Elecoglipron (AZD5004)

Research snapshot

Peptide category	Not a peptide — oral, non-peptide small-molecule GLP-1 receptor agonist
Primary research interest	Obesity/overweight and type 2 diabetes
Highest available evidence	Published human Phase 2 clinical trial data (VISTA trial published in a peer-reviewed journal)
Human research available	Yes — completed Phase 2 VISTA (obesity) and SOLSTICE (type 2 diabetes) trials; Phase 3 program announced
Development status	Phase 3-bound (EMBOLD and ELUMINATE programs announced June 2026)
Regulatory status	Not approved anywhere; investigational only

Technical identity

Primary name	Elecoglipron
Alternative names	AZD5004, ECC5004
Peptide sequence	Not applicable — elecoglipron is a small synthetic molecule, not a peptide
Molecular formula	Not reliably established from a primary source reviewed for this page
Molecular weight	Not reliably established from a primary source reviewed for this page
CAS Registry Number	Conflicting: commercial vendor listings give two different CAS numbers for “elecoglipron” (3011682-49-5) versus “AZD5004/ECC5004” or an “elecoglipron racemate” (2758659-09-3); the discrepancy is not resolved in the public record reviewed here
PubChem CID	Not reliably established from a primary source reviewed for this page
UNII	Not available
DrugBank ID	Not available
Chemical modifications	Not applicable — small molecule, not a modified peptide
Peptide class	Not a peptide; oral non-peptide small-molecule GLP-1 receptor agonist with a reported biased signaling profile
Primary biological target	GLP-1 receptor (agonist)
Developer or originator	Originated by Eccogene (Shanghai); licensed to and developed by AstraZeneca
Development status	Phase 3-bound following completed Phase 2 trials

What is elecoglipron?

Elecoglipron, carried through development under the codes AZD5004 and ECC5004, is an oral, non-peptide small-molecule GLP-1 receptor agonist. It was originated by the Shanghai-based biotech Eccogene and licensed to AstraZeneca, which has taken it through Phase 2 development for both obesity/overweight and type 2 diabetes. Like other oral GLP-1 candidates in development, it is designed to activate the same receptor that injectable drugs such as semaglutide target, but as a once-daily pill — and AstraZeneca has specifically highlighted that it can be taken without food or fluid restrictions, which is a meaningful convenience difference from some other oral GLP-1 candidates in development.

Elecoglipron has been studied in two separate Phase 2 trials: VISTA, in adults with obesity or overweight without diabetes, and SOLSTICE, in adults with type 2 diabetes (which also included an active semaglutide comparison arm). The VISTA trial results were published in a peer-reviewed journal. Based on these results, AstraZeneca announced in June 2026 that elecoglipron is moving into an extensive Phase 3 program, named EMBOLD for obesity (with and without diabetes) and ELUMINATE for type 2 diabetes (as monotherapy and in combination with the SGLT2 inhibitor dapagliflozin), alongside planned long-term cardiovascular and kidney outcome trials.

How does it work?

Plain-English explanation

Elecoglipron activates the GLP-1 receptor, the same target as injectable weight-loss and diabetes drugs, slowing digestion, reducing appetite, and improving blood sugar control. Because it is a small molecule rather than a peptide, it can be manufactured as a stable pill and taken once a day without the injection, refrigeration, or reconstitution that peptide-based GLP-1 drugs require. AstraZeneca has also said it can be taken without special food or fluid timing rules, which some other oral GLP-1 pills do require.

Technical explanation

Elecoglipron is described by AstraZeneca as having a “biased signaling profile” at the GLP-1 receptor — meaning it may preferentially engage certain downstream signaling pathways over others compared with a peptide agonist — which the company has linked to its once-daily oral dosing without food or fluid restrictions. Full discovery chemistry details have not been disclosed publicly as of this review (a 2026 Lancet publication on the VISTA trial noted the discovery was undisclosed), so the precise structural basis for this signaling profile is not independently verifiable from public sources at this time.

Potential benefits and research applications

Weight loss in obesity and overweight

In the 26-week Phase 2 VISTA trial (310 participants with obesity or overweight and at least one comorbidity, no diabetes), weight loss ranged from 2.6% to 10.5% across doses, with the highest 75 mg dose producing 10.5% loss versus 0.6% on placebo; 88.8% of participants on 75 mg lost at least 5% of body weight versus 15.6% on placebo. A 36-week extension of the highest dose showed 11.8% weight loss versus 0.3% on placebo, with continued improvement rather than a plateau. VISTA was published in a peer-reviewed journal, making this the strongest tier of evidence available for elecoglipron’s obesity effect so far.

Glycemic control and weight loss in type 2 diabetes

In the 26-week Phase 2 SOLSTICE trial (roughly 405 participants with type 2 diabetes and inadequate glycemic control, including an active semaglutide 14 mg comparison arm), the highest 75 mg dose produced an HbA1c reduction of about 1.9 percentage points versus 0.2 on placebo, with 90% of participants reaching HbA1c below 7% and weight loss of 7.7% versus 1.7% on placebo. Company-reported topline results describe this as company-reported, congress/press-release-level human trial data as of this review, pending full peer-reviewed publication of SOLSTICE specifically.

What dosage information circulates?

Figures in this section summarize amounts and schedules reported in AstraZeneca’s published and presented clinical trial data. Their inclusion documents what is reported and does not establish that any particular dose is the one that will eventually be approved. Elecoglipron is not sold anywhere, so there is no community-reported or vendor-reported dosing to include here — every figure below traces back to AstraZeneca’s own trials.

