What Is Eloralintide?

1. How does eloralintide work?

Amylin is a hormone the pancreas releases together with insulin after a meal. It slows gastric emptying, suppresses glucagon, and signals fullness to the brainstem through its own receptors, a pathway separate from the incretin receptors that semaglutide and tirzepatide act on. Pramlintide, the amylin analogue approved for diabetes in 2005, has to be injected at every meal because it lasts hours; eloralintide is engineered to last a week.

“Selective” is the design claim. Amylin receptors are built from the calcitonin receptor plus an accessory protein, and older amylin analogues such as cagrilintide also activate the bare calcitonin receptor, a related receptor with its own effects on bone and calcium. Eloralintide is described by Lilly as selective for the amylin receptors, meaning it is designed to leave that second receptor alone, which is the mechanistic bet behind its tolerability profile. Whether that selectivity matters clinically is what the Phase 3 program will show.

2. How much weight do people lose on eloralintide?

The Phase 2 trial, NCT06230523, ran at 46 research centres in the US from February 2024 to August 2025 and randomised 263 adults aged 18 to 75 (mean age 49, 78% female, 78% White, mean BMI 39.1) with obesity or overweight and no diabetes to placebo or one of four fixed doses or two escalation schedules for 48 weeks, in a 2:1:1:1:2:1:2 ratio. Average starting weight was 109 kg. The two escalation arms started low and stepped up: 6 mg for 20 weeks then 9 mg for 28 weeks (arm size n=24), or 3 mg for 4 weeks, 6 mg for 4 weeks, then 9 mg for 40 weeks (n=52). The fixed-dose arms ranged from n=24 (3 mg) to n=54 (9 mg), and placebo was n=53. The Lancet’s published efficacy-estimand figures carry confidence intervals: 9 mg produced -20% (95% CI -22.7 to -17.5), 6 mg -18% (-20.7 to -14.5), 3 mg -12% (-14.9 to -9.8), and 1 mg -9% (-12.6 to -6.3), against -0.4% on placebo (-2.2 to 1.4). These round slightly differently from Lilly’s press-release figures used in the chart above (20.1%, 17.6%, 12.4%, 9.5%) because the two sources use different rounding and estimand conventions on the same trial.

Lilly’s release and the ClinicalTrials.gov results table differ by a tenth of a point on two arms (9.4% and 16.5% in the registry); the chart uses Lilly’s figures. The clean dose-response is the notable feature: each step up in dose produced more loss, and 9 mg reached the same territory as tirzepatide 15 mg did at 72 weeks in SURMOUNT-1 (20.9%), in a shorter trial with a different population. Lilly also reported improvements in waist circumference, blood pressure, lipids, glycemic measures, and inflammatory markers as secondary endpoints, without releasing the numbers; those figures are not yet in the public registry results and are not repeated here. These are separate trials, not a comparison.

The registry’s posted secondary outcomes show responder rates and BMI change alongside the headline weight-loss numbers. At 9 mg, 92.7% of participants reached at least 5% weight loss and 82.3% reached at least 10%, against 31.2% and 12.9% on placebo; the 6/9 mg escalation arm had the highest responder rate of any group, 97.5% at ≥5% and 91.1% at ≥10%. Mean BMI fell by 7.7 points on 9 mg and 7.8 points on the 6/9 mg escalation arm, against 0.2 points on placebo.

3. What are the side effects of eloralintide?

Lilly’s release reports that the most common adverse events were mild to moderate gastrointestinal symptoms and fatigue, seen more frequently in the higher-dose arms, and that the 1 mg and 3 mg arms had adverse event rates similar to placebo. The full per-arm results are posted on ClinicalTrials.gov:

Fixed-dose arms:

Escalation arms:

(Nausea and fatigue percentages above are the Lancet’s rounded figures for those two events, which differ slightly from ClinicalTrials.gov’s raw counts for the same arms; the other rows are calculated directly from the registry’s posted counts.) Discontinuation for adverse events was low and not clearly dose-related: 2 of 53 on placebo, 2 of 28 on 1 mg, 0 of 24 on 3 mg, 1 of 28 on 6 mg, 1 of 54 on 9 mg, 0 of 24 on 6/9 mg, and 2 of 52 on 3/6/9 mg. Completion rates ranged from 71% (1 mg) to 89% (9 mg); the 9 mg and 3/6/9 mg arms, the two that ran longest at the top dose, had the highest completion.

