--- title: "Avexitide | PepTracker Pro" url: https://peptrackerpro.com/peptides/avexitide description: "A first-in-class once-daily injectable GLP-1 receptor ANTAGONIST (exendin 9-39) from Amylyx for hyperinsulinemic hypoglycemia. The mirror image of GLP-1 agonists like semaglutide, it blocks GLP-1 to stop the insulin surges that cause post-bariatric hypoglycemia. Phase 3 LUCIDITY completed enrollment March 2026 with topline data expected Q3 2026." lang: en --- Skip to main content **Educational information only.** This site does not provide medical advice. Read full disclaimer (https://peptrackerpro.com/disclaimer) **Research-only content.** This page is for educational purposes and does not constitute medical advice. Read full disclaimer → (https://peptrackerpro.com/research-disclaimer) # Avexitide Medium Evidence A first-in-class once-daily injectable GLP-1 receptor ANTAGONIST (exendin 9-39) from Amylyx for hyperinsulinemic hypoglycemia. The mirror image of GLP-1 agonists like semaglutide, it blocks GLP-1 to stop the insulin surges that cause post-bariatric hypoglycemia. Phase 3 LUCIDITY completed enrollment March 2026 with topline data expected Q3 2026. Aliases Exendin (9-39) +5 more Evidence Medium Evidence Last Updated 2026-08-04 Reading Time 4 min ## What It Is Avexitide is a first-in-class, once-daily injectable GLP-1 receptor ANTAGONIST being developed by Amylyx Pharmaceuticals for hyperinsulinemic hypoglycemia — most advanced in post-bariatric hypoglycemia (PBH) and also studied in congenital hyperinsulinism (HI). It is the mirror image of the blockbuster GLP-1 agonist class (semaglutide, tirzepatide, orforglipron): where those drugs activate the GLP-1 receptor to boost insulin and curb appetite, avexitide BLOCKS it. Chemically, avexitide is exendin (9-39), a synthetic 31-amino-acid peptide fragment of exendin-4 (the same lizard-derived peptide that inspired exenatide), and it is a potent, selective competitive GLP-1 receptor antagonist. By blocking GLP-1 signaling on pancreatic beta cells, it dampens the exaggerated, glucose-independent insulin surges that cause dangerous post-meal blood-sugar crashes. Post-bariatric hypoglycemia is a debilitating complication of gastric bypass (Roux-en-Y, RYGB) in which rapid nutrient delivery drives excessive GLP-1 and insulin release, producing severe hypoglycemia; there is currently no FDA-approved therapy. Avexitide originated at Eiger BioPharmaceuticals, which took it through five clinical trials; after Eiger entered Chapter 11 bankruptcy in April 2024, Amylyx acquired the Phase 3-ready asset for about $35.1 million in July 2024, pivoting the company into the metabolic space following the discontinuation of its ALS drug. In a Phase 2b PBH trial, avexitide 90 mg once daily produced a 64% least-squares-mean reduction in the composite rate of Level 2 and Level 3 hypoglycemic events. The pivotal Phase 3 LUCIDITY trial (NCT06747693) enrolled 78 adults with PBH after RYGB in a 16-week, randomized, double-blind, placebo-controlled design; its FDA-agreed primary endpoint is the reduction in the composite of Level 2 and Level 3 hypoglycemic events through Week 16. LUCIDITY completed enrollment in March 2026, and Amylyx expects topline data in the third quarter of 2026, with a potential commercial launch in 2027 if approved. Avexitide holds FDA Breakthrough Therapy Designation for both post-bariatric hypoglycemia (granted to Amylyx in 2024) and congenital hyperinsulinism (originally granted to Eiger in 2021), plus Orphan Drug Designation. It is not approved for any use anywhere, and — as an injectable clinical-stage peptide — is not a supplement or research chemical. Also known as: Exendin (9-39), Exendin-4 (9-39), Exendin 9-39 amide, AMX-0114 (metabolic program, Amylyx), Amylyx avexitide, GLP-1 receptor antagonist peptide ## Regulatory Status Investigational — not approved FDA Breakthrough Therapy Designation for post-bariatric hypoglycemia (2024) and congenital hyperinsulinism (2021), plus Orphan Drug Designation. Pivotal Phase 3 LUCIDITY trial in PBH completed enrollment (78 participants) in March 2026; Amylyx expects topline data in Q3 2026 and, if positive, a potential U.S. launch in 2027. Not approved for any indication anywhere. Effective: March 2026 View FDA Source (https://www.amylyx.com/news/amylyx-pharmaceuticals-announces-completion-of-enrollment-in-pivotal-phase-3-lucidity-clinical-trial-of-avexitide-in-post-bariatric-hypoglycemia) ## Why Researchers Study It Avexitide is the leading clinical example of a counterintuitive idea: BLOCKING the GLP-1 receptor rather than activating it. In hyperinsulinemic hypoglycemia — post-bariatric hypoglycemia and congenital hyperinsulinism — the problem is too much insulin at the wrong