Eli Lilly's retatrutide beats Ozempic on weight and blood sugar

Why people are searching this today

Eli Lilly's experimental drug retatrutide did better than Ozempic on blood sugar and weight loss in a head-to-head trial. The results were reported on 28 October 2026 [2]. Readers want to know how big the gap is and whether they can get the drug. The answer to the second question is no, at least not yet. Retatrutide is still investigational [2].

What the trial showed

The study is called TRANSCEND-T2D-2. It is a phase 3, randomized, open-label trial, so patients and doctors knew which drug was being given [1]. It enrolled 1,298 adults with type 2 diabetes whose blood sugar was not well controlled on metformin, with or without an SGLT2 inhibitor [1] [2]. Participants were assigned 2:2:1 to retatrutide 9 mg, retatrutide 12 mg or semaglutide 2 mg, each taken once a week for 80 weeks [1]. Retatrutide started at 2 mg and was raised every four weeks [1].

Blood sugar fell further on retatrutide. Average HbA1c dropped 2.2 percentage points on both retatrutide doses, from a mean baseline of 8.3%. The semaglutide group fell 1.8 points [1] [2].

Weight loss was larger too. Patients on 9 mg lost 19.5%, or 44.3 pounds. Patients on 12 mg lost 20.9%, or 47.4 pounds. The semaglutide group lost 9.4%, or 20.9 pounds [1] [2]. Both retatrutide doses beat semaglutide on weight, with P below .001 [2].

The trade-off was tolerability. Dysesthesia was reported by 4.8% on 9 mg, 6.5% on 12 mg and 2.7% on semaglutide [1]. Stopping treatment because of an adverse event happened in 4.8% on 9 mg, 7.9% on 12 mg and 2.7% on semaglutide [1]. Gastrointestinal events were the most common side effects [2].

The drug and the Ozempic comparison

Retatrutide is an investigational once-weekly injection that acts on three receptors: GIP, GLP-1 and glucagon [1] [2]. Ozempic is also an incretin-based therapy [1]. The trial used 2 mg of semaglutide, which Lilly described as the highest approved dose of Ozempic for type 2 diabetes [1]. Novo Nordisk makes Ozempic [1].

Lilly's Kenneth Custer, who leads its cardiometabolic health business, said that retatrutide "if approved, could shift the treatment paradigm for people living with type 2 diabetes" [2]. The word "if" matters here. The drug has not cleared a regulator [2].

What comes next

Retatrutide has not been approved by the FDA or any other regulator, according to Lilly [2]. The figures above have not yet appeared in a peer-reviewed journal. Detailed results will be presented at a future medical meeting and published later [2]. An extension will follow about 650 participants for another 24 weeks [2].

Phase 3 studies continue in obesity, knee osteoarthritis pain, obstructive sleep apnea, cardiovascular outcomes and fatty liver disease [2]. A separate trial, TRIUMPH-5, is comparing retatrutide with tirzepatide and is still running [2].