Peptide Update October 2026: What Congresses, Journals and Study Registries Reveal Anew

UBT251 comes from United Biotechnology (Hengqin), a subsidiary of the Chinese The United Laboratories (TUL), and activates - like Lilly's retatrutide - the receptors for GLP-1, GIP and glucagon simultaneously. Since March 2025, Novo Nordisk has held the rights outside mainland China, Hong Kong, Macau and Taiwan. On 8 Oct 2026, the Chinese Phase 2 study appeared peer-reviewed in Cell Metabolism: 205 adults with overweight or obesity without type 2 diabetes, randomized, double-blind, placebo-controlled, 24 weeks. The mean weight change was, depending on the study arm, -13.6 to -19.7% versus -2.0% with placebo (placebo-adjusted -11.5 to -17.7 percentage points); a plateau had, according to the manufacturer, not yet been reached by the end of the study. Already in September, the Phase 1 data had appeared in Diabetes, Obesity and Metabolism.

The assessment remains sober: the study was short, compared only with placebo, enrolled exclusively participants in China, and was sponsored by the manufacturer. In China, Phase 3 studies in obesity and in type 2 diabetes (UNIGUIDE-1 versus placebo, UNIGUIDE-2 versus semaglutide) have been running since September 2026; Novo Nordisk is testing the active substance internationally in Phase 1b/2a and Phase 2 studies, in part with centers in Germany. The Chinese diabetes data (presented at EASD 2026) so far exist only as a congress or company statement. UBT251 is approved in no country - we have created a full profile.

• Phase 2 obesity (China, 205 participants, 24 weeks): -13.6 to -19.7% versus -2.0% with placebo - peer-reviewed (Cell Metabolism, 8 Oct 2026).
• Phase 3 in China since September 2026 (obesity; type 2 diabetes UNIGUIDE-1/-2).
• Novo Nordisk: results of the global Phase 1b/2a study according to the company in the first half of 2027, Phase 3 start planned for mid-2027 (planning statements).
• Limits: short, China only, manufacturer-sponsored - a serious comparison with retatrutide or tirzepatide is not possible.

At the annual congress of the European Association for the Study of Diabetes (EASD) in late September 2026 in Milan, combinations with amylin agents took center stage. Eli Lilly presented Phase 2b data on EloraTZP, the combination of the selective amylin agonist eloralintide with tirzepatide: 367 adults with obesity or overweight and type 2 diabetes, 48 weeks. In the best combination arm, weight fell, according to the manufacturer, by up to 23.3% versus 14.8% with tirzepatide alone and 3.0% with placebo; HbA1c also fell more strongly. The downside: study discontinuations due to adverse effects were markedly more frequent in the combination arms than with tirzepatide alone (10.8 to 27.0% versus 2.9%). Lilly plans Phase 3 studies of a combined formulation by the end of 2026. All of this is manufacturer's information and congress data - a peer-reviewed publication is not yet available.

On the fixed combination CagriSema (cagrilintide plus semaglutide), Novo Nordisk presented at the Menopause Society congress two post-hoc analyses of the Phase 3 study REDEFINE 1. In 2,309 women, the mean weight loss after 68 weeks was 25.0% versus 3.0% with placebo; broken down by menopause status, 26.7% (premenopausal), 24.8% (perimenopausal) and 23.1% (postmenopausal). These analyses are exploratory and hypothesis-generating: menopause status was derived retrospectively, and a correction for multiple testing is lacking. An FDA decision on CagriSema remains pending; Novo Nordisk expects it in the 4th quarter of 2026.

• EloraTZP (eloralintide + tirzepatide): up to 23.3% versus 14.8% with tirzepatide alone - manufacturer's information/congress, preliminary; more discontinuations due to adverse effects.
• CagriSema in women: 25.0% versus 3.0% after 68 weeks (post hoc, congress contribution without peer review).
• CagriSema: FDA decision according to Novo Nordisk expected in the 4th quarter of 2026 - not yet approved.

For the MC4R agonist setmelanotide, the pivotal study TRANSCEND appeared in July 2026 in the New England Journal of Medicine: 120 people aged 4 to 66 years with acquired hypothalamic obesity, randomized, double-blind, 52 weeks. BMI fell by 16.5% with setmelanotide, while with placebo it rose by 3.3%; hunger also decreased more strongly. Adverse events were common (100% versus 90%, serious ones 28% versus 8%), above all hyperpigmentation, nausea, vomiting and headache. After the USA (March 2026), the EU approval now also covers this indication; in Japan it was approved on 24 Aug 2026.

