Eli Lilly announced results today (October 28, 2026) from TRANSCEND-T2D-2, the first Phase 3 head-to-head trial of its investigational triple-agonist retatrutide against Ozempic (semaglutide) 2 mg. Here is what was reported, what it can and can't tell us, and where retatrutide stands.
Retatrutide is investigational. It has not been approved by the FDA or any regulatory authority anywhere in the world. This article is educational and is not medical advice.
What was studied
- Trial: TRANSCEND-T2D-2, a Phase 3, randomized, open-label, head-to-head study
- Who: 1,298 adults with type 2 diabetes not well controlled on metformin, with or without an SGLT2 inhibitor (average baseline A1C 8.3%, average weight 102.4 kg / 225.8 lbs)
- Arms: retatrutide 9 mg, retatrutide 12 mg, or Ozempic 2 mg, once weekly, randomized 2:2:1
- Length: 80 weeks, with retatrutide started at 2 mg and increased every four weeks
The headline numbers (80 weeks)
| Arm | A1C change | Body weight change |
|---|---|---|
| Retatrutide 9 mg | −2.2% | −19.5% (−44.3 lbs) |
| Retatrutide 12 mg | −2.2% | −20.9% (−47.4 lbs) |
| Ozempic 2 mg | −1.8% | −9.4% (−20.9 lbs) |
Lilly reports that both retatrutide doses were superior to Ozempic 2 mg for A1C and body weight, and that retatrutide also showed greater improvements in non-HDL cholesterol, triglycerides and systolic blood pressure. These figures use the efficacy estimand, which reflects results while participants stayed on treatment.
Side effects
Gastrointestinal effects were the most common, as is typical for this drug class. Lilly reported:
- Diarrhea: 28.3% (9 mg) and 32.7% (12 mg) vs. 26.4% (Ozempic)
- Nausea: 21.2% and 23.8% vs. 21.3%
- Vomiting: 10.2% and 15.0% vs. 13.2%
- Constipation: 14.2% and 13.1% vs. 19.8%
- Dysesthesia (unusual skin sensations): 4.8% and 6.5% vs. 2.7%
More people stopped treatment because of side effects on retatrutide: 4.8% (9 mg) and 7.9% (12 mg), compared with 2.7% on Ozempic. Lilly says most events were mild to moderate and generally resolved during treatment.
What these results don't tell us
- It's a diabetes trial. Participants had type 2 diabetes. The weight results don't automatically carry over to people without diabetes, who typically lose less weight on this class of drugs.
- It's open-label. Participants and investigators knew which drug was being used, which can influence some outcomes.
- The comparator is Ozempic 2 mg. The release does not report a comparison against other doses.
- It's company-reported. The data come from a press release. Detailed results are expected at a future medical meeting and in a peer-reviewed journal; no dates were given.
- Long-term safety is still being established. About 650 participants will continue retatrutide for an additional 24 weeks, and other Phase 3 trials are ongoing, including a head-to-head trial against tirzepatide in obesity (TRIUMPH-5).
Where retatrutide stands
Retatrutide targets three hormone receptors (GIP, GLP-1 and glucagon). As of today, Lilly's release does not mention a regulatory submission, and the drug is not available as a prescription medication anywhere. That also means it is not something a licensed pharmacy can lawfully compound for a patient: compounding under federal law (Section 503A) generally requires an ingredient that is part of an FDA-approved drug, has a USP monograph, or appears on FDA's list of eligible substances.
A word of caution about "research" retatrutide
News like this tends to spark a wave of online sellers offering retatrutide labeled "for research use only." Those products are unapproved, are not made or checked under pharmacy standards, and are not intended for human use. If you're interested in GLP-1-based treatment, talk with a licensed clinician about the options that are actually available and approved today.
The bottom line
Today's results are an encouraging data point for a drug still in development, and they raise the bar in the head-to-head conversation. But they are early, company-reported, and specific to people with type 2 diabetes. We'll update this post when the full data are published.
Sources: Eli Lilly press release, October 28, 2026 · Investing.com coverage · STAT News
Educational only. Not medical advice. Prescription medications require evaluation by a licensed clinician. Compounded medications are not FDA-approved.
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