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A specimen of the Metabolic drawer Drawer A · Metabolic

Pemvidutide

Investigational

A dual GLP-1/glucagon receptor agonist developed by Altimmune showing 15.6% weight loss at 48 weeks with a high proportion of fat mass lost. Phase 2 trials completed for obesity (MOMENTUM) and MASH (IMPACT), with the IMPACT trial meeting its MASH-resolution primary endpoint (52% at 1.8 mg vs 20% placebo at 24 weeks). FDA Fast Track designation for MASH.

ALT-801 · GLP-1/Glucagon Dual Agonist

Research evidence
Moderate

12 human studies

Preclinical
29%
Clinical
43%

Based on 28 cited sources

Evidence Score75/100
Emerging / moderate
Research Depth88/100
Mechanism93/100
Plausibility88/100
Global Coverage49/100
Community Experience32/100
Effectiveness73/100

clinically demonstrated · moderate confidence

Demonstrated effect magnitude — not a recommendation or safety claim.

Research Depth 88: multiple double-blind placebo-controlled Phase 2b RCTs — IMPACT MASH (41237796, Lancet, n=212), MASLD 12-wk (39002641, J Hepatol, n=94) and 24-wk extension (41113119, JHEP Rep, n=64), plus MOMENTUM obesity — now topped by a GRADE-assessed meta-analysis of pemvidutide RCTs (41879841); total human N in the 300-1,000 band; direct population/route/outcome match; moderate pemvidutide-specific preclinical foundation (1E). 1B held mid-band (22) because the meta-analysis is single/recent and the fibrosis-improvement co-primary was not met at 24 wk. Mechanism 93: GLP-1R + GCGR are validated targets with functional and loss-of-function confirmation for the class (Finan triagonist KO/blockade 25485909), full target-to-effect pathway, and monotonic human dose-response (1.2/1.8/2.4 mg) plus in-vivo BAT thermogenesis (24917578). Plausibility 88: near-full mechanism->surrogate (liver fat, weight)->clinical (MASH resolution) chain, fully coherent with hepatic/ metabolic biology, multiple same-class analogues (survodutide, tirzepatide, retatrutide); minor deduction as fibrosis/hard outcomes not yet met and the claim spans several metabolic systems. Global Coverage 49: pivotal trials are Altimmune-sponsored (single sponsor) at US/Australia sites, but an independent meta-analysis and multi-country reviews exist; ~12 pemvidutide-specific studies; FDA Fast Track + trial registration (4D=5, not yet approved). Community Experience 32: niche, recent investigational use only, limited but broadly consistent reports, no recurring adverse signal. Effectiveness basis clinical (moderate): MOMENTUM 15.6% vs 2.3% placebo weight loss and IMPACT ~52-58% vs 20% placebo MASH resolution far exceed their MCIDs (large effect), but evidence is Phase 2b, single-sponsor, with the fibrosis co-primary missed at 24 wk and no head-to-head vs resmetirom.

Scored June 2026 How we rate →
~
Evidence Level
moderate
Not approved for human use by any regulatory agency
Limited human clinical trial data
Consult a healthcare provider before use
Not FDA Approved WADA Prohibited
Identity
SCALE · 1:1 N-TERMINUS C-TERMINUS 30 AA · ~7,000 Da (with PEG)
Also Known As
ALT-801 • GLP-1/Glucagon Dual Agonist
Class
Pegylated peptide
Length
30 amino acids
Mol. weight
~7,000 Da (with PEG)
Sequence
Proprietary (GLP-1/glucagon hybrid)
Molecular Structure
H
A
E
G
T
F
T
S
D
V
Hydrophobic
Polar
Positive
Negative

The mechanisms of pemvidutide are well-characterized through Phase 2b clinical trials and extensive preclinical research on GLP-1/glucagon dual agonism.

How It Works (Simplified)

Pemvidutide activates TWO hormone receptors simultaneously for enhanced metabolic effects:

GLP-1 receptor activation in the brain signals satiety, reducing hunger and caloric intake naturally.

Liver Fat Burning

Glucagon receptor activation directly tells liver cells to oxidize fat, reducing steatosis and improving MASH.

Metabolic Boost

Glucagon increases energy expenditure and thermogenesis, burning more calories at rest.

Muscle Preservation

Balanced dual agonism preferentially targets fat stores, preserving 78% fat mass loss vs typical 65-70%.