Doses tested ranged from 5 mg up to 75 mg once daily across both trials, with the two lower doses (5 mg, 15 mg) given without titration and the higher doses (50 mg, 75 mg) reached through a step-up schedule over several weeks to manage gastrointestinal tolerability. SOLSTICE also tested a 25 mg fixed dose not used in VISTA. AstraZeneca has not yet disclosed the specific dose or doses being carried into the Phase 3 EMBOLD and ELUMINATE programs.

Reported use or research objective	Route reported	Amount reported	Frequency reported	Reported duration	Evidence or source category
Phase 2 VISTA, obesity/overweight without diabetes	Oral	5 mg or 15 mg (no titration); 50 mg (4-week titration); 75 mg (weekly or bi-weekly titration)	Once daily	26 weeks (36-week extension at highest dose)	Published, peer-reviewed human clinical trial
Phase 2 SOLSTICE, type 2 diabetes	Oral	Fixed 5 mg, 15 mg, or 25 mg; 50 mg (2-week titration); 75 mg (2- or 4-week titration); active comparator semaglutide 14 mg	Once daily	26 weeks	Company-reported, congress-presented human clinical trial
Phase 3 EMBOLD (obesity, with and without T2D)	Oral	Not yet disclosed	Once daily (expected)	Not yet started	Planned, not yet initiated
Phase 3 ELUMINATE (type 2 diabetes, monotherapy and with dapagliflozin)	Oral	Not yet disclosed	Once daily (expected)	Not yet started	Planned, not yet initiated

Side effects, risks, and limitations

Gastrointestinal adverse events were the most common finding in both trials, consistent with the GLP-1 drug class. At the highest 75 mg dose in VISTA: nausea in 55% (vs. 20% placebo), constipation in 41% (vs. 6%), diarrhea in 35% (vs. 25%), and vomiting in 29% (vs. 5%). At 75 mg in SOLSTICE, rates were somewhat lower: nausea 37% (vs. 3%), constipation 29% (vs. 4%), diarrhea 21% (vs. 15%), and vomiting 18% (vs. 1%). Discontinuation due to adverse events was reported as low (roughly 2–4% in VISTA), and AstraZeneca has reported no hepatic (liver) safety signals and infrequent hypoglycemia in the diabetes trial, with no serious hypoglycemic events attributed to elecoglipron. Long-term safety beyond the 26- to 36-week periods reported here, safety in broader populations, and any rare adverse events that only emerge at larger trial scale are not yet established. No independent, non-company safety data exists, and no real-world or post-market safety data exists since elecoglipron is not approved anywhere.

Regulatory and developmental status

Elecoglipron is not approved for any use in any country. AstraZeneca has completed Phase 2 development (VISTA and SOLSTICE) and announced in June 2026 that it is advancing to an extensive Phase 3 program: EMBOLD trials in obesity and overweight (with and without type 2 diabetes) and ELUMINATE trials in type 2 diabetes (as monotherapy and combined with dapagliflozin), alongside planned long-term cardiovascular and kidney outcome studies. No regulatory submission has been made, and no approval timeline has been confirmed by the FDA, EMA, or any other regulator.

Frequently asked questions

What is elecoglipron?

Elecoglipron (AZD5004, originally ECC5004) is AstraZeneca’s investigational once-daily oral, small-molecule GLP-1 receptor agonist for obesity and type 2 diabetes, originated by Eccogene.

How does elecoglipron work?

It activates the GLP-1 receptor, like injectable GLP-1 drugs, but as an oral small molecule that AstraZeneca says can be taken without food or fluid restrictions.

What dosage has been studied?

Phase 2 trials tested 5 mg to 75 mg once daily, with higher doses reached through gradual titration. The Phase 3 dose has not been disclosed.

How much weight loss has elecoglipron produced in trials?

Up to 10.5% at 26 weeks and 11.8% at 36 weeks (75 mg) in people with obesity without diabetes, and 7.7% in people with type 2 diabetes at the same dose.

Is elecoglipron a peptide?

No. It is a chemically synthesized small molecule, not a peptide, which allows it to be taken as a pill.

What side effects have been reported?

Gastrointestinal side effects (nausea, constipation, diarrhea, vomiting) were most common, generally mild to moderate, with low discontinuation rates and no reported liver safety signals.

Is elecoglipron approved?

No. It is not approved anywhere. AstraZeneca announced Phase 3 plans (EMBOLD and ELUMINATE) in June 2026, with no confirmed regulatory filing timeline.

How is elecoglipron different from other oral GLP-1 pills in development?

AstraZeneca has highlighted a distinct “biased signaling profile” at the GLP-1 receptor and dosing without food or fluid restrictions, though full discovery chemistry has not been publicly disclosed.

What remains unknown?

The specific Phase 3 dose, the resolution of the conflicting CAS number listed by different chemical vendors, full peer-reviewed publication of the SOLSTICE diabetes trial, and long-term safety data are all still unknown.

Bottom line

Elecoglipron is one of the more advanced AstraZeneca-backed oral GLP-1 candidates, with published Phase 2 obesity data (VISTA) showing weight loss competitive with other leading oral and injectable GLP-1 therapies at similar trial durations, plus meaningful glycemic benefit in a head-to-head-adjacent diabetes trial (SOLSTICE) that included an active semaglutide comparator. AstraZeneca’s June 2026 announcement of an extensive Phase 3 program (EMBOLD and ELUMINATE) signals real confidence in the compound, but the specific Phase 3 doses, full peer-reviewed publication of SOLSTICE, and basic chemical identifiers like molecular formula and a single confirmed CAS number are all still unresolved in the public record as of this review. It is not approved or sold anywhere.

Related entries: orforglipron, an oral non-peptide GLP-1 agonist.