There were also regulatory steps for further peptide agents: on 23 Sep 2026, the FDA approved Onswik (insulin efsitora alfa), the second weekly insulin for adults with type 2 diabetes. The EMA's CHMP recommended EU approval of glepaglutide (Zeydovio, GLP-2 analogue) in short bowel syndrome (17 Sep 2026) and of navepegritide (Yuviwel, CNP prodrug) in childhood achondroplasia (15 Oct 2026); added to this are three new pediatric indications for the weekly growth hormone somapacitan. CHMP recommendations are not yet approvals - the decision by the EU Commission usually follows only a few weeks later. In China, the GLP-1 agonist ecnoglutide has additionally been approved for weight management since March 2026, according to the manufacturer.

• Setmelanotide/TRANSCEND in the NEJM: BMI -16.5% versus +3.3% with placebo (52 weeks); approved in the USA, EU and Japan.
• FDA: Onswik as the second weekly insulin in type 2 diabetes (23 Sep 2026).
• CHMP recommendations: glepaglutide (short bowel syndrome), navepegritide (achondroplasia), somapacitan (three pediatric indications) - the EU Commission has yet to decide.
• China: ecnoglutide approved for weight management (manufacturer's information, March 2026).

Study registries such as ClinicalTrials.gov show early on where an active substance is heading - but they document plans, not results. Novo Nordisk now lists amycretin under the international nonproprietary name zenagamtide; on 6 Oct 2026, a large Phase 3 study on cardiovascular endpoints in people with cardiovascular disease and overweight was registered under the name AMBIENCE (not yet recruiting, completion estimated at 2030 according to the registry). Viking Therapeutics started the Phase 3 program SUNRISE for the tablet form of VK2735 on 14 Oct 2026 and reported in September a maintenance study in which less frequent administration held a large part of the previously achieved weight loss - a company topline with small study arms and an exploratory endpoint.

Two peptides still have to demonstrate their readiness for approval: for elamipretide (Forzinity), approved on an accelerated basis in the USA for Barth syndrome, the confirmatory study 4TAZPower (72 weeks, completion estimated at 2029) has been running since July 2026. For the GLP-2 analogue apraglutide, the confirmatory Phase 3 study STARS-2 required by the FDA has been recruiting since summer 2026, including with centers in Germany and Austria.

• Amycretin = zenagamtide (INN); cardiovascular endpoint study AMBIENCE registered.
• VK2735: Phase 3 SUNRISE (tablet) started; maintenance data so far only as a company topline.
• Elamipretide: confirmatory study 4TAZPower running; apraglutide: STARS-2 recruiting.
• Registry entries are plans - start and completion dates are estimates by the sponsors.

A correction of our own: in the autumn update of 9 Oct 2026, we described a study registered in September 2026 (NCT07803250) as - as far as discernible - the first randomized, placebo-controlled human study of BPC-157. That was wrong. As early as 2015, a randomized Phase 1 study was registered (NCT02637284, without published results), and since February 2026 a randomized, placebo-controlled Phase 2 study in thigh muscle strains has been recruiting in China (NCT07437547). This does not change the core message: as of 24 Oct 2026, results are available from no randomized study - the efficacy and safety of BPC-157 in humans are still not demonstrated. The article and profile have been corrected.

On the regulatory side, things remain in motion but without a decision: following the PCAC meeting of July 2026 on seven "wellness" peptides, the FDA has published neither an outcome nor an entry in the Federal Register; a further meeting (including on GHK-Cu, LL-37 and Melanotan II) is to take place before the end of February 2027. On 14 Oct 2026, the FDA submitted to the White House (OIRA) a still-unpublished document on an "Interim Access Policy" for the compounding of certain peptides for review - which peptides it concerns is officially open. In parallel, warnings are accumulating: warning letters to five online peptide dealers (August) and to two semaglutide online shops (September), Class II recalls of compounded GLP-1 products and sermorelin due to sterility defects (October), and in the United Kingdom the seizure of more than 12,000 counterfeit retatrutide and tirzepatide pens. The WADA Prohibited List 2027 now explicitly names peptides as examples of non-approved substances (S0).

• Correction: NCT07803250 was not the first BPC-157 RCT; still no RCT results.
• Section 503A: no FDA decision after the PCAC meeting; next meeting announced before the end of February 2027.
• FDA "Interim Access Policy" for peptide compounding under OIRA review - content unpublished, legal situation unchanged.
• Counterfeits and sterility defects: warning letters, Class II recalls, more than 12,000 counterfeit pens in Birmingham.
• WADA 2027: peptides explicitly as S0 examples; GLP-1 agonists still only in monitoring.