What it is
Eloralintide is an experimental, once-weekly amylin drug from Eli Lilly, development code LY3841136. Amylin is the hormone the pancreas releases alongside insulin after a meal; it slows digestion and tells the brain to stop eating. The first drug to copy it, pramlintide, lasted under an hour and was injected before every meal. Eloralintide is built to last a week.
What is not in the public record: the sources opened for this entry — Lilly's two phase 1 papers, the phase 2 Lancet report and the registry — do not give its full amino-acid sequence. This entry therefore does not print one.
How it is meant to work
Amylin acts through a family of receptors, all built on the calcitonin receptor. Adding one of three helper proteins turns it into an amylin receptor (AMY1, AMY2 or AMY3). Lilly's discovery paper (Mol Metab 2025) reports that, in cells carrying the human receptors, eloralintide activated:
| Receptor | Relative preference |
|---|---|
| Amylin 1 receptor (AMY1) | reference |
| Calcitonin receptor | 12-fold weaker |
| Amylin 3 receptor (AMY3) | 11-fold weaker |
The design bet is that selectivity buys tolerability. In lean rats, eloralintide produced significantly less conditioned taste avoidance — a laboratory proxy for nausea — than cagrilintide, which the paper calls non-selective. That is an animal result; no trial has compared the two drugs in people.
What the human evidence shows
| Study | Design | People | Finding |
|---|---|---|---|
| Phase 1, single ascending dose (NCT05295940) | Placebo-controlled, healthy volunteers, 0.04–12 mg once | small | Supports weekly dosing; −2.5% weight at 4 weeks after one 4 or 12 mg dose |
| Phase 1, China (NCT06916091) | Completed | 30 | No results posted |
| Phase 2 (NCT06230523), Lancet 2025 | Double-blind, placebo, 48 weeks, 46 US centres | 263 | See below |
The phase 2 trial is the one that counts. It enrolled adults without type 2 diabetes, with a BMI of 30 or more (or 27 with a weight-related condition); 78% were women, mean weight 109.1 kg. Results at 48 weeks:
| Arm | n | Mean weight change |
|---|---|---|
| Placebo | 53 | −0.4% |
| 1 mg | 28 | −9% |
| 3 mg | 24 | −12% |
| 6 mg | 28 | −18% |
| 9 mg | 54 | −20% |
| 6 → 9 mg | 24 | −20% |
| 3 → 9 mg | 52 | −16% |
Nausea was the commonest adverse event: 64% in the fixed 6 mg arm, 54% in the 6→9 mg arm, and 11–33% in the others, against 14% on placebo. Fatigue came next. So the tolerability advantage seen in rats has not yet been shown in people in any simple way — the arms that started high had the most nausea.
Where it stands
Not approved anywhere. ClinicalTrials.gov lists 18 records mentioning eloralintide on 2026-09-27:
- 5 phase 3 trials, planning 5,615 participants between them: obesity without diabetes (1,980), obesity with type 2 diabetes (1,035), obstructive sleep apnoea (800), knee osteoarthritis pain (900), and people who remain obese on a weekly incretin drug (900);
- 4 phase 2, several testing it with Lilly's macupatide or inside a master protocol;
- 9 phase 1, including kidney and liver impairment studies and one combining it with tirzepatide.
Only one of the 18 has posted results. Europe PMC's MEDLINE index holds 9 records naming it in the title or abstract — the phase 1 and phase 2 reports, and reviews.
Related reading
The amylin line in this library runs from pramlintide, the 2005 original, through cagrilintide, the non-selective weekly analogue paired with semaglutide, to eloralintide. For the GLP-1 drugs it is being combined with, see tirzepatide and retatrutide.