TRIUMPH-2 Published in The Lancet (September 29, 2026)
The TRIUMPH-2 Lancet paper, Sep 29, 2026: 18.8% weight loss on 12 mg vs 5.1% on placebo in people with type 2 diabetes. Side effects, deaths, A1C targets.
Event date Last verified Primary source The Lancet
The TRIUMPH-2 Lancet paper was published on September 29, 2026, and it puts retatrutide's weight loss in people with obesity and type 2 diabetes at 18.8% on 12 mg against 5.1% on placebo after 80 weeks, counting everyone who was randomized. The primary source is Bellido and colleagues in The Lancet, published online the same day NEJM published TRIUMPH-1.
Key takeaways
- The Lancet published TRIUMPH-2 online on September 29, 2026, the same day NEJM published TRIUMPH-1, and Lilly presented it at the EASD meeting in Milan the next day.
- The paper's primary result: 11.9%, 16.8% and 18.8% weight loss on 4, 9 and 12 mg against 5.1% on placebo, counting everyone randomized.
- More people stopped 9 mg than 12 mg because of side effects or death (12% against 8%).
- The investigators judged all 7 deaths in the trial unrelated to the study treatment.
Lilly had announced the topline on July 23. This page is about what the paper and Lilly's same-day release added; the TRIUMPH-2 page has the whole trial.
Who was in TRIUMPH-2
The trial ran at 92 sites in 8 countries and enrolled people from July 11, 2023 to November 1, 2024. Of 2,047 screened, 1,152 adults with a BMI of 27 or more and type 2 diabetes were randomized: 292 to 4 mg, 284 to 9 mg, 287 to 12 mg and 289 to placebo. They averaged 55.1 years old, a BMI of 38.2 and an A1C of 7.71%, and had had diabetes for a median of 5.6 years. Nearly all (92%) were on oral diabetes drugs, and 965 (84%) completed study treatment.
What the TRIUMPH-2 Lancet paper found
| Dose | Weight change, Lancet primary (treatment-regimen) | Weight change, Lilly (efficacy estimand) | Stopped for side effects or death |
|---|---|---|---|
| 4 mg | -11.9% | -12.7% | 11 (4%) |
| 9 mg | -16.8% | -19.1% | 33 (12%) |
| 12 mg | -18.8% | -20.8% | 22 (8%) |
| Placebo | -5.1% | -4.0% | 14 (5%) |
Against placebo, the differences were 6.9, 11.8 and 13.8 percentage points (p < 0.0001 for all three). Diarrhea hit 27%, 34% and 34% of people on 4, 9 and 12 mg against 13% on placebo, and nausea 14%, 21% and 28% against 8%. Low blood pressure (hypotension) was reported in 1%, 5% and 6% against under 1%.
The Lancet counts 7 deaths: 2 on 4 mg, 3 on 9 mg, 1 on 12 mg and 1 on placebo. The investigators judged all of them unrelated to the study treatment.
What Lilly's same-day release added
Lilly's September 29 release, using the efficacy estimand, added the targets people care about. At 80 weeks, 79.0% of people on 12 mg had an A1C of 6.5% or below, against 26.3% on placebo. On 12 mg, 52.0% lost 20% or more of their body weight, against 1.5%. On the same dose, triglycerides fell 39.5%, systolic blood pressure 10.8 mmHg and hsCRP, a marker of inflammation, 58.3%. Lilly presented the trial in detail at the EASD meeting in Milan on September 30.
What it means
Our read: 9 mg had the higher dropout rate for side effects, so in this trial the top dose wasn't the hardest one to stay on. If you have type 2 diabetes, expect the retatrutide numbers that apply to you to look more like these than like TRIUMPH-1's. The retatrutide for type 2 diabetes page puts TRIUMPH-2 next to the two TRANSCEND trials.
What comes next
The sleep apnea group inside TRIUMPH-2 was published separately in NEJM on October 21. Lilly's September 29 release repeated its plan to submit in the first quarter of 2027. On October 2, 2026, the FDA decided that retatrutide is a drug, not a biological product, so an application would need to be filed under section 505 of the Federal Food, Drug, and Cosmetic Act, and Lilly's appeal is pending with no ruling found as of October 31, 2026.
No approved version exists yet, and anything listed as retatrutide for sale online isn't the drug in this trial. The clinical trials guide lines TRIUMPH-2 up with the rest of the Phase 3 readouts.
Frequently asked questions
Is TRIUMPH-2 published?
Yes. Bellido and colleagues published it in The Lancet online on September 29, 2026, in the issue dated October 10 (volume 408, pages 1455 to 1472). The Lancet ran a comment piece alongside it.
How much weight did people with diabetes lose on retatrutide in TRIUMPH-2?
Counting everyone randomized, 11.9% on 4 mg, 16.8% on 9 mg and 18.8% on 12 mg after 80 weeks, against 5.1% on placebo. Lilly's efficacy estimand figure for 12 mg is 20.8%.
Why is weight loss lower in TRIUMPH-2 than in TRIUMPH-1?
The trials don't say why. Across retatrutide's six Phase 3 trials, the three lowest top-dose averages all come from people with type 2 diabetes. In TRIUMPH-1, in people without diabetes, 12 mg gave 25.0% on the same estimand as the Lancet's 18.8%.
Did anyone die in TRIUMPH-2?
The Lancet reports 7 deaths: 2 on 4 mg, 3 on 9 mg, 1 on 12 mg and 1 on placebo. The investigators judged every one of them unrelated to the study treatment.
Sources
- Bellido V et al., TRIUMPH-2 trial report, Lancet 2026;408(10563):1455-1472. The Lancet, 2026. doi.org
- Lilly's triple agonist, retatrutide, delivered substantial weight loss and A1C reduction, underscoring its potential promise for people with obesity and type 2 diabetes. Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
- Holst JJ, Retatrutide in adults with obesity and type 2 diabetes: what have we learned from TRIUMPH-2?, Lancet 2026;408(10563):1398-1399. The Lancet, 2026. doi.org
- Lilly's triple agonist, retatrutide, successful in two additional Phase 3 obesity trials, delivering significant improvements in weight and A1C (TRIUMPH-2 and TRIUMPH-3 topline). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
- Lilly to present new data on Foundayo, retatrutide, and eloraTZP at EASD 2026, as it strives to change the course of cardiometabolic health. Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
Dr. Juan Pablo Frías, MD
Physician-Scientist & Clinical Trialist • Endocrinology, Diabetes & Metabolism
Dr. Frías earned his M.D. from Vanderbilt University School of Medicine and completed his endocrinology fellowship at UC San Diego. A principal investigator on landmark incretin trials (including retatrutide, tirzepatide and semaglutide), he reviews all guides on Retatrutide360 for clinical accuracy, dosing safety and evidence fidelity.
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