Head to head
Cotadutide against Survodutide
Two GLP-1 and glucagon dual agonists developed for overlapping metabolic and liver indications. Their development paths diverged, which is the useful part of the comparison, since it shows how much of a class outcome is decided by sponsor decisions rather than by mechanism.
Column A
CotadutideCotadutide (MEDI0382), GLP-1 and glucagon receptor dual agonist
A once-daily GLP-1 and glucagon dual agonist that AstraZeneca stopped developing in 2023 for what its own registry entries call strategic pipeline considerations, not safety. It leaves a randomised human record of more than a thousand people across phase 2 trials in type 2 diabetes, kidney disease and biopsy-proven MASH, and it never reached phase 3.
Column B
SurvodutideSurvodutide (GLP-1 / glucagon dual agonist)
An investigational once-weekly GLP-1 and glucagon receptor dual agonist studied for obesity and metabolic liver disease.
Side by side, on the facts we can check
| Attribute | Cotadutide | Survodutide |
|---|---|---|
| Category | Metabolic | Metabolic |
| FDA status | Never approved anywhere. Development discontinued by AstraZeneca in early 2023 for stated strategic pipeline reasons (ClinicalTrials.gov NCT05668936 and NCT05517226). No phase 3 was registered. | Investigational, not FDA-approved |
| Half-life | Not reported | ~6 days |
| Molecular weight | Not reported | ~4,900 Da |
| Mechanism | In people, cotadutide's GLP-1 receptor action produces the familiar effects of the class: enhanced insulin secretion after meals, slower gastric emptying and reduced food intake. A 65 person phase 2a trial found postprandial glucose area under the curve fell 21.5 percent against a 6.3 percent rise on placebo, postprandial insulin rose, and gastric emptying half-time lengthened by about two hours. A 19 person energy balance study found weight loss was accounted for by a 41.3 percent reduction in energy intake with no meaningful change in energy expenditure by doubly labelled water. The glucagon receptor component is what distinguished it. In a randomised phase 2a with magnetic resonance spectroscopy, cotadutide reduced postprandial and fasting liver glycogen and liver fat more than both placebo and liraglutide, which the investigators interpreted as direct glucagon receptor action on the human liver promoting glycogenolysis. Glucagon receptor agonism also raises energy expenditure and hepatic fat oxidation in animals, and the mouse study most cited for cotadutide's liver effects (Nature Metabolism, 2020) found that its weight and glucose effects were mediated mainly through GLP-1 signalling while its effects on liver lipid, glycogen flux and mitochondrial turnover ran through the glucagon receptor, with greater fibrosis reduction than liraglutide or obeticholic acid at matched weight loss. That paper is animal work in mouse models of steatohepatitis and has been miscited as a human trial; it is not one. | Agonizes both GLP-1 and glucagon receptors, combining appetite suppression and improved glucose handling with increased energy expenditure and hepatic fat reduction. |
| Human studies cited | 8 | 3 |
| Legal status, US | Investigational, not approved | Investigational, not approved |
Frequently asked questions
What is the difference between Cotadutide and Survodutide?
Cotadutide: A once-daily GLP-1 and glucagon dual agonist that AstraZeneca stopped developing in 2023 for what its own registry entries call strategic pipeline considerations, not safety. It leaves a randomised human record of more than a thousand people across phase 2 trials in type 2 diabetes, kidney disease and biopsy-proven MASH, and it never reached phase 3. Survodutide: An investigational once-weekly GLP-1 and glucagon receptor dual agonist studied for obesity and metabolic liver disease.
Which has stronger research evidence, Cotadutide or Survodutide?
This database does not grade compounds. It counts what was run in people: 8 of the 10 studies cited on the Cotadutide profile were human work, against 3 of 3 for Survodutide. Those counts are of our own citation lists and understate any larger literature, and neither is a recommendation.
Are Cotadutide and Survodutide FDA-approved?
Cotadutide: Never approved anywhere. Development discontinued by AstraZeneca in early 2023 for stated strategic pipeline reasons (ClinicalTrials.gov NCT05668936 and NCT05517226). No phase 3 was registered.. Survodutide: Investigational, not FDA-approved.
Reviewed Sep 2026. This page sets two published records side by side. It is educational, it is not medical advice, and it contains no dosing protocols or recommendations for personal use.