Survodutide (BI 456906)

Identity an investigational peptide engineered for weekly subcutaneous dosing via a fatty-acid albumin-binding strategy (the same long-acting trick as semaglutide and tirzepatide). Developed by Boehringer Ingelheim in partnership with Zealand Pharma. Its defining feature is which two receptors it hits: GLP-1 and glucagon — deliberately not GIP. ## Mechanism (as proposed) survodutide co-activates two receptors. The GLP-1 arm does the familiar work: suppresses appetite, slows gastric emptying, improves glycaemia. The glucagon (GCGR) arm is the differentiator: although glucagon is classically a counter-regulatory hormone that raises blood sugar, deliberately activating its receptor increases hepatic energy expenditure (the liver burns more calories processing nutrients — a thermogenic effect) and directly promotes liver fat oxidation (breaking down stored hepatic fat). The GLP-1 component is needed partly to offset glucagon's glucose-raising tendency. This is why survodutide targets the fat accumulation that defines MASH more directly than pure incretin drugs — but also why its safety requires balancing two opposing glucose effects.