CT-388vsVK2735

CT-388 is a once-weekly subcutaneous dual GLP-1/GIP receptor agonist, mechanistically similar to tirzepatide but with a distinct molecular structure designed for differentiated pharmacology. Activation of both receptors produces complementary metabolic effects: GLP-1 receptor agonism centrally suppresses appetite through hypothalamic and brainstem signalling, slows gastric emptying, and stimulates glucose-dependent insulin secretion from pancreatic beta cells, while GIP receptor agonism enhances beta-cell insulin response, modulates lipid handling in adipose tissue, and amplifies the central anorectic effect of GLP-1 through distinct hypothalamic neuronal circuits.

The molecule was engineered with a balanced potency profile across the two receptors and incorporates fatty acid acylation that enables strong albumin binding, extending half-life to approximately one week. This pharmacokinetic profile supports once-weekly subcutaneous dosing with stable plasma exposure across the dosing interval, which is associated with better gastrointestinal tolerability than less stable formulations that produce sharp peaks and troughs.

In the Phase 2 obesity trial of 469 participants, CT-388 produced up to 22.5% placebo-adjusted body weight reduction at 48 weeks at the highest dose. The weight-loss curve had not yet plateaued at the end of the trial, suggesting further reductions might be achievable with longer dosing. Roche acquired Carmot Therapeutics in late 2024 specifically to obtain CT-388, positioning it as their lead anti-obesity asset competing directly against tirzepatide and the next-generation Lilly and Novo Nordisk pipeline.

VK2735 is a once-weekly subcutaneous dual GLP-1/GIP receptor agonist with a structure optimised for high potency and a clean tolerability profile. Dual incretin receptor activation produces complementary effects on appetite, glucose handling, and energy expenditure: GLP-1 receptor agonism delivers central appetite suppression through hypothalamic arcuate-nucleus signalling, slows gastric emptying, and triggers glucose-dependent insulin secretion, while GIP receptor activation amplifies the insulin response, supports beta-cell function, and modulates adipose tissue lipid handling.

The molecule's pharmacokinetic profile delivers sustained receptor exposure across a one-week dosing interval, achieved through structural modifications that enable albumin binding and resistance to proteolytic degradation. In the Phase 2 VENTURE trial, the 15 mg dose produced 14.7% mean body weight loss at 13 weeks — the fastest early weight loss observed for any obesity drug, with the loss curve still descending steeply at trial end. This rapid trajectory suggests substantially greater total weight loss would be achievable with longer dosing, and Phase 3 VANQUISH trials launched in 2026 are testing 68-week treatment durations to characterise the full magnitude of effect.

Viking is also developing an oral tablet formulation of VK2735 in parallel, which entered Phase 1 in 2024-2025. If both formulations succeed, Viking would have one of the most flexible GLP-1/GIP product profiles on the market — though as a small biotech company it faces significant manufacturing and commercial scaling challenges relative to Lilly and Novo Nordisk.