Cotadutide (MEDI0382) is a dual GLP-1/glucagon receptor agonist developed by AstraZeneca (originally MedImmune). It is a once-daily injectable peptide designed to combine GLP-1 receptor-mediated glucose lowering and appetite suppression with glucagon receptor-mediated hepatic fat oxidation and energy expenditure. Phase II trials have been completed in type 2 diabetes, obesity, and NASH/MASH. Development status is uncertain after mixed Phase II results and AstraZeneca portfolio prioritization.
Category: Metabolic / Dual GLP-1/Glucagon Agonist. Evidence rating: C (early/mixed human evidence).
Clinical status: Phase II completed for T2D, obesity, and NASH/MASH. Development status uncertain; AstraZeneca has not advanced to Phase III.
Cotadutide is a synthetic peptide that activates both the GLP-1 receptor and the glucagon receptor in a balanced ratio. The GLP-1 component provides glucose-dependent insulin secretion, gastric emptying delay, appetite suppression, and glucagon suppression at the pancreatic level. The glucagon…
Research base: 0 registered clinical trials and 1 indexed publication reference Cotadutide.
Safety considerations: Common: nausea, vomiting, diarrhea, decreased appetite (GLP-1 class effects); GI adverse events are dose-dependent; titration helps manage tolerability; Once-daily dosing may produce more GI side effects than weekly formulations due to peak-trough fluctuations.
Reviewed by the PeptideAtlas Editorial Team.
| Half-life | ~12-13 hours (once-daily dosing) |
|---|---|
| Production method | synthetic |
| Anti-doping status | not-listed |
| US regulatory status | Investigational. Phase II completed. Not FDA-approved. Phase III status unclear. |
Related peptides: Mazdutide, Pemvidutide.
AstraZeneca completed several Phase II trials showing promising results for T2D, obesity, and NASH/MASH. However, the company has not announced Phase III plans, and it is unclear whether cotadutide will advance further. Portfolio prioritization and competition from more advanced dual agonists may be factors.
Both are dual GLP-1/glucagon agonists. Survodutide (by Boehringer Ingelheim/Zealand Pharma) is dosed once weekly and is more advanced in development (Phase III). Cotadutide requires daily injection and development has stalled. The GLP-1:glucagon activity ratios also differ between the molecules.
In the competitive GLP-1 agonist market, once-weekly injection is the standard for newer agents (semaglutide, tirzepatide, dulaglutide). Once-daily dosing increases injection burden and may reduce patient adherence and market competitiveness.