Clinical trial Recruiting at 2 sites Phase 1 Interventional Ages 18 and up

Switching to Zenagamtide From Tirzepatide in Adults With Overweight or Obesity With or Without Type 2 Diabetes

Official title: An Open-label, Multiple-arm Study to Assess Tolerability in Participants With Overweight or Obesity, With or Without Type 2 Diabetes, When Switching From Tirzepatide to Zenagamtide

Run by Novo Nordisk A/S · NCT07868354 · Data updated 2026-11-12

This study tests whether adults who are overweight or have obesity (with or without type 2 diabetes) can switch from tirzepatide to a new treatment called zenagamtide to find a tolerable dose.

More Obesity trials

Quick facts

PhasePhase 1
Study typeInterventional
Ages18 Years and up
SexAll
Enrollment60 (estimated)
SponsorNovo Nordisk A/S
Industry-sponsored
Locations2 sites (Glendale, California and 1 other locations)
StatusRecruiting
StartedOctober 8, 2026
Main results expectedSeptember 7, 2028
Study endsSeptember 7, 2028
Registry record updatedOctober 16, 2026
Trial IDNCT07868354 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Adults aged 18 or older with overweight or obesity, with or without type 2 diabetes, who are on a stable tirzepatide dose for at least 4 weeks and meet additional screening criteria.

Probably not a fit

Patients not experiencing tolerability issues with tirzepatide or not eligible for a dose switch may not receive benefit from this study.

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This early-phase study enrolls adults with overweight or obesity, with or without type 2 diabetes, who are already on a stable tirzepatide dose. All participants will receive tirzepatide and zenagamtide to determine which zenagamtide dose can be switched to from the current tirzepatide maintenance regimen. The trial uses a dose-switch design to assess tolerability and safety, with eligibility based on medical history, physical exams, vital signs, ECG, and stabilized glucose-lowering therapy when applicable. Primary goals focus on tolerability and identifying feasible zenagamtide doses for people continuing tirzepatide treatment. Conducted at two U.S. sites, the study is sponsored by Novo Nordisk A/S in collaboration with PAREXEL EPCUs.

Why it matters

Potential benefit: If successful, the study could identify a zenagamtide dosing strategy that is tolerable for people switching from tirzepatide, potentially informing future diabetes and weight-management options.

How similar studies have gone: Prior studies in related peptide therapies have shown tolerability profiles can vary with dose-switch strategies, making this approach exploratory but informed by similar methodologies.

Who can join: the full rules

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Male or female (sex assigned at birth, inclusive of all gender identities).
* Age 18 years or older at the time of signing the informed consent.
* Considered eligible based on the medical history, physical examination, and the results of vital signs, electrocardiogram and clinical laboratory tests performed during the screening visit, as judged by the investigator.
* Participants on a stable treatment dose of tirzepatide for at least 4 weeks.

Only for participants with T2D:

* Diagnosed with type 2 diabetes before screening.
* Treatment with 0-2 marketed oral glucose-lowering medications (metformin or sodium-glucose cotransporter-2 inhibitors (SGLT2i) as a single agent or in combination) according to local label. Treatment with oral glucose-lowering medications must be stable (same drug(s), stable daily doses) for at least 90 days before screening.

Exclusion Criteria:

* Female who is pregnant, breast-feeding or intends to become pregnant or is of childbearing potential and not using adequate contraceptive method.
* History of reduction in dose of tirzepatide, due to intolerability, without successful reescalation.
* Presence of any clinically relevant condition that causes symptoms which are similar to the gastrointestinal adverse events (GI AEs) linked to glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatment, and which could confound evaluation of GLP-1 RA-related GI AEs and tolerability endpoints.
* Ongoing use of medications causing clinically relevant gastrointestinal symptoms that could confound evaluation of GLP-1 RA-related GI AEs and tolerability endpoints, as judged by the investigator.
* Use of prescription medicinal products or non-prescription drugs within 14 days before screening. Exceptions are:
* use of tirzepatide as described in inclusion criterion 5
* glucose-lowering medication mentioned in inclusion criterion 7 (only for participants with T2D)
* stable use (initiated minimum 30 days before screening) of statins, blood pressure lowering medicine, beta blockers
* highly effective contraceptives
* occasional use of paracetamol, ibuprofen and acetylsalicylic acid.

Only for participants without T2D:

\- Presence or history of any clinically relevant respiratory, metabolic, renal, hepatic, cardiovascular, gastrointestinal, or endocrinological conditions.

Only for participants with T2D:

* Glycated haemoglobin (HbA1c) more than or equal to (≥) 10.5 percent (%) \[91 millimoles per mole (mmol/mol)\] at screening.
* Participant with diabetic retinopathy or maculopathy who received treatment with retinal photocoagulation, vitrectomy or anti-Vascular Endothelial Growth Factor (anti-VEGF) within 180 days before screening or are expected to require treatment within 180 days after screening. Diabetic retinopathy or maculopathy must be verified by an eye examination performed within 90 days before screening. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
* Presence or history of any clinically relevant respiratory, metabolic, renal, hepatic, cardiovascular, gastrointestinal, or endocrinological conditions, except conditions associated with diabetes mellitus.

Where it's running

  • PAREXEL Glendale/LA EPCU
    Glendale, California, United States
    Recruiting
  • PAREXEL Intl - EPCU-Baltimore
    Baltimore, Maryland, United States
    Recruiting

Study contacts

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.