Three agents dominate coverage of what is coming next, and they are in three different regulatory states. One is already approved — in the United States, since April 2026. Two have no approval in Singapore or the United States and are still in clinical trials, and the most-quoted number attached to either of them comes from a phase 2 trial. None of the three can be prescribed in Singapore. This article sets out what each one is, what its trials measured, and why the phase matters more than the percentage.
Two of the three — CagriSema and retatrutide — are still in trials. This is what that means for those two.
Availability in Singapore. This is an investigational medicine. It is not registered with Singapore's Health Sciences Authority, and it has no approved application with the United States Food and Drug Administration either, so it cannot be prescribed in either country. It is available only to people taking part in a clinical trial, and anything offered for sale under this name is not what the trials studied.
All 5,511 records on Singapore's register were enumerated on 23 August 2026. None of the three appears on it (HSA register).
What the trial phases mean
Phase 2 and phase 3: phase 2 finds the dose and looks for a signal, usually in a few hundred people. Phase 3 tests that dose at scale, against a comparator, in the population the medicine is meant for — usually thousands. A phase 2 result is a reason to run phase 3, not a result to plan around.
This is the single most useful thing to hold while reading anything else about the pipeline. Numbers move between the two stages, in both directions, and that is the ordinary functioning of the process rather than a scandal.
Orforglipron — approved, in another country
Availability in Singapore. This medicine is not available in Singapore. It is not registered with the Health Sciences Authority, so no doctor here can prescribe it and there is no legitimate local supply. Anything offered under this name in Singapore is coming from outside the regulated system, and what that actually means is set out here.
Its United States application, NDA220934, was originally approved on 1 April 2026, with a further supplement approved on 4 August 2026 (Drugs@FDA). The American prescribing information indicates it in combination with a reduced-calorie diet and increased physical activity, to reduce excess body weight and maintain weight reduction long term in adults with obesity or overweight with at least one weight-related comorbid condition (DailyMed).
What is different about it is chemical rather than commercial. It is a small molecule, not a peptide — so unlike the semaglutide tablet, it does not need a formulation built around carrying a fragile peptide past the stomach. That is what makes a conventional once-daily tablet possible. The peptide-tablet problem, and the product that solves it differently, is covered in the tablet, and what it is for.
ATTAIN-1, its phase 3 trial, randomised 3,127 patients with obesity and without diabetes. Mean weight change at 72 weeks was −7.5%, −8.4% and −11.2% at 6 mg, 12 mg and 36 mg once daily, against −2.1% with placebo (Wharton 2025). Individual results vary and are not guaranteed.
Read the top dose against the injectables' own trials and it sits below them. Convenience and effect size are pulling in different directions here, which is a real trade rather than a disappointment.
CagriSema — phase 3 results, no approval
A co-formulation of semaglutide with cagrilintide, a long-acting analogue of amylin — a different appetite-regulating hormone from GLP-1, acting through a different pathway. The idea is that two pathways together do more than one.
REDEFINE 1 randomised 3,417 adults. Estimated mean weight change at 68 weeks was −20.4% against −3.0% with placebo (Garvey 2025). Gastrointestinal adverse events affected 79.6% of the treatment group against 39.9% on placebo, mainly transient and mild to moderate. Individual results vary and are not guaranteed.
It has no approval in Singapore and none in the United States.
Retatrutide — the number that needs its phase attached
Retatrutide acts at three receptors: GIP, GLP-1 and glucagon.
The figure circulating for it comes from a phase 2 trial. In 338 adults, least-squares mean weight change at 48 weeks was −24.2% at 12 mg against −2.1% with placebo (Jastreboff 2023). Individual results vary and are not guaranteed.
That is the highest number in this article and the least settled one. Phase 3 results for weight have not been published, and the agent remains under active investigation — a trial protocol published in 2026 describes an ongoing randomised trial in chronic kidney disease (TRANSCEND-CKD).
What a pooled analysis says about all three
A 2026 network meta-analysis of 262 trials and 99,791 participants placed them against a common comparator at one year, and attached a certainty grading to each — which is the part worth reading.
Cagrilintide-semaglutide came out at −14.8% and orforglipron at −9.9%. The emerging agents, retatrutide among them, were estimated at 13.1% to 14.6% — with very low to low certainty. Discontinuation because of adverse events was among the highest with orforglipron and with CagriSema (Nong 2026). Those are pooled trial averages, and individual results vary.
Two things fall out of that. The certainty grading on the newest agents is low precisely because the evidence is thin, which is what "emerging" means. And the pattern the analysis found across all 19 drugs it examined was that larger benefits generally came with greater harms and more people stopping.
Should anyone wait?
Nothing on this page supports a date, because none has been announced for this market.
Two of the three have no approval in Singapore or the United States. The third is approved in a country whose regulator does not license medicines here. Registration in Singapore is a separate application, assessed separately, on a timetable nobody outside the process knows.
Whether to do something now, or nothing, is a conversation to have with a doctor who has assessed you — not a decision to make against a calendar that has not been published. That cuts both ways: nothing here is a reason to act today either.
What none of this changes
Every trial on this page tested a medicine alongside diet and physical activity. That has been true of every trial in this class since the beginning, and there is no sign of it changing.
And every one of them measured weight. Not one of these agents is designed to determine whether what comes off is fat or muscle — that is decided by protein intake, resistance training and the rate of loss, exactly as it is with the medicines already registered here. The next molecule does not solve the composition problem; if anything, a more effective molecule makes it more urgent. We cover the comparison that already exists in semaglutide vs tirzepatide, and how the class got here at all in from lizard venom to the biggest drug class in medicine.
Common questions
Is retatrutide approved anywhere?
Not in Singapore and not in the United States. It does not appear on Singapore's register of therapeutic products (HSA register), and it has no approved application in the United States drug database. A trial protocol published in 2026 confirms it is still being studied (TRANSCEND-CKD).
Where does the 24% figure for retatrutide come from?
A phase 2 trial of 338 adults, in which least-squares mean weight change at 48 weeks was −24.2% at the 12 mg dose against −2.1% with placebo (Jastreboff 2023). Phase 2 is the dose-finding stage. Numbers commonly move when a phase 2 result is retested at scale, and phase 3 results for this agent have not been published.
Is orforglipron available in Singapore?
No. It does not appear on Singapore's register (HSA register). It was approved in the United States on 1 April 2026 (Drugs@FDA), which has no effect on what a doctor here may prescribe.
How does an oral GLP-1 tablet differ from the semaglutide tablet?
Orforglipron is a small molecule rather than a peptide, so it does not need the absorption workaround that a peptide tablet is built around. That is a genuine chemical difference rather than a formulation tweak — and it is the reason a once-daily conventional tablet is possible at all.
Should I wait for one of these?
Nothing here supports a date. Two of the three have no approval in Singapore or the United States, the third is not registered here, and no arrival date has been announced for any of them in this market. Whether to do anything now, or nothing, is a conversation to have with a doctor rather than a decision to make against a calendar nobody has published.