Zealand Pharma Advances Petrelintid to Phase 3 Trials After Second Phase 2 Success in Obesity and Type 2 Diabetes
Zealand Pharma achieved the primary endpoint in the Phase 2 ZUPREME-2 clinical trial with its investigational drug candidate petrelintid, according to data published on October 7, 2026. Participants receiving petrelintid across three dosage arms achieved an average body weight reduction of 7,4–9,2 %, compared to a 2.0% reduction in the placebo group.
Glycemic Control and HbA1c Reductions Recorded in ZUPREME-2 Trial
Beyond weight loss, the 28-week trial measured changes in glycemic control among the diabetic participants. The placebo-adjusted reduction in long-term blood sugar levels, measured by HbA1c, ranged from 0.61 to 0.88 percentage points across the active treatment arms. In contrast, participants in the placebo group experienced a 0.23% increase in HbA1c levels over the same period. Zealand Pharma announced plans to present the complete ZUPREME-2 results at an upcoming medical conference.
Safety Profile and Discontinuation Rates Across Treatment Arms
Safety evaluations showed no unexpected signals during the course of the trial. Early treatment discontinuation resulting from gastrointestinal side effects occurred in 1.9% of the participants treated with petrelintid, compared to 1.7% in the placebo group. These findings align with safety and efficacy trends observed in the preceding Phase 2 ZUPREME-1 trial, which tested petrelintid over longer evaluation periods.
In the ZUPREME-1 study, participants taking petrelintid achieved a 7,9–9,8 % weight loss at 28 weeks, compared to 1.7% for placebo. By 42 weeks, weight loss in the active treatment groups reached 8,7–10,7 %. Between 34–56% of treated patients lost at least 10% of their body weight at 42 weeks, versus 9% in the placebo group. Nausea occurred in 20% of petrelintid-treated patients in ZUPREME-1, compared to 6% on placebo, with 1% permanently discontinuing treatment due to gastrointestinal events.
Expansion of Clinical Development Program With Roche
Building on the Phase 2 findings, Zealand Pharma is advancing the clinical development of petrelintid in partnership with Roche. The companies plan to initiate a Phase 3a program consisting of three separate clinical trials. This upcoming late-stage development phase is expected to enroll approximately 7,000 participants in total.
Frequently Asked Questions About the Petrelintid Trials
What is petrelintid and how does it work?
Petrelintid is an investigational drug candidate developed by Zealand Pharma for the treatment of metabolic disorders, including overweight, obesity, and type 2 diabetes. Clinical trials such as ZUPREME-2 evaluate its efficacy in reducing body weight and improving glycemic control over a 28-week treatment period.
How many participants were involved in the ZUPREME-2 study?
The Phase 2 ZUPREME-2 trial enrolled 220 participants in the United States who suffered from overweight or obesity and type 2 diabetes. The study tested three different dosage arms of petrelintid against a placebo group.
What are the next steps for Zealand Pharma and Roche?
Zealand Pharma and its partner Roche are preparing to launch a Phase 3a clinical development program. This next phase will encompass three separate studies involving an estimated 7,000 participants.