GLP-1/glucagon agonist · fatty liver
An experimental injectable peptide from Altimmune that activates two hormone receptors: the GLP-1 receptor, which curbs appetite, and the glucagon receptor, which acts directly on the liver. It is being developed mainly for metabolic dysfunction-associated steatohepatitis (MASH), an inflammatory form of fatty liver disease, and has also been studied in obesity and alcohol-associated liver disease.
Pemvidutide is a dual agonist. Its GLP-1 receptor activity reduces appetite through effects in the brain and gut, which leads to weight loss. Its glucagon receptor activity acts directly on liver cells, where it stimulates the burning of fatty acids and inhibits the making of new fat1,3. The developers' rationale is that this direct liver action may clear liver fat more strongly than weight loss alone, which matters because excess liver fat is thought to drive the inflammation and scarring of MASH1. Whether this leads to less liver scarring and better clinical outcomes over time is what longer trials, including a phase 3 study, are designed to answer2,5.
All registered trials are sponsored by its developer, Altimmune. In a 12-week randomized trial of 94 adults with overweight or obesity and fatty liver disease, liver fat measured by MRI fell by roughly 47% to 69% across three dose levels versus 4% on placebo, alongside modest weight loss and lower liver-enzyme levels1.
In a 12-week extension with 64 of them, reductions reached about 56% to 76% and body weight fell about 6% at 24 weeks3. The phase 2b IMPACT trial randomized 212 adults with biopsy-confirmed MASH and moderate or advanced fibrosis: at 24 weeks, MASH resolved without worsening fibrosis in 52% to 58% on pemvidutide versus 20% on placebo, but the second main goal, fibrosis improvement, was not met2.
A 391-person phase 2 obesity trial was completed in 2023 without results posted on the registry4; a phase 3 MASH trial began recruiting in 20265, and a phase 2 trial in alcohol-associated liver disease is under way6.
Not approved by the FDA or any other regulator; it remains an investigational drug.
In the 12-week fatty liver study it was well tolerated, with no severe or serious adverse events1. In the 24-week extension, nausea was most common, affecting about a third of those on the drug, mostly mildly or moderately; a few had diarrhea or constipation, and three stopped treatment because of adverse events3.
In IMPACT, adverse events occurred in 78% to 81% on pemvidutide versus 67% on placebo, mostly mild or moderate, and one person on the drug stopped because of them2. Long-term data are lacking.
This page is educational reference material about compounds studied in research settings. It is not medical advice, and nothing here is a recommendation to buy, possess, or use any compound. Research findings described are from published literature; individual compounds may not be approved for human use. Talk to a licensed clinician about anything that affects your health.
Brand names on this page belong to their owners and are used only to identify a product. goodtides is not affiliated with those companies.