Key Research: MOMENTUM (NCT05295875) and IMPACT (NCT05989711) Phase 2 trials demonstrated consistent efficacy. [Altimmune 2024]

Important Limitations

  • Phase 2b data only; Phase 3 confirmatory trials pending
  • No head-to-head comparisons with approved agents
  • Type 2 diabetes population not yet studied
  • Long-term safety and durability beyond 48 weeks unknown
  • All trials sponsored by single company (Altimmune)
i. GLP-1 Receptor Pathway · Appetite & Insulin
PemvidutideGLP-1R activationBrain (hypothalamus): Satiety ↑Pancreas: Insulin secretion ↑GI tract: Gastric emptying delayed
ii. Glucagon Receptor Pathway · Liver & Metabolism
PemvidutideGCGR activationLiver: Fat oxidation ↑, lipogenesisAdipose: Lipolysis ↑, thermogenesis ↑Energy expenditure: 10-15% increase
Mechanism GLP-1 receptor agonism reducing appetite and slowing gastric emptying
Established 12 direct studies
Benefit shown to reduce body weight through decreased caloric intake
Evidence Level
High
4 Human
6 Animal
2 In Vitro
Mechanism Glucagon receptor agonism promoting hepatic lipid oxidation
Established 8 direct studies
Benefit shown to reduce liver fat content and resolve MASH
Evidence Level
High
2 Human
4 Animal
2 In Vitro
Mechanism Balanced dual agonism preferentially targeting fat stores via glucagon-driven lipolysis
Supported 4 direct studies
Benefit appears to preserve lean muscle mass during weight loss
Evidence Level
Moderate
2 Human
2 Animal
Mechanism Glucagon-mediated increase in energy expenditure and thermogenesis
Supported 5 direct studies
Benefit may increase metabolic rate
Evidence Level
Moderate
1 Human
4 Animal
2 In Vitro
Mechanism Confidence
Established
Supported
Emerging
Evidence Level
High
Moderate
Low
Very Low
Phase 01 1
Week 1-4

Titration phase beginning at 0.6mg weekly. Initial appetite suppression and satiety effects. Common GI side effects (nausea, diarrhea) typically most pronounced during this period but improve with continued use.

NCT05295875
Phase 02 2
Week 4-12

Dose escalation to maintenance dose (1.8-2.4mg). Progressive weight loss averaging 1-2% body weight per month. Liver fat reduction begins. GI tolerability improves.

NCT05295875
Phase 03 3
Week 12-24

Sustained weight loss reaching approximately 10% at 24 weeks with 1.8mg dose. Significant improvements in liver enzymes. Metabolic parameters (lipids, blood pressure) show measurable improvement.

NCT05295875
Phase 04 4
Week 24-48

Continued weight loss to 15.6% at 48 weeks in the obesity trial. In the separate IMPACT MASH trial, MASH resolution without fibrosis worsening was observed in 52% of patients at 1.8 mg (vs 20% placebo) by the 24-week biopsy; the co-primary fibrosis-improvement endpoint was not met at 24 weeks. Weight loss trajectory not yet plateaued, suggesting further benefit with extended treatment.

NCT05989711

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 (5 indicators)
Manufactured under GMP conditions for clinical trials
Clear, colorless solution in prefilled syringe or vial
Proper cold chain storage (refrigerated 2-8°C)
Within expiration date with proper lot documentation
No visible particulates or discoloration
Warning Signs (3 indicators)
Storage outside recommended temperature range
Approaching expiration date
Minor cloudiness that clears on gentle swirling
Bad Signs (5 indicators)
Visible particles or precipitate in solution
Yellow or brown discoloration
Frozen product (may damage peptide structure)
Compromised packaging or broken seals
Sourced outside regulated clinical trial or pharmacy
Positive quality indicator
Requires evaluation
Potential quality issue

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.

Synergistic
Compatible
Caution
Avoid

Different mechanisms of action. BPC-157 focuses on tissue repair while pemvidutide targets metabolic pathways. No known contraindications.

Non-overlapping mechanisms. TB-500 targets tissue repair and cell migration while pemvidutide modulates metabolic function. No interaction data available.

Both target GLP-1 receptors. Co-administration would result in overlapping mechanisms with potential for increased GI side effects. Not recommended to combine.

Both are incretin-based dual agonists targeting overlapping receptor systems. Combining would create redundant and potentially dangerous receptor overstimulation.

Both are GLP-1/glucagon dual agonists with nearly identical mechanisms. No rationale for combination; risk of adverse effects from receptor overstimulation.

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.

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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