Description
Sur-3W-GN (BI 456906)
Sur-3W-GN is an investigational dual receptor agonist peptide developed by Boehringer Ingelheim (in collaboration with Zealand Pharma) that targets both the GLP-1 receptor and the glucagon receptor. It is being studied primarily for the treatment of obesity/overweight and metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH). By combining GLP-1-mediated appetite suppression with glucagon-mediated increases in energy expenditure and fat metabolism, Sur-3W-GN aims to deliver robust weight loss while improving liver health.
Key Benefits
- Significant Weight Loss: Phase 3 data (SYNCHRONIZE-1) showed up to 16.6% average body weight reduction after 76 weeks (vs 3.2% with placebo) in adults with obesity/overweight without type 2 diabetes. Up to 85.1% of participants achieved ≥5% weight loss. Weight loss appears driven primarily by fat mass reduction.
- Liver Health Improvement: Strong efficacy in MASH — up to 62% achieved MASH resolution without worsening of fibrosis (Phase 2). Significant reductions in liver fat content (often >80% relative reduction) and improvements in fibrosis scores.
- Cardiometabolic Improvements: Reductions in waist circumference, triglycerides, and other metabolic risk markers.
- Glycemic Control: Beneficial effects on blood glucose and HbA1c in patients with type 2 diabetes (ongoing Phase 3 trials).
- Additional Potential: Being studied for its effects on energy expenditure and preservation of lean mass compared to pure GLP-1 agonists.
Administration Options
- Subcutaneous (SQ) Injection: Once-weekly dosing (primary method in clinical trials).
Note: Sur-3W-GN is not FDA-approved and remains in Phase 3 clinical development as of 2026.
Potential Side Effects
- Common (dose-dependent, often improve with titration): Nausea, vomiting, diarrhea, constipation, and other gastrointestinal issues.
- Other: Injection site reactions, headache, or fatigue.
- Overall Safety: Generally consistent with the GLP-1 receptor agonist class. Higher discontinuation rates during rapid dose escalation due to GI tolerability. Long-term safety data continue to be collected in ongoing Phase 3 trials.
Peptide Combinations
Peptides it may pair well with (research interest only):
- Other incretin-based peptides (e.g., Sem-2W-GL or RET-3W-GL3) for potentially enhanced metabolic effects — though no formal combination studies exist and additive GI risk is a concern.
Peptides/Drugs to Avoid Combining:
- Other strong GLP-1 or glucagon receptor agonists to prevent excessive gastrointestinal side effects, elevated heart rate, or other additive risks. All combinations should only be considered under strict medical supervision.


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