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Study summary · research use only

Mazdutide versus placebo in Chinese adults with type 2 diabetes

RCT · human · Nature · 2026 · DOI 10.1038/s41586-025-10026-w · PMID 41407859

Plain-language summary

Paraphrased from the published abstract below — not a verdict on whether anything works.

This phase 3 human trial in Chinese adults with type 2 diabetes (T2D) randomized 320 participants (mean HbA1c 8.24%, BMI 28.2 kg/m2, T2D duration 1.9 years) 1:1:1 to weekly subcutaneous mazdutide 4 mg, mazdutide 6 mg, or placebo for 24 weeks, followed by a 24-week extension of mazdutide. At week 24, HbA1c changed by -1.57% (4 mg) and -2.15% (6 mg) versus -0.14% (placebo, both p<0.0001), and weight changed by -5.61% (4 mg) and -7.81% (6 mg) versus -1.26% (placebo, both p<0.0001). More participants receiving mazdutide reached HbA1c <7.0%, weight loss ≥5%, and the composite endpoint than placebo. The most common adverse events were diarrhoea, decreased appetite, and nausea, described as consistent with the GLP-1R agonist class.

Abstract

Despite advances in type 2 diabetes (T2D) management, unmet needs remain for therapies that effectively control hyperglycaemia while addressing comorbid metabolic disorders1,2. Here we assessed the efficacy and safety of the dual glucagon receptor (GCGR)/glucagon-like peptide-1 receptor (GLP-1R) agonist mazdutide monotherapy versus placebo in Chinese adults with T2D controlled inadequately with diet and exercise alone. In this phase 3 trial, 320 participants (mean glycated haemoglobin A1c (HbA1c) of 8.24%, body mass index of 28.2 kg m-2 and diabetes duration of 1.9 years) were randomized 1:1:1 to receive weekly subcutaneous injections of mazdutide (4 mg or 6 mg) or placebo for 24 weeks, followed by a 24-week extended mazdutide treatment. At week 24, mazdutide significantly reduced HbA1c versus placebo (primary endpoint): -1.57% with mazdutide 4 mg and -2.15% with mazdutide 6 mg, versus -0.14% with placebo, with treatment differences of -1.43% and -2.02% (both P < 0.0001). Weight loss from baseline at week 24 occurred with -5.61% (4 mg) and -7.81% (6 mg) versus -1.26% (placebo) (both P < 0.0001). Furthermore, more participants with mazdutide achieved HbA1c < 7.0%, weight loss ≥ 5% (all P < 0.0001) and composite endpoints (HbA1c < 7.0% and weight loss ≥ 5%) versus placebo (P = 0.0006 for 4 mg; P < 0.0001 for 6 mg) at week 24. The most common adverse events-diarrhoea, decreased appetite and nausea-were consistent with GLP-1R agonists. These results establish mazdutide monotherapy as an effective intervention providing clinically meaningful glycaemic control and weight reduction alongside a favourable safety profile in this population.

Read the full study on PubMed ↗

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