The liver-first glucagon dual that fights the muscle-loss problem — and the small biotech betting on differentiation. Pemvidutide (Altimmune) closes the register's GLP-1/glucagon dual cluster with a distinctive strategy and a strong story. Three threads: (1) it's a balanced 1:1 glucagon/GLP-1 agonis
Pemvidutide (Altimmune's ALT-801) is a once-weekly, balanced 1:1 glucagon/GLP-1 dual agonist — and it closes the register's glucagon-dual cluster with a distinctive liver-first identity. Where most obesity drugs lead with GLP-1, pemvidutide leans on glucagon's direct liver effects (cutting liver fat, inflammation, fibrosis) to target MASH, with weight loss as the GLP-1-driven partner effect — earning FDA Breakthrough Therapy status for MASH. Its most compelling data is body composition: in the MOMENTUM Phase 2, ~15.6% weight loss was ~78% fat, only ~22% lean mass — class-leading muscle preservation that speaks directly to the GLP-1 era's muscle-loss worry. But it's also a small-biotech-vs-giants story with real volatility: its MASH trial showed MASH resolution and fibrosis improvement, yet an earlier primary-endpoint miss and analyst verdicts of "non-differentiating" weight loss hit the stock. The honest read: a mechanistically differentiated, muscle-sparing, liver-focused dual with Breakthrough status and a Phase 3 ahead — genuinely distinctive, but facing hard questions about whether its magnitude stands out in a crowded field. Its differentiation is strategy (liver + muscle), not headline weight number.
investigational; not approved. Phase 2/2b complete; Phase 3 (PERFORMA, MASH) planned H2 2026. FDA Fast Track + Breakthrough (MASH) — advanced, well-validated program, but not yet approved.
An honest grade per outcome — drawn from the evidence, not any catalogue. Hype and undemonstrated marketing claims grade low.
A credentialed reviewer (PharmD / PhD / MD) will be named before this entry is finalised. Until then, treat it as a working draft. Last updated July 2026 (PERFORMA Phase 3 MASH H2 2026, end-of-Phase-2 FDA meeting, and AUD/ALD readouts are the catalysts — and the test of whether liver/muscle differentiation beats raw-magnitude competition).
Grades reflect the published evidence, not our interest. No dosing, reconstitution, or administration is published for research compounds — that restraint is deliberate.
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