Fatigue occurred in up to 46% of an eloralintide arm against 12% on placebo, and bradycardia occurred in up to 11% of an eloralintide arm against 0% on placebo; both will be watched in Phase 3. Lilly’s release states there were no unexpected safety signals and no imbalance in serious adverse events.

4. What is the ENLIGHTEN program?

ENLIGHTEN-1, NCT07321886, is the first Phase 3 trial: randomised, double-blind, placebo-controlled, in adults with obesity or overweight (BMI 30, or 27 with a weight-related condition such as high blood pressure, dyslipidemia, sleep apnea, or heart disease) and no diabetes, with four dose arms plus placebo and a primary endpoint of percent weight change at week 64. It started recruiting on February 6, 2026, with an estimated 1,980 participants and a primary completion date estimated for March 2028.

ENLIGHTEN-1 is one piece of a larger registered program under the LY3841136 development code. ClinicalTrials.gov lists Phase 3 trials in people with obesity and type 2 diabetes (NCT07282600), obstructive sleep apnea and obesity (NCT07369011), osteoarthritis knee pain and obesity (NCT07353931), and people whose weight has plateaued on a weekly incretin drug (NCT07392190). Earlier-phase studies cover Chinese participants, renal and hepatic impairment, and a Phase 1 study in female participants, alongside a Phase 2 trial pairing eloralintide with Lilly’s other amylin-adjacent candidate, macupatide (LY3532226).

The trial that may matter more commercially is the combination with tirzepatide. NCT06603571 is a Phase 2 study, active but no longer recruiting, that randomised 367 adults with obesity and type 2 diabetes across ten arms: three eloralintide-alone doses, five eloralintide-plus-tirzepatide dose pairs, a tirzepatide-alone arm, and placebo. Amylin and incretin drugs work through different receptors, so the hypothesis is additive weight loss without additive gastrointestinal burden, the same logic behind Novo Nordisk’s CagriSema. If the combination works, eloralintide’s commercial role could be as a partner for Zepbound rather than a rival to it.

5. How does eloralintide compare with the other amylin drugs?

The petrelintide and cagrilintide pages cover the other two. For a log, an investigational drug is entered like any other: product, date, milligrams, and site. How GLP-1 tracking works covers what to record.

6. Eloralintide FAQ

• How much weight do people lose on eloralintide?

  In the 48-week Phase 2 trial, 9.5% on 1 mg, 12.4% on 3 mg, 17.6% on 6 mg, and 20.1% on 9 mg, against 0.4% on placebo. Two escalation arms produced 19.9% (6 then 9 mg) and 16.4% (3, 6, then 9 mg). Average starting weight was 109 kg.

• How is eloralintide different from Ozempic or Zepbound?

  Different hormone. Semaglutide and tirzepatide act on the incretin receptors GLP-1 and GIP. Eloralintide activates amylin receptors; amylin is released from the pancreas alongside insulin and signals fullness through a separate pathway. That is why Lilly is testing it both alone and combined with tirzepatide.

• What are the side effects of eloralintide?

  Mild to moderate gastrointestinal symptoms and fatigue, more often at higher doses. ClinicalTrials.gov's posted results list nausea in about 64% of the 6 mg arm, fatigue in about 43% of the 9 mg arm, and a slow heart rate (bradycardia) in up to 11% of the 6 mg arm and 6% of the 9 mg arm. The 1 mg and 3 mg arms had adverse event rates similar to placebo.

• Is eloralintide the same as cagrilintide?

  No, but they are the same class. Cagrilintide is Novo Nordisk's long-acting amylin analogue, combined with semaglutide as CagriSema. Eloralintide is Lilly's selective amylin agonist. Petrelintide, from Zealand Pharma and Roche, is the third amylin drug in late development.

• When will eloralintide be approved?

  No filing exists. ENLIGHTEN-1, the first Phase 3 trial, started in February 2026 with a 64-week primary endpoint and an estimated primary completion in March 2028, so the earliest data arrive in 2027 or 2028. Approval would follow a filing after that.

• Did many people drop out of the Phase 2 trial?

  Some, but not disproportionately at the higher doses. Only 2 of 53 on placebo, 1 of 54 on 9 mg, and 2 of 52 on the 3/6/9 mg escalation arm discontinued specifically because of an adverse event; the 9 mg and 3/6/9 mg arms had the highest overall completion rates (89% and 88%). The 1 mg arm had the lowest completion (71%), driven mostly by withdrawals and loss to follow-up, not adverse events.

7. Sources