Retatrutide Phase 3 Results: Up to 71.2 lbs Lost and Significant Osteoarthritis Pain Relief
Eli Lilly’s investigational triple agonist Retatrutide has delivered some of the most compelling weight loss data seen in a Phase 3 clinical trial to date — with participants losing an average of 28.7% of body weight over 68 weeks, while simultaneously experiencing near-complete relief from knee osteoarthritis pain.
Once-weekly injectable peptides like retatrutide represent the next frontier in metabolic research.
What Is Retatrutide?
Retatrutide is a once-weekly injectable peptide that simultaneously activates three hormone receptors: GIP (glucose-dependent insulinotropic polypeptide), GLP-1 (glucagon-like peptide-1), and glucagon. This triple-receptor mechanism sets it apart from existing GLP-1 single agonists like semaglutide and dual agonists like tirzepatide — making it the first-in-class triple hormone receptor agonist of its kind.
By targeting all three pathways simultaneously, retatrutide amplifies the body’s natural metabolic signaling: reducing appetite, improving insulin response, and increasing energy expenditure through glucagon receptor activation.
Structural visualization of retatrutide’s triple agonism at GLP-1R, GIPR, and GCGR receptors (Cell Discovery).
TRIUMPH-4 Trial: Overview
The TRIUMPH-4 trial (NCT05931367) enrolled 445 adults with obesity or overweight and knee osteoarthritis over 68 weeks. Participants had an average starting weight of 248.5 lbs (112.7 kg) and a BMI of 40.4 kg/m², with 84% having a BMI of 35 or above. Both the 9 mg and 12 mg doses of retatrutide met all primary and key secondary endpoints.
Weight Loss Outcomes
| Group | Average Weight Loss | Average lbs Lost |
|---|---|---|
| Retatrutide 9 mg | -26.4% | -64.2 lbs |
| Retatrutide 12 mg | -28.7% | -71.2 lbs |
| Placebo | -2.1% | -4.6 lbs |
The proportion of participants achieving major weight loss thresholds on the 12 mg dose was remarkable:
- 58.6% of the 12 mg group lost ≥25% of body weight
- 39.4% lost ≥30% of body weight
- 23.7% lost ≥35% of body weight
- Only 0.8% of placebo participants reached ≥30% weight loss
Osteoarthritis Pain Relief


WOMAC pain scores — a validated patient-reported measure where higher values indicate worse symptoms — were reduced dramatically:
| Group | WOMAC Score Reduction | % Reduction |
|---|---|---|
| Retatrutide 9 mg | -4.5 points | -75.8% |
| Retatrutide 12 mg | -4.4 points | -74.3% |
| Placebo | -2.4 points | -40.3% |
Physical function improved by over 71% in both dose groups. Notably, 14.1% of patients on the 9 mg dose were completely free of knee pain at week 68, compared to just 4.2% on placebo.
Cardiovascular and Metabolic Benefits
Beyond weight and pain, retatrutide also reduced cardiovascular risk markers including non-HDL cholesterol, triglycerides, and high-sensitivity C-reactive protein (hsCRP). The 12 mg dose lowered systolic blood pressure by an average of 14.0 mmHg.
Safety Profile
Adverse events were consistent with other incretin-based therapies. The most commonly reported side effects in the 9 mg and 12 mg groups respectively were:
| Side Effect | 9 mg | 12 mg | Placebo |
|---|---|---|---|
| Nausea | 38.1% | 43.2% | 10.7% |
| Diarrhea | 34.7% | 33.1% | 13.4% |
| Constipation | 21.8% | 25.0% | 8.7% |
| Vomiting | 20.4% | 20.9% | 0.0% |
| Decreased appetite | 19.0% | 18.2% | 9.4% |
| Dysesthesia | 8.8% | 20.9% | — |
Overall discontinuation rates due to adverse events were 12.2% (9 mg) and 18.2% (12 mg), compared to 4.0% on placebo, and were highly correlated with baseline BMI. Dysesthesia events were generally mild and rarely led to discontinuation.
What’s Next for Retatrutide?
Retatrutide’s 28.7% weight loss surpasses results seen with current GLP-1 and dual agonist therapies.
TRIUMPH-4 is the first of eight Phase 3 trials in the TRIUMPH program. Seven additional trials evaluating retatrutide across obesity, type 2 diabetes, obstructive sleep apnea, chronic low back pain, cardiovascular outcomes, and metabolic liver disease are expected to report results through 2026.
A maintenance dose of 4 mg is also being evaluated, and analysts have noted that TRIUMPH-1 — the longest trial at 80 weeks — could potentially exceed 30% average weight loss.
“Lilly’s triple agonist, retatrutide, delivered weight loss of up to an average of 71.2 lbs…” — Investor Relations Press Release, December 10, 2025












