# Retatrutide beat Ozempic 2 mg on blood sugar and weight in its first head-to-head trial

> Source: https://peptidewellnessusa.com/news/retatrutide-vs-ozempic-transcend-t2d-2-october-2026/
> News · Research · October 2026
> By PeptideWellness Editorial Team · Updated November 4, 2026 · 3 min read

Lilly's experimental triple agonist lowered A1C more than Ozempic 2 mg and more than doubled its weight loss over 80 weeks in adults with type 2 diabetes. These are topline company figures, the drug is not approved, and the comparison that matters most is still running.

On October 28, 2026, Eli Lilly reported topline results from TRANSCEND-T2D-2, the first Phase 3 trial to put retatrutide against an approved drug instead of placebo [1]. In adults with type 2 diabetes, both retatrutide doses lowered A1C more than Ozempic 2 mg, the highest approved dose of semaglutide for diabetes, and produced more than twice the weight loss over 80 weeks.

The results come from a company press release. The trial has not been published or presented yet, and retatrutide is not approved anywhere.

## The trial

TRANSCEND-T2D-2 (NCT06260722) enrolled 1,298 adults whose type 2 diabetes was not controlled on metformin, with or without an SGLT2 inhibitor, and whose A1C was between 7.0% and 10.5% [1][2]. They were randomly assigned 2:2:1 to weekly retatrutide 9 mg, retatrutide 12 mg or Ozempic 2 mg. The trial was open-label, so participants and doctors knew which drug was given. The main goal was to show that 12 mg was not worse than Ozempic on A1C at 80 weeks.

## The results

| At 80 weeks | Retatrutide 9 mg | Retatrutide 12 mg | Ozempic 2 mg |
| --- | --- | --- | --- |
| A1C change (baseline 8.3%) | −2.2 points | −2.2 points | −1.8 points |
| Body weight change (baseline 102.4 kg) | −19.5% (−20.1 kg) | −20.9% (−21.5 kg) | −9.4% (−9.5 kg) |

Lilly says 12 mg was better than Ozempic on both A1C and weight with full statistical control, and 9 mg was better on weight. The 9 mg advantage on A1C is reported as a nominal result. Retatrutide also improved non-HDL cholesterol, triglycerides and systolic blood pressure more than Ozempic, according to the release [1].

All of these are efficacy-estimand figures: what the drugs did in people who stayed on treatment without adding other diabetes medication. Lilly did not report the treatment-regimen figures, which count everyone as randomised and usually come out lower. They should appear in the full paper.

## Side effects

The most common side effects were digestive, as with every drug in this class [1].

| Adverse event | 9 mg | 12 mg | Ozempic 2 mg |
| --- | --- | --- | --- |
| Diarrhea | 28.3% | 32.7% | 26.4% |
| Nausea | 21.2% | 23.8% | 21.3% |
| Constipation | 14.2% | 13.1% | 19.8% |
| Vomiting | 10.2% | 15.0% | 13.2% |
| Dysesthesia (tingling or altered skin sensation) | 4.8% | 6.5% | 2.7% |
| Stopped treatment because of side effects | 4.8% | 7.9% | 2.7% |

Dysesthesia has now been reported in five retatrutide Phase 3 trials. It was more frequent here than on Ozempic, at rates close to those in TRIUMPH-2 and TRIUMPH-3 and well below the 12.5% at 12 mg in TRIUMPH-1. Lilly says most events were mild to moderate and resolved during treatment. Our [retatrutide guide](https://peptidewellnessusa.com/peptides/retatrutide/) has the figures from every trial.

## What it does not answer

The comparison most readers want is against tirzepatide (Zepbound, Mounjaro), the strongest approved option. That trial, TRIUMPH-5, is still running; its estimated primary completion date is November 2026 [3]. Until it reads out, every retatrutide-versus-tirzepatide number is an estimate across separate trials. See our [tirzepatide vs retatrutide comparison](https://peptidewellnessusa.com/peptides/compare/tirzepatide-vs-retatrutide/).

This trial also studied people with diabetes only. People with diabetes typically lose less weight on these drugs than people without it, so the 20.9% here is not directly comparable to obesity trials.

## Where retatrutide stands

There is no retatrutide application at the FDA. Drugs@FDA has no record of it, and Lilly has said it plans to file in the first quarter of 2027 [5]. Retatrutide cannot be compounded under federal law [4], and Lilly's release says plainly that anyone selling it to consumers is breaking the law [1]. Products sold online as "retatrutide" are not the trial drug and have not been checked for identity, strength or sterility.

The only legal routes are a clinical trial or Lilly's expanded access program, both arranged by a physician. If you have type 2 diabetes and want a stronger option today, approved drugs such as [semaglutide](https://peptidewellnessusa.com/peptides/semaglutide/) and [tirzepatide](https://peptidewellnessusa.com/peptides/tirzepatide/) are the ones to discuss with your doctor.

## References

1. [Eli Lilly and Company — "Lilly's retatrutide delivered greater A1C reduction and more than double the weight loss of Ozempic's highest approved dose in head-to-head trial," October 28, 2026.](https://investor.lilly.com/news-releases/news-release-details/lillys-retatrutide-delivered-greater-a1c-reduction-and-more)
2. [ClinicalTrials.gov — NCT06260722 (TRANSCEND-T2D-2). Primary completion August 27, 2026; no results posted. Read November 4, 2026.](https://clinicaltrials.gov/study/NCT06260722)
3. [ClinicalTrials.gov — NCT06662383 (TRIUMPH-5), retatrutide compared with tirzepatide in adults with obesity. Estimated primary completion November 2026. Read November 4, 2026.](https://clinicaltrials.gov/study/NCT06662383)
4. [FDA — "FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss" (retatrutide and cagrilintide).](https://www.fda.gov/drugs/drug-alerts-and-statements/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss)
5. [Eli Lilly and Company — TRIUMPH-2 and TRIUMPH-3 topline results, July 23, 2026, including the plan to submit a Biologics License Application in the first quarter of 2027.](https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-successful-in-two-additional-phase-3-obesity-trials-delivering-significant-improvements-in-weight-and-a1c-302832674.html)

> Editorial note: Informational only — not medical advice. Retatrutide is an investigational drug and is not approved by the FDA for any use. The figures above are topline results reported by the manufacturer and have not yet been peer-reviewed. PeptideWellness has no commercial relationship with Eli Lilly or Novo Nordisk. Last reviewed November 2026.