A once-daily oral GLP-1 pill called aleniglipron helped adults with obesity or overweight lose up to 12.1% of their body weight over 36 weeks, according to a randomized phase 2b trial published in June 2026 in Nature Medicine.
Most approved GLP-1 medications are peptide-based drugs like semaglutide, the active ingredient in Novo Nordisk's Ozempic and Wegovy, which require weekly self-injection. Aleniglipron is a small molecule, chemically synthesized and taken as a pill.
For many patients, needle avoidance is a real barrier. A pill also avoids the cold-chain refrigeration and complex peptide manufacturing that injectable GLP-1s require, which Structure Therapeutics says could improve access if aleniglipron reaches the market.
The data are early stage. Structure Therapeutics, which developed and funded the trial, plans to move the drug into a phase 3 program in the third quarter of 2026. Aleniglipron is not FDA-approved.
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What the trial found
The ACCESS trial enrolled 230 adults, average age 50, across 38 US medical centers. Participants were randomly assigned to placebo or one of three daily doses of aleniglipron (45, 90 or 120 mg), stepped up every four weeks.
At 36 weeks, the placebo group lost 0.5% of body weight. The 45 mg group lost 9.0%, the 90 mg group 10.7%, and the 120 mg group 12.1%.
No apparent weight-loss plateau was seen by the end of the double-blind period, suggesting the drug's effect had not yet leveled off. The study met its primary endpoint at all three doses.
How the drug is different
Robert Kushner, MD, professor emeritus of medicine at Northwestern University's Feinberg School of Medicine, co-authored the study. "The difference with aleniglipron is it's a small molecule, which means it's chemically made and could be taken with or without food," he said.
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Gastrointestinal side effects were reported as mild to moderate across the dose groups and decreased over time. The overall discontinuation rate was 10.4%, and no drug-induced liver injury was reported.
The oral GLP-1 race is on
Aleniglipron enters a rapidly widening field. In December 2025, the FDA approved an oral version of Wegovy for chronic weight management.
In April 2026, Eli Lilly's orforglipron, another small-molecule oral GLP-1, became the first pill in its class approved for weight loss with no food or water restrictions.
Whether aleniglipron's 12.1% figure holds up in a larger phase 3 trial remains to be seen. Patients considering GLP-1 treatment for weight management should talk with their doctor about which options are appropriate.
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