Elecoglipron (AZD5004 / ECC5004)
Also known as: AZD5004, ECC5004, AstraZeneca oral GLP-1
Overview
Elecoglipron is an investigational, once-daily, oral non-peptide small-molecule glucagon-like peptide-1 (GLP-1) receptor agonist being developed by AstraZeneca for obesity, overweight with comorbidity, and type 2 diabetes. Originally discovered by Shanghai-based Eccogene under the code ECC5004, the drug was licensed to AstraZeneca outside Greater China in November 2023 in a deal worth up to $2 billion in milestone-tied payments, and was renamed AZD5004 and later elecoglipron. The drug mimics the natural human GLP-1 hormone by binding the GLP-1 receptor as a small-molecule synthetic compound, in contrast to peptide-based GLP-1 agonists like semaglutide and liraglutide that require subcutaneous injection or, in the oral semaglutide case, an absorption enhancer plus strict fasting and water-timing rules. Elecoglipron can be taken with or without food. In the Phase 2b VISTA trial (n=310) of adults with obesity or overweight and at least one weight-related comorbidity, the 75-mg dose achieved 10.5% average body weight reduction at 26 weeks and 11.8% at 36 weeks versus 0.6% and 0.3% with placebo, with up to 88.8% of participants reaching ≥5% weight loss. In the Phase 2b SOLSTICE trial (n=404) of adults with type 2 diabetes, the 75-mg dose produced an HbA1c reduction of 1.9 percentage points versus 0.2 with placebo at 26 weeks, with 90% of participants reaching HbA1c below 7% and average body weight reduction of 7.7%. Both trials were published in The Lancet on June 8, 2026 and presented at the American Diabetes Association Scientific Sessions in New Orleans. AstraZeneca is advancing elecoglipron into a Phase 3 program branded EMBOLD (obesity, with and without type 2 diabetes) and ELUMINATE (type 2 diabetes, monotherapy and in combination with dapagliflozin), with cardiovascular and renal outcome trials to follow. The drug is not approved for any indication and is available only through clinical trials.
Mechanism of Action
Non-peptide small-molecule agonist at the human GLP-1 receptor. Binds the receptor and activates Gs-coupled signaling, mimicking endogenous GLP-1. Drives insulin secretion in a glucose-dependent manner, delays gastric emptying, suppresses glucagon secretion, and acts at hypothalamic and brainstem GLP-1 receptors to reduce appetite and food intake. The small-molecule chemistry permits oral absorption without an enhancer, unlike peptide-based oral GLP-1s such as oral semaglutide.
Potential Benefits
- Oral once-daily dosing with no food or fluid-timing restrictions
- Phase 2b weight loss of 11.8% at 36 weeks (75-mg highest dose in VISTA)
- Phase 2b HbA1c reduction of 1.9 percentage points (75-mg highest dose in SOLSTICE)
- Up to 89.6% of participants achieved HbA1c below 7% in SOLSTICE
- Improvements in blood pressure and C-reactive protein in VISTA exploratory analyses
- Non-peptide manufacturing scales without recombinant peptide cold-chain logistics
Research Dosage Notes
The following reflects doses used in published research studies. This is not medical advice.
VISTA evaluated fixed doses of 5 mg and 15 mg, plus escalation regimens to 50 mg (every-4-week titration) and 75 mg (weekly or every-2-week titration), administered once daily as oral tablets. SOLSTICE evaluated fixed doses of 5, 15, and 25 mg plus escalation to 50 mg and 75 mg (every-2-week or every-4-week titration). The 75-mg dose with slow escalation showed the best efficacy/tolerability balance. Phase 3 program uses a refined escalation schedule informed by Phase 2 tolerability. Not for clinical use — the drug is investigational.
Amino Acid Sequence
Not applicable — non-peptide small molecule
Side Effects & Safety
- Nausea (55% at 75-mg in VISTA vs 20% placebo; 37% in SOLSTICE vs 3% placebo)
- Constipation (41% VISTA vs 6% placebo; 29% SOLSTICE vs 4% placebo)
- Diarrhea (35% VISTA vs 25% placebo; 21% SOLSTICE vs 15% placebo)
- Vomiting (29% VISTA vs 5% placebo; 18% SOLSTICE vs 1% placebo)
- Most events mild-to-moderate. No liver safety signals observed. Hypoglycemia uncommon in SOLSTICE.
Synergistic Compounds
The following compounds have been studied alongside Elecoglipron (AZD5004 / ECC5004) for potential complementary or synergistic effects:
Learn More
References & Further Reading
- Elecoglipron, an oral small molecule GLP-1 receptor agonist in adults with type 2 diabetes (SOLSTICE)
- VISTA Phase 2b trial of elecoglipron in obesity
- AstraZeneca: Elecoglipron Phase 3 announcement
- Multiple Clinical Trial Data for Elecoglipron (AZD5004/ECC5004) to be Presented at ADA 2026
- VISTA trial registration NCT06579092
Latest News & Research
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AstraZeneca's Elecoglipron Pill Hits 11.8% Weight Loss At 36 Weeks, Heads To Phase 3
AstraZeneca's elecoglipron oral GLP-1 hit 11.8% weight loss at 36 weeks in VISTA and 1.9% HbA1c drop in SOLSTICE Phase 2b at ADA 2026, advancing to Phase 3.
Enicepatide (CT-388): Roche's biased GLP-1/GIP peptide drops Phase 2 detail at ADA 2026
Roche's enicepatide (CT-388) hit 22.5% placebo-adjusted weight loss at 48 weeks in Phase 2 with no plateau; Phase 3 enrolling.
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April–May 2026 actions in TX, FL, CA, and OH show state boards targeting peptide and compounded GLP-1 practices via records, prescriber relationships, and volume.