Eloralintide (LY3841136)
Lilly's once-weekly amylin receptor agonist is already in Phase 3 on its own and is now headed into Phase 3 as a fixed combination with tirzepatide. It is Lilly's answer to Novo's CagriSema.
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At a glance
Eloralintide is a once-weekly selective amylin receptor agonist from Eli Lilly, and Phase 3 trials of it on its own are under way in obesity. At EASD 2026, Lilly reported a Phase 2b in 367 adults with obesity or overweight and type 2 diabetes. The highest combination dose with tirzepatide produced 23.3% weight loss at 48 weeks, against 14.8% for tirzepatide 15 mg alone. Discontinuation for side effects was considerably higher on the combination. Lilly plans to begin Phase 3 trials of a single co-formulated product in the fourth quarter of 2026.
- Class
- Amylin receptor agonist, once weekly
- Sponsor
- Eli Lilly
- Stage
- Phase 3 as monotherapy; combination Phase 3 planned Q4 2026
- Target
- Obesity, with and without type 2 diabetes
What it is
Eloralintide, previously coded LY3841136, is a selective amylin receptor agonist given by weekly injection. Amylin is a hormone released alongside insulin after meals. It slows stomach emptying and signals fullness through brain regions that overlap only partly with those GLP-1 drugs act on, which is why the two pathways are expected to add together.
It joins a crowded class. Pramlintide is the original approved amylin analogue, used in diabetes. Cagrilintide is the amylin half of Novo's CagriSema, and petrelintide is the Zealand and Roche candidate. Eloralintide is Lilly's entry, and owning both halves of the combination lets Lilly co-formulate it with its own tirzepatide.
Current research status
Phase 3 trials of eloralintide as monotherapy are ongoing in adults with obesity, with and without type 2 diabetes. The combination with tirzepatide, which Lilly calls EloraTZP, completed a Phase 2b (NCT06603571) that Lilly presented at EASD on September 30, 2026.
Lilly plans to start Phase 3 studies of a single co-formulated EloraTZP product by the end of 2026, using an optimised dose-escalation schedule. That last detail matters, because tolerability was the weak point of the Phase 2b. Eloralintide is investigational and not approved anywhere.
Mechanistic rationale
The combination logic mirrors CagriSema's. GLP-1 and GIP signalling, which tirzepatide supplies, reduce appetite through the incretin system. Amylin signalling adds a separate satiety input and slows gastric emptying. Two partly independent routes to fullness should produce more weight loss than either alone, and the Phase 2b numbers are consistent with that.
The trade-off is that both pathways cause gastrointestinal side effects, and stacking them can stack the side effects too. The higher discontinuation rate on the combination is what the mechanism would predict, and it is the problem the co-formulation and slower escalation are meant to address.
Available evidence
| Arm (48 weeks) | Weight change | HbA1c change |
|---|---|---|
| Eloralintide 9 mg + tirzepatide 15 mg | −23.3% | −2.9 |
| Eloralintide 6 mg + tirzepatide 10 mg | −19.9% | −2.6 |
| Eloralintide 6 mg + tirzepatide 5 mg | −19.4% | −2.7 |
| Tirzepatide 15 mg alone | −14.8% | −2.4 |
| Eloralintide 6 mg alone | −12.3% | −1.4 |
| Placebo | −3.0% | −0.3 |
Why it's interesting
The magnitude is the headline, and the population makes it more striking. People with type 2 diabetes typically lose less weight on incretin drugs than people without it, which is why tirzepatide alone reached 14.8% here. A 23.3% result in that population is a strong signal that amylin adds something real on top of dual incretin agonism.
It also lands in a pointed context. Novo's CagriSema fell short of tirzepatide 15 mg in its obesity head-to-head, REDEFINE 4. Lilly's approach is to add amylin to tirzepatide rather than to compete with it, which sidesteps that contest entirely.
Limitations & risks
Tolerability is the central question. A combination that up to a quarter of participants stop taking because of side effects would struggle in practice, whatever its efficacy. The Phase 3 programme's slower escalation and single injection are designed to fix this, and until they report it is unknown whether they will.
The results are also narrower than the headline suggests. They come from a Phase 2b, use only the efficacy estimand, include only people with type 2 diabetes, and gave the two drugs as separate injections rather than the co-formulation that will be tested in Phase 3. Cross-trial comparisons with CagriSema should be treated with the usual caution, because the populations, durations, and estimands differ.
Community discussion notes
Expect EloraTZP and CagriSema to be framed as a two-company race, and expect the 23.3% figure to circulate without its tolerability context. Eloralintide is investigational and not available outside clinical trials. Anything marketed under that name is not the investigational drug.
How it stacks up
Eloralintide strengthens the case that amylin is the next major pathway in obesity pharmacology, and EloraTZP posted one of the largest weight-loss figures yet reported in type 2 diabetes. The open question is whether that efficacy can be delivered at a tolerability people will accept. Lilly's own Phase 3 design suggests it knows this is the problem to solve.
Frequently asked questions
What is eloralintide?
A once-weekly selective amylin receptor agonist from Eli Lilly, in the same class as pramlintide, cagrilintide, and petrelintide. It is in Phase 3 on its own and is being developed in combination with tirzepatide.
How does EloraTZP compare with CagriSema?
They have not been compared directly. EloraTZP's 23.3% came from a 48-week Phase 2b in people with type 2 diabetes, using the efficacy estimand. CagriSema's results come from different trials, populations, and durations, so a cross-trial comparison cannot settle which is better.
Why did more people stop treatment on the combination?
Both amylin and incretin drugs cause gastrointestinal side effects, mainly during dose escalation, and combining them increased those effects. Discontinuation for adverse events ranged from 10.8% to 27.0% on the combination arms. Lilly's Phase 3 will use a co-formulation and a slower escalation schedule.
When could eloralintide be available?
Monotherapy is in Phase 3, and Phase 3 trials of the combination were planned to start in the fourth quarter of 2026. Approval of either is several years away.
Is eloralintide available now?
No. It is investigational and available only in clinical trials.
References
- Eli Lilly. Lilly's EloraTZP, a combination of eloralintide and tirzepatide, Phase 2b results. September 2026. https://investor.lilly.com/news-releases/news-release-details/lillys-eloratzp-combination-eloralintide-and-tirzepatide
- Drug Discovery News. Lilly's amylin combo raises the bar, and the stakes, for obesity drug developers. 2026. https://www.drugdiscoverynews.com/lilly-s-amylin-combo-raises-the-bar-and-the-stakes-for-obesity-drug-developers-17564
- BioPharma Dive. Three takeaways from the European obesity scientific meeting. 2026. https://www.biopharmadive.com/news/3-takeaways-from-european-obesity-scientific-meeting/831870/