Skip to content
phase 2Weight Loss & Diabetes

Pemvidutide

Also known as: ALT-801, Altimmune GLP-1/glucagon

Pemvidutide is a once-weekly GLP-1/glucagon receptor dual agonist developed by Altimmune for obesity and metabolic-associated steatotic liver disease (MASLD/MASH). Unlike balanced GLP-1/glucagon agonists, pemvidutide has a glucagon-biased activity ratio, emphasizing energy expenditure increase and hepatic fat mobilization. Phase 2 MOMENTUM trial showed up to 10.3% weight loss at 48 weeks with significant liver fat reduction, positioning it as a potential treatment for MASH with associated obesity.

4 cited references·5 researched benefits

Quick Answer

Pemvidutide (ALT-801) is a once-weekly injectable GLP-1/glucagon dual receptor agonist developed by Altimmune with glucagon-biased activity. Phase 2 MOMENTUM trial demonstrated up to 10.3% body weight loss and approximately 56% reduction in liver fat at 48 weeks. This glucagon-predominant design specifically targets hepatic lipid metabolism, positioning pemvidutide as a potential treatment for both obesity and metabolic-associated steatotic liver disease (MASLD/MASH).

Key Facts

Mechanism
Pemvidutide is an engineered peptide dual agonist with preferential glucagon receptor activity over GLP-1 receptor activity. The glucagon-biased design prioritizes hepatic metabolic effects: enhanced hepatic fatty acid oxidation, increased ketogenesis, stimulated energy expenditure through thermogenesis, and mobilization of liver fat stores. The GLP-1 component provides appetite suppression through hypothalamic satiety signaling and counters glucagon's hyperglycemic potential through glucose-dependent insulin secretion. This glucagon-forward approach distinguishes pemvidutide from balanced dual agonists, theoretically offering superior liver fat reduction at the cost of somewhat less appetite suppression.
Research Status
phase 2
Half-Life
~60–70 hours
Primary Use
Weight Loss & Diabetes
Table of Contents

Benefits

  • Liver fat reduction — approximately 56% reduction in hepatic fat fraction in phase 2, relevant for MASLD/MASH treatmentmoderate
  • Weight loss — up to 10.3% body weight reduction at 48 weeks in phase 2 MOMENTUM trialmoderate
  • Glucagon-biased mechanism — preferential hepatic metabolic effects through enhanced fatty acid oxidation and thermogenesismoderate
  • Liver biomarker improvements — significant reductions in ALT, AST, and other hepatic inflammation markersmoderate
  • Lipid improvements — reductions in triglycerides and improvements in lipid profile beyond weight loss alonepreliminary

Dosage Protocols

RouteDosage RangeFrequencyNotes
Subcutaneous injection1.2–2.4 mgOnce weeklyPhase 2 MOMENTUM trial tested 1.2 mg and 1.8 mg weekly doses with dose escalation. Higher doses (2.4 mg) being explored in ongoing studies. Administered as a single subcutaneous injection.

Medical disclaimer

Dosage information is provided for educational reference only. Always follow your prescriber's instructions and consult a qualified healthcare provider before starting any peptide protocol.

Side Effects

  • Nausea — most common adverse event (25–35%), typically mild to moderate and transientcommon
  • Diarrhea — gastrointestinal effects in 10–15% of patientscommon
  • Vomiting — reported in 8–12% during dose titrationcommon
  • Heart rate increase — modest elevation consistent with GLP-1 RA class effectrare
  • Transient blood glucose elevations — potential glucagon-mediated hyperglycemia, particularly in patients with impaired glucose tolerancerare

Frequently Asked Questions

What makes pemvidutide different from other GLP-1/glucagon dual agonists?
Pemvidutide is glucagon-biased, meaning it has relatively stronger glucagon receptor activation compared to GLP-1 activation. Other dual agonists like survodutide and mazdutide aim for more balanced activity. This glucagon-forward design prioritizes hepatic metabolic effects (liver fat reduction, increased energy expenditure) over appetite suppression, which may make pemvidutide particularly suited for MASH treatment rather than pure weight loss. The trade-off may be somewhat less weight loss compared to GLP-1-balanced competitors.
What is MASH and why is liver fat reduction important?
MASH (metabolic dysfunction-associated steatohepatitis, formerly NASH) is a progressive liver disease affecting approximately 5–8% of US adults, characterized by liver fat accumulation with inflammation and fibrosis that can progress to cirrhosis and liver failure. Reducing liver fat is the primary therapeutic target. Pemvidutide's 56% liver fat reduction in phase 2 is clinically meaningful and compares favorably with resmetirom (the first FDA-approved MASH therapy) and other GLP-1/glucagon agonists in development.
What were the MOMENTUM trial results?
MOMENTUM was pemvidutide's phase 2 randomized, placebo-controlled trial in adults with overweight/obesity. At 48 weeks, the 1.8 mg dose achieved 10.3% placebo-adjusted weight loss, with 57% of patients achieving ≥10% weight loss. Liver fat (measured by MRI-PDFF) was reduced by approximately 56%. Liver enzyme levels normalized in most patients with elevated baseline values. GI side effects were manageable with dose titration. These results supported advancement to phase 2b for MASH.
When might pemvidutide be available?
Pemvidutide is currently in phase 2 for obesity and MASH. Assuming positive phase 2b results and successful phase 3 initiation, the earliest FDA approval would likely be 2028–2029. Altimmune is a smaller biotech company compared to Novo Nordisk and Eli Lilly, which may affect development speed and commercial scale-up. Partnership or acquisition by a larger pharmaceutical company could accelerate the timeline.
How does pemvidutide compare to resmetirom for MASH?
Resmetirom (Rezdiffra) is a thyroid hormone receptor beta agonist — the first FDA-approved drug specifically for MASH. It targets liver fat through a different mechanism (enhanced hepatic lipid metabolism via thyroid receptor activation). Pemvidutide addresses both liver fat (via glucagon) and obesity (via GLP-1), potentially treating the metabolic root cause. They target different patient populations and could potentially be complementary. Direct comparisons are not available.

References

  1. 1
    Pemvidutide, a GLP-1/glucagon dual receptor agonist, for weight loss and liver fat reduction: phase 2 MOMENTUM results(2023)
  2. 2
    Glucagon-biased dual GLP-1/glucagon agonists for NASH: preclinical rationale and early clinical evidence(2022)PubMed ↗
  3. 3
    GLP-1/glucagon co-agonism as a novel therapeutic approach for metabolic liver disease(2021)PubMed ↗
  4. 4
    The role of glucagon in hepatic lipid metabolism and therapeutic implications for MASH(2022)PubMed ↗

Latest Research

Last updated: 2026-02-19