully coherent with incretin pathophysiology validated by FDA-approved tirzepatide (3B 24); multiple same-class agents reliably produce weight loss (3C 18); tightly scoped single-mechanism claim (3D 13). Global Coverage 24: CT-388-specific evidence is single-developer (Carmot/Genentech/Roche), one primary paper, <5 CT-388 studies, US+Mexico trial sites only, investigational with regulator trial registration (4A 6 / 4B 7 / 4C 6 / 4D 5). Community Experience 8: dossier confirms no meaningful real-world user discussion (5A 3 / 5B 2 / 5C 0 / 5D 3); investigational, not yet available. Effectiveness basis clinical (low confidence): published 4-week RCT data -4.7% to -8.0% bodyweight vs -0.5% placebo already far exceeds the ~5% weight-loss MCID with a large effect on a patient-relevant outcome (E1 26 / E2 22 / E3 13 / E4 16), but rests on a single small short-duration sponsor-run early-phase trial with no head-to-head and longer-term efficacy unpublished.
CT-388 (INN enicepatide; also RO7795068) is a dual GLP-1/GIP receptor agonist that has completed Phase 1 and Phase 2 obesity trials, with Phase 3 trials beginning in 2026. Its mechanism is well-characterized based on the established biology of incretin hormones.
How It Works (Simplified)
CT-388 activates two hormone receptors simultaneously to reduce appetite and improve metabolism:
Signals fullness to the brain, slows stomach emptying, and enhances glucose-dependent insulin release from the pancreas.
Synergizes with GLP-1 for enhanced insulin secretion and directly improves fat cell function and lipid metabolism.
Dual receptor activation creates stronger satiety signals than single-receptor drugs, leading to reduced food intake.
Improves insulin sensitivity, reduces blood glucose levels, and may improve lipid profiles through multiple pathways.
Key Research: Chakravarthy MV et al. (2025) reported the first published CT-388 clinical data, including the Phase 1 trial (NCT04838405). PMID:41319798 Willard FS et al. (2020) established the mechanistic basis for cAMP-biased GLP-1/GIP dual agonism (in the related agent tirzepatide). PMID:32730231
Important Limitations
- CT-388 is investigational and not yet FDA approved
- Only Phase 1 efficacy data are peer-reviewed (4-week timepoint); the ~18.8% at 24 weeks is from an unpublished press release, and Phase 2/3 results are pending
- Specific receptor binding affinities not publicly disclosed
- Head-to-head comparisons with tirzepatide not yet available
- Long-term cardiovascular outcomes data not yet established
Based on the published Phase 1 trial: initial GI adaptation period with potential nausea and decreased appetite. Mean weight loss of 4.7-8.0% vs 0.5% placebo was observed by day 29, with improved glycemic parameters.
Continued weight loss expected as dose escalation proceeds and GI side effects typically diminish, based on incretin-class experience. CT-388 data beyond 4 weeks are not yet published.
A reported ~18.8% placebo-adjusted weight loss by 24 weeks comes from an unpublished Phase 1 extension (press release only, not peer-reviewed) and should be treated as preliminary. Peer-reviewed 24-week and 48-week data from the Phase 2 trials are pending.
Based on tirzepatide data, continued weight loss expected through 52-72 weeks. Maintenance of weight loss requires ongoing treatment. Long-term CT-388 data pending Phase 2/3 results.
Research-based observations
This timeline reflects observations from published clinical and preclinical studies. Individual responses may vary significantly. This is not a guarantee of effects or a dosing schedule. Consult qualified healthcare providers for personalized guidance.
Good Signs (6 indicators)
Warning Signs (5 indicators)
Bad Signs (6 indicators)
For Research Evaluation Only
These quality indicators are general guidelines based on typical peptide characteristics. Professional laboratory testing (HPLC, mass spectrometry) provides definitive quality verification. This checklist is for initial visual evaluation only.
Tesamorelin
CompatibleDifferent mechanisms (incretin vs GHRH). No known contraindications. Both target metabolic improvements through distinct pathways.
BPC-157
CautionBoth affect GI function. CT-388 slows gastric emptying significantly while BPC-157 has gastroprotective effects. Unclear if effects interact; monitor GI symptoms if combined.
Tirzepatide
AvoidBoth are dual GLP-1/GIP receptor agonists with overlapping mechanisms. Combining would duplicate effects and increase risk of severe GI adverse events. No clinical rationale for combination.
Semaglutide
AvoidCT-388 already activates GLP-1 receptors. Adding a GLP-1-only agonist would provide no additional benefit while increasing adverse event risk.
Survodutide
AvoidOverlapping GLP-1 receptor activation. Combining dual/triple agonists has no clinical rationale and would compound GI side effects.
Research Note: Interaction data is based on published literature, mechanistic understanding, and theoretical considerations. Most peptide combinations lack direct clinical study. This information is for educational purposes only and does not constitute medical advice. Always consult qualified healthcare providers.
Key Studies Cited
Full reference list available on request. All citations link to PubMed for verification.
This dossier synthesizes available evidence from peer-reviewed literature, regulatory documents, and clinical trial registries. Evidence strength ratings follow a modified GRADE approach.
For complete methodology details, see our Methodology page.
Important Disclaimer
This dossier is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making health decisions.
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