time, and GLP-1 amplifies it. Researchers study avexitide as a mechanistically precise, first-in-class therapy for conditions with no approved treatment, and as living proof that the GLP-1 axis can be tuned in both directions. Its Breakthrough Therapy Designations and imminent Phase 3 readout make it one of the most closely watched rare-metabolic peptides of 2026. ## Proposed Mechanisms - Competitive, selective antagonism of the GLP-1 receptor by exendin (9-39), a 31-amino-acid exendin-4 fragment - Blunts glucose-independent, GLP-1-driven insulin secretion from pancreatic beta cells - Raises nadir blood glucose and reduces the frequency and severity of Level 2 and Level 3 hypoglycemic events - Targets the excessive post-meal GLP-1 surge that follows Roux-en-Y gastric bypass in post-bariatric hypoglycemia ## Evidence Snapshot Medium Evidence Low Medium High | Study Type | Model | Outcome | Link | | --- | --- | --- | --- | | Phase 2b (post-bariatric hypoglycemia) | Adults with PBH after RYGB — dose-ranging | Avexitide 90 mg once daily produced a 64% least-squares-mean reduction in the composite rate of Level 2 and Level 3 hypoglycemic events versus baseline | Source: https://www.amylyx.com/news/amylyx-pharmaceuticals-announces-completion-of-enrollment-in-pivotal-phase-3-lucidity-clinical-trial-of-avexitide-in-post-bariatric-hypoglycemia | | Phase 3 (LUCIDITY, PBH, NCT06747693) | 78 adults with post-bariatric hypoglycemia after RYGB — 16-week randomized, double-blind, placebo-controlled | Fully enrolled March 2026; FDA-agreed primary endpoint is reduction in the composite of Level 2 and Level 3 hypoglycemic events through Week 16; topline data expected Q3 2026 | Source: https://clinicaltrials.gov/study/NCT06747693 | | Phase 2 (congenital hyperinsulinism) | Children and adolescents with congenital HI (three completed Phase 2 studies, 39 participants total) | Exendin (9-39) reduced hyperinsulinemic hypoglycemia and raised fasting and post-meal glucose, supporting Breakthrough Therapy Designation in congenital HI | Source: https://diabetesjournals.org/care/article/45/6/1381/144984/Exendin-9-39-Effects-on-Glucose-and-Insulin-in | ## Commonly Discussed Benefits Glycemic Control: https://peptrackerpro.com/benefits/glycemic-control Metabolism: https://peptrackerpro.com/benefits/metabolism Rare Disease Treatment: https://peptrackerpro.com/benefits/rare-disease-treatment Researching Avexitide? Track it, set reminders, and keep notes in the free app. Track in App (https://app.peptrackerpro.com/?add=avexitide) ## Safety & Cautions - Investigational — not approved for any use anywhere - Pivotal Phase 3 LUCIDITY topline data are not yet reported (expected Q3 2026); efficacy to date is from earlier-phase trials - A GLP-1 receptor ANTAGONIST — opposite in mechanism to GLP-1 agonists; it is NOT a weight-loss drug and is not interchangeable with semaglutide or tirzepatide - Being developed for rare hyperinsulinemic hypoglycemia disorders under specialist care, not for general metabolic or performance use - Any 'avexitide' or 'exendin 9-39' offered by a vendor is unverified — this is a clinical-stage pharmaceutical, not a supplement or research chemical ## Comparisons See how Avexitide compares to related peptides: Avexitide vs Orforglipron: https://peptrackerpro.com/compare/avexitide-vs-orforglipron Avexitide vs Semaglutide: https://peptrackerpro.com/compare/avexitide-vs-semaglutide Avexitide vs Setmelanotide: https://peptrackerpro.com/compare/avexitide-vs-setmelanotide Avexitide vs Tirzepatide: https://peptrackerpro.com/compare/avexitide-vs-tirzepatide ## Calculator Tools Use our research tools to explore dosing and reconstitution data: Reconstitution Calculator: https://peptrackerpro.com/calculators ## Citations 1. [1] Amylyx Pharmaceuticals — Completion of Enrollment in Pivotal Phase 3 LUCIDITY Trial of Avexitide in Post-Bariatric Hypoglycemia PubMed (https://www.amylyx.com/news/amylyx-pharmaceuticals-announces-completion-of-enrollment-in-pivotal-phase-3-lucidity-clinical-trial-of-avexitide-in-post-bariatric-hypoglycemia) 2. [2] Amylyx Pharmaceuticals — Acquisition of Phase 3-ready GLP-1 Receptor Antagonist Avexitide with FDA Breakthrough Therapy Designation (July 2024) PubMed (https://www.amylyx.com/news/amylyx-pharmaceuticals-announces-acquisition-of-glp-1-receptor-antagonist-avexitide-with-fda-breakthrough-therapy-designation) 3. [3] Amylyx Pharmaceuticals — First Quarter 2026 Financial Results (avexitide program update) PubMed (https://www.amylyx.com/news/amylyx-pharmaceuticals-reports-first-quarter-2026-financial-results) 4. [4] Exendin (9-39) Effects on Glucose and Insulin in Children With Congenital Hyperinsulinism — Diabetes Care PubMed (https://diabetesjournals.org/care/article/45/6/1381/144984/Exendin-9-39-Effects-on-Glucose-and-Insulin-in) 5. [5] LUCIDITY (Avexitide in Post-Bariatric Hypoglycemia) — ClinicalTrials.gov NCT06747693 PubMed (https://clinicaltrials.gov/study/NCT06747693) ### Keep researching in the app - Log Avexitide to your private tracker - Set a dosing reminder - Compare it side-by-side with your stack Open PepTracker Pro Free: https://app.peptrackerpro.com/?add=avexitide Browse more peptides: https://peptrackerpro.com/peptides ## Related Peptides ### Orforglipron High Evidence The first oral non-peptide GLP-1 receptor agonist, FDA-approved in April 2026 for chronic weight management with no food or water restrictions. Weight Management (https://peptrackerpro.com/benefits/weight-management)Appetite Regulation (https://peptrackerpro.com/benefits/appetite-regulation)Metabolism (https://peptrackerpro.com/benefits/metabolism)Fat Loss (https://peptrackerpro.com/benefits/fat-loss)+1 more View Details: https://peptrackerpro.com/peptides/orforglipron \+ Compare: https://peptrackerpro.com/compare?select=orforglipron Track in App: https://app.peptrackerpro.com/?add=orforglipron ### Semaglutide High Evidence A GLP-1 receptor agonist FDA-approved for type 2 diabetes and chronic weight management. Weight Management (https://peptrackerpro.com/benefits/weight-management)Appetite Regulation (https://peptrackerpro.com/benefits/appetite-regulation)Metabolism (https://peptrackerpro.com/benefits/metabolism)Fat Loss (https://peptrackerpro.com/benefits/fat-loss)+3 more View Details: https://peptrackerpro.com/peptides/semaglutide \+ Compare: https://peptrackerpro.com/compare?select=semaglutide Track in App: https://app.peptrackerpro.com/?add=semaglutide ### Setmelanotide High Evidence A once-daily subcutaneous cyclic octapeptide melanocortin-4 receptor (MC4R) agonist, FDA-approved for several rare genetic and acquired forms of obesity that act through the leptin-melanocortin pathway. Weight Management: https://peptrackerpro.com/benefits/weight-management Appetite Regulation: https://peptrackerpro.com/benefits/appetite-regulation View Details: https://peptrackerpro.com/peptides/setmelanotide \+ Compare: https://peptrackerpro.com/compare?select=setmelanotide Track in App: https://app.peptrackerpro.com/?add=setmelanotide ### Tirzepatide High Evidence A dual GIP/GLP-1 receptor agonist FDA-approved for type 2 diabetes, weight management, and MASH with liver fibrosis. View Details: https://peptrackerpro.com/peptides/tirzepatide \+ Compare: https://peptrackerpro.com/compare?select=tirzepatide Track in App: https://app.peptrackerpro.com/?add=tirzepatide ## Structured data ```json [ { "@context": "https://schema.org", "@type": "Organization", "name": "PepTracker Pro", "url": "https://peptrackerpro.com", "logo": "https://peptrackerpro.com/favicon.png", "description": "Evidence-based educational resource dedicated to improving peptide research literacy.", "contactPoint": { "@type": "ContactPoint", "email": "hello@peptrackerpro.com", "contactType": "customer support" }, "sameAs": [] }, { "@context": "https://schema.org", "@type": "MedicalWebPage", "name": "Avexitide", "description": "A first-in-class once-daily injectable GLP-1 receptor ANTAGONIST (exendin 9-39) from Amylyx for hyperinsulinemic hypoglycemia. The mirror image of GLP-1 agonists like semaglutide, it blocks GLP-1 to stop the insulin surges that cause post-bariatric hypoglycemia. 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Phase 3 LUCIDITY completed enrollment March 2026 with topline data expected Q3 2026." } }, { "@type": "Question", "name": "Those curious how a GLP-1 receptor ANTAGONIST differs from GLP-1 agonists like semaglutide and tirzepatide?", "acceptedAnswer": { "@type": "Answer", "text": "Avexitide is a research peptide studied in preclinical models. A first-in-class once-daily injectable GLP-1 receptor ANTAGONIST (exendin 9-39) from Amylyx for hyperinsulinemic hypoglycemia. The mirror image of GLP-1 agonists like semaglutide, it blocks GLP-1 to stop the insulin surges that cause post-bariatric hypoglycemia. Phase 3 LUCIDITY completed enrollment March 2026 with topline data expected Q3 2026." } }, { "@type": "Question", "name": "Investors and researchers following Amylyx Pharmaceuticals' pivot into metabolic disease?", "acceptedAnswer": { "@type": "Answer", "text": "Avexitide is a research peptide studied in preclinical models. A first-in-class once-daily injectable GLP-1 receptor ANTAGONIST (exendin 9-39) from Amylyx for hyperinsulinemic hypoglycemia. The mirror image of GLP-1 agonists like semaglutide, it blocks GLP-1 to stop the insulin surges that cause post-bariatric hypoglycemia. Phase 3 LUCIDITY completed enrollment March 2026 with topline data expected Q3 2026." } } ] } ] ```