Carl read the papersWhat it actually is
Pemvidutide activates the GLP-1 and glucagon receptors, the same pair as survodutide and mazdutide. It is made by Altimmune, a much smaller company than Lilly or Boehringer.
Its obesity trial (MOMENTUM) reported decent weight loss with a high share of it as fat, but the company has since bet on liver disease: a phase 3 trial in MASH started in 2026, alongside phase 2 work in alcohol-related liver disease and alcohol use disorder.
How it’s thought to work
- GLP-1 receptor — Appetite and fullness, as with every drug in this family.
- Glucagon receptor — Pushes the liver to burn fat and make less of it, so liver fat drops faster than weight loss alone would explain.
- No-titration dosing — In the MASH trial, 1.2 and 1.8 mg were started at full dose with few dropouts. In the obesity trial the same approach went less smoothly: about 1 in 5 on 1.8 mg stopped for side effects.
- Lean mass — In a 50-person MRI sub-study, about 78% of the weight lost was fat and 22% lean mass, per the company's 2024 presentation.
What the research says
Phase 2 only, but decent. In fatty liver disease, 12 weeks cut liver fat by up to 68.5% on 1.8 mg against 4.4% on placebo. The IMPACT phase 2b (212 people with MASH and F2 to F3 fibrosis) hit one of its two goals at 24 weeks: MASH resolution in 58% (1.2 mg) and 52% (1.8 mg) against 20%. Fibrosis improvement on biopsy, the other goal, was not significantly better than placebo; the 48-week update used blood tests and scans, not biopsy. The MOMENTUM obesity trial reported -15.6% at 48 weeks on 2.4 mg against -2.2%, but about 19% on 1.8 and 2.4 mg quit for side effects (6% on placebo). Those numbers come from the company and a conference, not a journal paper we could find.
- MASLD trial (n=94, 12 wks): liver fat -46.6%, -68.5%, -57.1% on 1.2, 1.8, 2.4 mg vs -4.4% placebo.
- IMPACT phase 2b (n=212, 24 wks): MASH resolution 58% and 52% vs 20%; biopsy fibrosis goal missed.
- MOMENTUM obesity (n=391, 48 wks, company data): -10.3%, -11.2%, -15.6% vs -2.2%; side-effect dropouts 5%, 19%, 20% vs 6%.
- Phase 3 (PERFORMA, 1.8 and 2.4 mg) is in MASH only; no obesity phase 3 is registered.
Reported protocols
These are the doses the peptide community actually reports running (Reddit & forums), alongside published research — logged for education, not as a recommendation to use.
| Parameter | Commonly reported range |
|---|---|
| Trial doses | 1.2, 1.8 or 2.4 mg weekly; 1.2 and 1.8 mg given with no titration, 2.4 mg after a 4-week step-up (MOMENTUM). PERFORMA uses 1.8 and 2.4 mg |
| Community dose | Not established. We found no vendor-independent reports of people using it; it is barely discussed online |
| Frequency | Once weekly |
| Route | Subcutaneous |
| Cycle | Trials ran 12 to 48 weeks |
| Note | Trial doses are the only numbers that exist. Copying them onto grey-market powder of unknown purity is not the same as being in the trial. |
Common use cases
| Goal | Community protocol notes |
|---|---|
| MASH / fatty liver | where the phase 2b data are strongest; phase 3 (PERFORMA) under way |
| Weight loss | phase 2 only; no obesity phase 3 registered |
| Alcohol use disorder, alcohol-related liver disease | the company says 2.4 mg cut heavy drinking days in a phase 2 trial (July 2026); the liver trial is still running |
Mixing it (reconstitution)
Freeze-dried peptides must be reconstituted with bacteriostatic water before they can be measured. Carl’s calculator turns “mg in the vial + ml of water + target dose” into “units on the syringe” — and tells you how long the vial lasts.
→ Open the Reconstitution Calculator
Injection & handling
Subcutaneous, once weekly. The liver trials started on the full 1.2 or 1.8 mg dose with no step-up and few dropouts; the obesity trial did the same and lost about 1 in 5 people on 1.8 mg to side effects, while its 2.4 mg arm used a 4-week step-up. There is no community dosing pattern to report, so trial numbers are the only reference. Reconstituted, keep it cold.
Stacks it appears in
- None studied — No trial or credible community report combines pemvidutide with anything. Adding it to another GLP-1 doubles up on the same receptor.
- Versus survodutide — Same two receptors, far more evidence behind survodutide. For weight, pemvidutide is the less-proven choice.
Sources
- Pemvidutide in MASLD, J Hepatol 2025 (PMID 39002641)
- 24-week extension, JHEP Rep 2025 (PMID 41113119)
- IMPACT phase 2b, Lancet 2025 (PMID 41237796)
- HCPLive: MOMENTUM 48-week results (ADA 2024)
- ClinicalTrials.gov: PERFORMA phase 3 in MASH (NCT07795164)
- SAHPRA, Peptide Products: Public Information (published 26 May 2026)
- WADA 2026 Prohibited List (S0 non-approved substances; S6.B specified stimulants)
- Altimmune: MOMENTUM 48-week topline (BioSpace, 30 Nov 2023)
- Altimmune: IMPACT 48-week data at EASL 2026 (BioSpace, 28 May 2026)
- Altimmune: RECLAIM phase 2 topline in alcohol use disorder (BioSpace, 28 Jul 2026)
