Metabolic and neuroendocrine
Dual glucagon and GLP-1 receptor signalling
Combined glucagon and GLP-1 receptor agonism aims to reduce energy intake through GLP-1 pathways while adding glucagon-mediated effects on energy expenditure, hepatic metabolism and fat mobilisation.
Biological pathway
GLP-1 receptor and glucagon receptor agonism → Gs protein and cyclic-AMP signalling → central appetite effects plus pancreatic, hepatic and energy-metabolism responses.
Evidence summary
Randomized trials of survodutide and pemvidutide support biological activity in body-weight and liver-fat outcomes.
Limitations
Optimal receptor balance is uncertain. Glucagon activity may affect heart rate, glucose and liver metabolism, and long-term cardiovascular and safety outcomes remain under study.