Efinopegdutide vs Semaglutide
Written by Aaron CuhaReviewed Sep 2026
The short answer
A drug that hits both the GLP-1 and glucagon switches, against one that hits only GLP-1. They were tested head to head on liver fat, not on weight. This pair is here because the result pulls apart two things that usually move together with these drugs. The liver effect was far bigger, while the weight gap was too small to count. That is what shows the glucagon part doing its own work.
- Efinopegdutide people
- 145
- Efinopegdutide nulls
- 1
- Semaglutide people
- 42,363
- Semaglutide nulls
- 2
Dose
No human dose established
Amounts that were given in studies sit in Human evidence on this page. None of them is a personal dose.
1 completed trial, 145 people given it
Dose
Approved titration: 0.25, 0.5, 1, 1.7 and 2.4 mg
0.25, 0.5, 1, 1.7 and 2.4 mg
The approved semaglutide ladder, in mg.
First-hand reports are counted on each profile and never added together. This page sets two published records side by side. It does not pick a winner.
Column A
EfinopegdutideEfinopegdutide (MK-6024), GLP-1 and glucagon receptor dual agonist
In a head-to-head test against semaglutide, it cut liver fat by 72.7 percent against 42.3 percent. Weight loss was about the same. Adding glucagon seems to do something to the liver that GLP-1 alone does not.
Column B
SemaglutideSemaglutide (GLP-1 receptor agonist)
A once a week shot for type 2 diabetes and weight loss. It is approved, and big studies show it also lowers the risk of heart attack and stroke.
These two were tested against each other in the same trial
One trial gave people each of them. This is not us lining up two separate records.
Liver fat fell 72.7 percent on efinopegdutide, against 42.3 percent on semaglutide. That gap was clear. Body weight fell 8.5 percent against 7.1 percent, and that gap was too small to count as a real difference. Side effects were slightly more common on efinopegdutide, mostly stomach and gut problems.
What the trial was
An early trial. Everyone knew which drug they were on. 145 people with fatty liver disease, not caused by alcohol, and liver fat of 10 percent or more on an MRI scan. They were split evenly between efinopegdutide 10 mg and semaglutide 1 mg a week for 24 weeks. Both doses were stepped up over eight weeks, and people with and without type 2 diabetes were spread evenly across the groups. The main measure was how much liver fat dropped by week 24. On average people started with a BMI of 34.3 and liver fat of 20.3 percent, and 33.1 percent had type 2 diabetes.
What the authors concluded
The authors state that efinopegdutide cut liver fat clearly more than semaglutide. They put it down to the glucagon part acting on the liver directly, making it burn more fat and make less new fat. That comes on top of the knock on effect of weight loss.
Where this result is weak
The semaglutide dose is the thing to notice. Semaglutide 1 mg is a type 2 diabetes dose, well below the 2.4 mg approved for obesity. So this is not a test against semaglutide at its strongest. Everyone knew which drug they got, which matters less for an MRI scan than for how people say they feel. And liver fat is a warning marker. It predicts risk, but it is not scarring, cirrhosis or death, and 145 people over 24 weeks could not measure any of those.
Phase IIa active-comparator study (NCT04944992), Journal of Hepatology, 2023
Side by side, on the facts we can check
| What we compare | Efinopegdutide | Semaglutide |
|---|---|---|
| Category | Metabolic | Metabolic |
| FDA status | Investigational. Not approved. Merck holds the rights. It came from Hanmi, and earlier went by Johnson and Johnson and Hanmi code names. | FDA-approved (Ozempic and Rybelsus for type 2 diabetes; the Wegovy shot, the Wegovy pill approved Dec 2025, and Wegovy HD 7.2 mg approved Mar 2026 for weight management) |
| Half-life | Long-acting, dosed once weekly by subcutaneous injection. No specific half-life figure was resolved in the sources loaded. | ~7 days |
| Molecular weight | Peptide conjugated to a long-acting carrier. No mass asserted; no source loaded states one. | 4,113.6 Da |
| How it works | It acts on two hormone receptors at once: GLP-1 and glucagon. It is built on a long-lasting carrier, so one shot lasts a week. The GLP-1 part cuts appetite and helps blood sugar, the usual way. The glucagon part makes the liver burn more fat and make less new fat. It also raises how much energy the body burns. That is how it is meant to clear liver fat. Glucagon can push blood sugar up, which is why these drugs are balanced so the glucagon part does not dominate. | It switches on the GLP-1 receptor, a switch on cells that normally answers a gut hormone after you eat. That makes the body release insulin when blood sugar is high. It holds back glucagon, a hormone that raises blood sugar. It slows how fast the stomach empties. It also acts on the part of the brain that runs hunger, so people eat less. |
| Studies in people | 3 | 15 |
| Evidence | Moderate: 1 completed trial, 145 people given it | Strong: 12 completed trials, 42,363 people given it |
| Legal status, US | Investigational, not approved | FDA-approved, prescription only |
Frequently asked questions
What is the difference between Efinopegdutide and Semaglutide?
Efinopegdutide: In a head-to-head test against semaglutide, it cut liver fat by 72.7 percent against 42.3 percent. Weight loss was about the same. Adding glucagon seems to do something to the liver that GLP-1 alone does not. Semaglutide: A once a week shot for type 2 diabetes and weight loss. It is approved, and big studies show it also lowers the risk of heart attack and stroke.
Which has stronger research evidence, Efinopegdutide or Semaglutide?
Each compound gets a band worked out from facts we counted, with the math shown. Efinopegdutide is Moderate (1 completed trial, 145 people given it). Semaglutide is Strong (12 completed trials, 42,363 people given it). That counts how much has been done in people. It does not rate whether either one works, and neither one is called the winner.
Are Efinopegdutide and Semaglutide FDA-approved?
Efinopegdutide: Investigational. Not approved. Merck holds the rights. It came from Hanmi, and earlier went by Johnson and Johnson and Hanmi code names.. Semaglutide: FDA-approved (Ozempic and Rybelsus for type 2 diabetes; the Wegovy shot, the Wegovy pill approved Dec 2025, and Wegovy HD 7.2 mg approved Mar 2026 for weight management).
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Reviewed Sep 2026. This page puts two published records side by side. It is for learning, and it is not medical advice. When this site shows a dose, it is the dose a trial or a clinic actually used, or what people say they did, with the source attached. None of it tells you what to take.