AstraZeneca announced positive results from the VISTA and SOLSTICE Phase IIb trials of elecoglipron, an investigational oral small molecule glucagon-like peptide-1 receptor agonist (GLP-1 RA). The data, presented at the American Diabetes Association’s (ADA) 2026 Scientific Sessions and simultaneously published in The Lancet paved the way for an extensive Phase III development programme. The progression of elecoglipron marks a pivotal step in AstraZeneca’s ambition to deliver a differentiated weight management portfolio of monotherapies and combinations. Administered as a once-daily tablet without food or fluid restrictions, elecoglipron is designed to address the biological complexity of obesity and its comorbidities, offering an accessible alternative to injectable therapies.
The Phase IIb VISTA trial evaluated the efficacy, safety, and tolerability of elecoglipron in adults living with obesity or overweight who did not have diabetes. Participants receiving the highest evaluated dose of 75 mg achieved a profound mean weight loss of 10.5% at 26 weeks, compared to just 0.6% for those in the placebo group. Crucially, the weight loss continued without reaching a plateau, ultimately achieving an 11.8% average weight reduction by week 36. Furthermore, 88.8% of participants on the 75 mg dose achieved a clinically significant weight loss of 5% or more at 26 weeks, alongside meaningful reductions in blood pressure and systemic inflammation markers like C-reactive protein.
In parallel, the SOLSTICE Phase IIb trial assessed the drug’s impact on adults with inadequately controlled type 2 diabetes. The 75 mg dose demonstrated potent glycemic control, reducing average HbA1c levels by 1.9% at 26 weeks compared to a 0.2% reduction in the placebo cohort. This high level of efficacy enabled 90% of patients to achieve the standard target HbA1c of under 7%, while 85% of patients reached a near-normal HbA1c of 6.5% or less. Alongside these substantial blood sugar improvements, patients in the SOLSTICE trial experienced a concomitant average body weight reduction of 7.7%.
Across both mid-stage trials, the overall safety and tolerability profile of elecoglipron was found to be consistent with the established GLP-1 RA class. Adverse events were predominantly gastrointestinal in nature, characterized by mild-to-moderate instances of nausea, vomiting, and diarrhoea. The insights gained from this mid-stage tolerability data have successfully informed the optimized dose-escalation schedules designed for the upcoming Phase III clinical trials to maximize patient adherence.
Backed by these positive results, AstraZeneca is fast-tracking elecoglipron into a comprehensive Phase III programme to evaluate its long-term impact on cardiometabolic health. The upcoming EMBOLD Phase III trials will focus on the efficacy and safety of elecoglipron for weight management in people living with obesity or overweight, both with and without type 2 diabetes. Concurrently, the ELUMINATE Phase III trials will assess elecoglipron both as a monotherapy and in combination with Forxiga (dapagliflozin) for the treatment of type 2 diabetes. Additionally, dedicated long-term cardiovascular and kidney outcome trials will explicitly track the drug’s capacity to reduce chronic weight-related complications and organ damage over time.
“The progression of elecoglipron is an important step in delivering a differentiated weight management portfolio, offering monotherapies and combinations designed to address the biological complexity of obesity and comorbidities,” said Sharon Barr, Executive Vice President, BioPharmaceuticalsR&D, AstraZeneca. “These results give us confidence as we kick off our extensive Phase III programme.
Written by: Pragna Biswas
Graphics by: Mainak Sen
