AstraZeneca’s once-daily oral small-molecule GLP-1 receptor agonist elecoglipron produced an 11.8% average reduction in body weight at 36 weeks in the Phase 2b VISTA trial, the company announced at the American Diabetes Association’s 2026 Scientific Sessions, with simultaneous publication in The Lancet.
VISTA enrolled 310 adults with obesity or overweight in a randomised, placebo-controlled design. Participants on elecoglipron 75 mg lost 10.5% of body weight by week 26 — versus 0.6% with placebo — and weight loss had not plateaued by week 36, where the gap widened to 11.8% versus 0.3%. These are Phase 2 data; confirmatory Phase 3 trials are needed before regulatory submissions.
The companion SOLSTICE trial (n=404) tested elecoglipron in adults with type 2 diabetes. The 75 mg dose cut HbA1c by 1.9 percentage points from baseline at 26 weeks (placebo: −0.2%), and drove 7.7% weight loss (placebo: −1.7%). Ninety percent of treated participants reached an HbA1c below 7%, and 85% reached 6.5% or lower.
Safety across both trials was consistent with the GLP-1 receptor agonist class: adverse events were predominantly mild-to-moderate gastrointestinal, discontinuations were uncommon, and no liver safety signals or treatment-linked serious hypoglycaemia were identified by investigators.
AstraZeneca is moving directly to Phase 3 with the EMBOLD programme (obesity/overweight) and the ELUMINATE programme (T2D monotherapy and combination with dapagliflozin), plus dedicated cardiovascular and renal outcomes trials.
The announcement arrives weeks after Eli Lilly’s orforglipron (Foundayo) received FDA approval for weight management — the first oral GLP-1 pill cleared for obesity in the U.S. — and as Novo Nordisk’s oral semaglutide pursues its own obesity indication. Elecoglipron’s Phase 2 weight-loss figures are broadly comparable to orforglipron’s Phase 2 results, but head-to-head and Phase 3 data will ultimately define competitive positioning. Elecoglipron is not approved for any indication.