AstraZeneca announced positive Phase 2b results for elecoglipron, an investigational oral small molecule glucagon-like peptide-1 receptor agonist (GLP-1 RA), across two trials in obesity and type 2 diabetes, paving the way for an extensive Phase 3 program.1
Results from the VISTA and SOLSTICE trials were presented at the American Diabetes Association (ADA) 2026 Scientific Sessions in New Orleans and simultaneously published in The Lancet.1
“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,” said Sharon Barr, executive vice president of BioPharmaceuticals Research and Development at AstraZeneca. “These results give us confidence as we kick off our extensive Phase 3 programme.”
Frequently Asked Questions
What is elecoglipron?
Elecoglipron is an investigational oral, once-daily small molecule GLP-1 receptor agonist in development by AstraZeneca for obesity, overweight, and type 2 diabetes, without food or fasting restrictions.
What did the VISTA trial show for elecoglipron?
In VISTA, adults with obesity or overweight receiving elecoglipron 75 mg achieved an average 10.5% reduction in body weight at 26 weeks versus 0.6% with placebo, with weight loss continuing to 11.8% at 36 weeks.
What were the SOLSTICE trial results for elecoglipron in type 2 diabetes?
In SOLSTICE, elecoglipron 75 mg reduced HbA1c by an average of 1.9% from baseline at 26 weeks versus 0.2% with placebo, with 90% of treated participants reaching an HbA1c below 7%.
The oral GLP-1 RA class has drawn considerable attention given adherence and accessibility advantages over injectable formulations. Elecoglipron, dosed once daily without food or fasting restrictions, advances AstraZeneca's cardiometabolic pipeline alongside plans for combination regimens with dapagliflozin and dedicated cardiovascular and kidney outcome trials.1
Elecoglipron safety profile and glycemic outcomes in VISTA
VISTA enrolled 310 adults with obesity or overweight and at least one comorbidity across seven countries (mean baseline weight 106.9 kg). The trial used a randomized, parallel-group, double-blind design evaluating multiple elecoglipron dose regimens versus placebo, with all participants receiving standardized diet and physical activity advice. The co-primary endpoints were percent change in body weight and the proportion of participants achieving at least 5% weight loss, both measured from baseline to 26 weeks.
At the highest dose (75 mg, weekly escalation), elecoglipron produced an average body weight reduction of 10.5% at 26 weeks versus 0.6% with placebo, meeting one primary endpoint.1 Weight loss continued without plateau to 11.8% at 36 weeks versus 0.3% with placebo.1 The proportion of participants achieving at least 5% weight loss at 26 weeks reached 88.8% with elecoglipron 75 mg versus 15.6% with placebo, meeting the second co-primary endpoint.1
In exploratory analyses, elecoglipron also produced clinically meaningful reductions in blood pressure and C-reactive protein levels.1
Elecoglipron safety profile and glycemic outcomes in SOLSTICE
SOLSTICE enrolled 404 adults with type 2 diabetes across 9 countries with a primary endpoint of change in HbA1c from baseline to 26 weeks. Elecoglipron 75 mg reduced HbA1c by an average of 1.9% from baseline at 26 weeks versus 0.2% with placebo.1
Among participants with baseline HbA1c of at least 7%, 90% receiving elecoglipron 75 mg achieved an HbA1c below 7% and 85% achieved an HbA1c of 6.5% or lower by 26 weeks. Elecoglipron 75 mg also produced a 7.7% reduction in body weight versus 1.7% with placebo in SOLSTICE.1
The safety profile across both trials was consistent with the GLP-1 RA class, with adverse events predominantly gastrointestinal and of mild to moderate severity. In VISTA, nausea occurred in 55% of participants on elecoglipron 75 mg versus 20% on placebo; constipation occurred in 41% versus 6%; diarrhea in 35% versus 25%; and vomiting in 29% versus 5%. Rates in SOLSTICE were lower across all 4 GI events.1
Adverse events leading to discontinuation were infrequent in both trials, no liver safety signals were observed, and hypoglycemia was uncommon in SOLSTICE with no serious hypoglycemic events attributed to elecoglipron.1 AstraZeneca noted the Phase II tolerability data have informed the dose escalation schedule for Phase III to further refine the tolerability profile.1
"The VISTA results show 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 University of Leicester and VISTA Principal Investigator.1
According to their press release, AstraZeneca is advancing elecoglipron into the EMBOLD Phase III trials evaluating the agent in obesity and overweight, with and without type 2 diabetes, and the ELUMINATE Phase III trials evaluating elecoglipron as monotherapy and in combination with dapagliflozin in type 2 diabetes. Additional outcome trials targeting long-term cardiovascular and kidney endpoints are also planned.1
References
AstraZeneca. Elecoglipron, an oral small molecule GLP-1 RA, moves to Phase III programme and unlocks next chapter in AstraZeneca's cardiometabolic and kidney portfolio. Published June 8, 2026. Accessed June 9, 2026. https://www.astrazeneca.com/media-centre/press-releases/2026/elecoglipron-an-oral-small-molecule-glp-1-ra-moves-to-phase-iii-programme.html
Davies M, et al. Elecoglipron in adults with obesity or overweight (VISTA): a phase 2b randomised controlled trial. The Lancet. Published June 8, 2026.
