Elecoglipron GLP-1 RA, advances into Phase III and marks the next chapter in AstraZeneca’s cardiometabolic and kidney portfolio

Promising results from the VISTA and SOLSTICE Phase IIb trials of elecoglipron, an oral small molecule GLP-1 receptor agonist, open a new chapter in AstraZeneca’s pursuit of therapies that strengthen cardiometabolic and kidney health while reducing weight-related complications. Unveiled at the 2026 Scientific Sessions of the American Diabetes Association and simultaneously published in The Lancet, these findings represent a pivotal moment in shaping AstraZeneca’s differentiated weight management portfolio of monotherapies and combinations, underpinned by a broad cardiometabolic pipeline and deep global commercial reach. AstraZeneca is now moving elecoglipron into an extensive Phase III programme spanning obesity and type 2 diabetes, with cardiovascular and kidney outcome trials included.

In VISTA, adults carrying a diagnosis of obesity or overweight alongside at least one comorbidity who received elecoglipron  achieved a clinically meaningful and statistically significant average body weight reduction of 10.5% at 26 weeks, set against just 0.6% in the placebo group, satisfying one half of the trial’s dual primary endpoint. Weight loss continued without plateauing, reaching 11.8% at 36 weeks with elecoglipron versus 0.3% with placebo. The second half of the dual primary endpoint was also met, with up to 88.8% of elecoglipron recipients achieving at least 5% weight loss by week 26. Beyond weight, elecoglipron produced clinically meaningful shifts across several exploratory cardiometabolic markers, including reductions in blood pressure and C-reactive protein, a key indicator of systemic inflammation.

In SOLSTICE (n=404), adults with type 2 diabetes receiving elecoglipron (75mg) saw a clinically meaningful and statistically significant average HbA1c reduction of 1.9% from baseline at 26 weeks compared to 0.2% with placebo, satisfying the trial’s primary endpoint. The majority of elecoglipron recipients reached guideline-recommended glycaemic targets within that timeframe, with 90% attaining an HbA1c below 7% and 85% reaching 6.5% or lower. Elecoglipron (75mg) also produced a clinically meaningful average body weight reduction of 7.7% at 26 weeks, against 1.7% with placebo.

Tolerability data gathered across the Phase II programme have since been used to shape the dose escalation schedule within Phase III, with the aim of further improving the tolerability experience for patients.

“Despite huge progress in the field of obesity management, significant opportunity remains to deliver broader, sustainable and more meaningful health benefits for the billions of people living with obesity or weight-related complications. The VISTA results show that people receiving once-daily oral elecoglipron achieved significant weight loss as well as lower blood pressure and systemic inflammation, demonstrating its potential to treat both obesity and its related complications,” said Melanie Davies, Professor of Diabetes Medicine at the University of Leicester, Honorary Consultant Diabetologist at University Hospitals of Leicester NHS Trust, and Principal Investigator for VISTA.

“In the SOLSTICE trial, the significant HbA1c and weight loss results achieved with elecoglipron show its potential to become an important treatment option for people with type 2 diabetes. As many as eight of every 10 patients who received elecoglipron reached their guideline-recommended glycaemic targets, which we know are linked with better outcomes and long-term health,” said Vanita Aroda, Director of Diabetes Clinical Research at Brigham and Women’s Hospital, Associate Professor at Harvard Medical School, and Principal Investigator for SOLSTICE.

“Our ambition is to have a portfolio that can tackle many of the cardiovascular, renal and metabolic diseases that are leading causes of death worldwide. The progression of elecoglipron is an important step in delivering a differentiated weight management portfolio, offering monotherapies and combinations, designed to address the biological complexity of obesity and comorbidities that can be tailored to individual needs, enabling people to live healthier lives. These results give us confidence as we kick off our extensive Phase III programme,” said Sharon Barr, Executive Vice President, BioPharmaceuticals R&D, AstraZeneca.

The elecoglipron Phase III programme encompasses the EMBOLD trials, which will assess elecoglipron as a treatment for individuals living with obesity or overweight, both with and without a type 2 diabetes diagnosis. The ELUMINATE trials will evaluate elecoglipron as both a standalone therapy and in combination with dapagliflozin for people with type 2 diabetes. Further outcome trials will examine long-term effects on cardiovascular and kidney health.

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AstraZeneca, Elecoglipron, Elecoglipron GLP-1 RA, kidney