Novo Nordisk has announced positive Phase II results for zenagamtide, an investigational once-weekly subcutaneous therapy for adults with type 2 diabetes (T2D).

The development demonstrates statistically significant improvements in both blood glucose control and body weight compared with placebo.

The findings were presented at the American Diabetes Association (ADA) Scientific Sessions 2026 and support the advancement of zenagamtide into Phase III clinical development later this year. 

The randomized, double-blind, placebo-controlled dose-finding study evaluated six dose levels of zenagamtide ranging from 0.4 mg to 40 mg in 262 adults with type 2 diabetes whose condition was inadequately controlled on metformin, with or without a sodium-glucose cotransporter-2 (SGLT2) inhibitor.

The trial achieved its primary endpoint, with all dose groups demonstrating significant reductions in glycated haemoglobin (HbA1c) after 36 weeks of treatment. The greatest reduction was observed in the 40 mg group, where HbA1c declined by an estimated 1.71%, compared with a 0.14% reduction in the placebo arm.

The study also reported strong glycaemic control outcomes, with up to 89.1% of participants receiving zenagamtide achieving HbA1c levels below 7%, while up to 76.2% reached HbA1c levels of 6.5% or lower. Participants across all dose groups spent more than 70% of their time within the target glucose range, reaching as high as 91.4% in the highest-dose cohort. 

For the key secondary endpoint, zenagamtide demonstrated substantial weight-loss benefits. Participants receiving the 40 mg dose experienced an average body weight reduction of up to 14.6% from a baseline weight of 99.2 kg, compared with a 2.1% reduction among placebo recipients. Researchers noted that no weight-loss plateau was observed at the highest doses tested.

The study employed a fixed-dose escalation design, and the most commonly reported adverse events were gastrointestinal in nature, generally mild to moderate in severity. The overall safety profile was consistent with that observed for other therapies within the same treatment class.

Based on the encouraging results, Novo Nordisk plans to initiate Phase III clinical trials of zenagamtide in adults with type 2 diabetes during the second half of 2026.

Martin Holst Lange, Executive Vice President and Chief Scientific Officer, Research & Development, Novo Nordisk, said, “These Phase II results build on the growing body of evidence, which demonstrates the potential of zenagamtide to meaningfully impact blood glucose control in patients with type 2 diabetes and also body weight in people living with obesity..”

“These results underscore our scientific leadership and position us to continue advancing innovative treatment options that could expand the therapeutic landscape and provide patients and healthcare professionals with greater choice in managing type 2 diabetes and obesity,” Lange added further.