Announcement • Jun 04

Fractyl Health Reports Positive One-Year Results from REVEAL-1 Open-Label Study of Revita Procedure for Post-GLP-1 Weight Maintenance

Fractyl Health, Inc. announced positive one-year results from its open-label REVEAL-1 Cohort. The REVEAL-1 Cohort is an open-label study in individuals with obesity who have lost at least 15% of their total body weight on a GLP-1 medication and who either need or choose to discontinue GLP-1 therapy. The REVEAL-1 data show that patients who underwent a single Revita procedure maintained approximately 78% of their prior GLP-1-induced weight loss at one year, with 33% of patients continuing to lose weight one year after discontinuing a GLP-1. Participants lost ~24% total body weight (>50 lbs.) on GLP-1 drugs prior to enrollment (duration on GLP-1 therapy ranging from five months to five years.) Patients were enrolled who had lost at least 15% total body weight on GLP-1 medicines, with 17 of 22 participants having greater than 17.5% total body weight loss on GLP-1 drugs. Safety and complete efficacy data through one year are available for 22 and 15 participants, respectively. Participants maintained stable weight after a single Revita procedure, with a mean total body weight change of 5.3% ± 2.1% (LS means ± SE; n=15) at one year. An efficacy estimand in the full analysis set demonstrated similar results, with mean total body weight change of 5.8% ± 2.0% (LS means ± SE; n=22). Participants retained ~78% of their drug-induced weight loss at one year. 33% of participants continued to lose weight at one year. Published third-party studies report ~15% weight regain by this time point after GLP-1 withdrawal alone. Across this cohort, ablation length clustered narrowly around its median ablation length and the study therefore does not have power to detect an ablation length dose response. 100% of patients in the REVEAL-1 Cohort maintained at least 5% of GLP-1-induced weight loss through one year. This =5% threshold is the responder definition used as the second co-primary endpoint in the REMAIN-1 Pivotal Cohort, which evaluates a responder rate among the Revita treated participants at one year to assess the durability of the Revita procedure for weight maintenance after GLP-1 discontinuation. Minimal change in HbA1c levels was observed after the Revita procedure (0.08% ± 0.08%; LS means ± SE from MMRM; n=15), compared to the ~0.4% increase in HbA1c seen post-GLP-1 discontinuation in the STEP-1 trial extension of GLP-1 withdrawal. No procedure-related serious adverse events and no new treatment emergent adverse events were observed. Mild treatment-emergent adverse events occurred in eight of 22 participants (36%), were transient, self-limited, and all occurred within the first month of treatment. No late device-related adverse events were observed, and all adverse events were consistent with prior Revita experience and similar to routine upper endoscopy findings. As previously reported, average ablation length was approximately 16 cm (n=22), consistent with Revita European real-world experience and the ongoing REMAIN-1 Pivotal study, supporting the potential translatability of results and scalability of technique. The REVEAL-1 Cohort (n=22) is an open-label study in individuals living with obesity who have lost at least 15% of their total body weight on a GLP-1 medication and who either need or choose to discontinue GLP-1 therapy. After stopping the GLP-1 based therapy, participants receive Revita treatment in an open-label setting and take part in a structured diet and lifestyle program. REVEAL-1 is designed to provide early, real-world insights on how Revita performs after GLP-1 discontinuation. To date, 22 participants have been treated in the REVEAL-1 Cohort and are included in safety and efficacy analyses. Five participants withdrew or were lost to follow up and two participants experienced protocol deviations. The profile of the REVEAL-1 Cohort closely mirrors that of the REMAIN-1 Midpoint and Pivotal Cohorts, with an average age of 50 and a gender distribution of 86% women. All 22 participants had previously been treated with a GLP-1 therapy for durations ranging from approximately 5 months to 5 years, with a mean total body weight loss of 24% while on therapy and a mean body weight of 80 kg ± 3 kg (SEM) at the time of intervention. Revita is Fractyl Health’s lead product candidate, designed to remodel the duodenal lining via a one-time, minimally invasive endoscopic procedure intended to restore healthy nutrient sensing and signaling disrupted by chronic metabolic disease. Revita has received Breakthrough Device designation from the U.S. Food and Drug Administration (FDA) for weight maintenance in people with obesity who discontinue GLP-1 therapies. Revita is for investigational use only in the United States and is CE marked in the European Union and United Kingdom. The next anticipated Revita clinical data readouts are one-year randomized data from the REMAIN-1 Midpoint Cohort in the third quarter 2026 and topline six-month randomized data from the REMAIN-1 Pivotal Cohort in early fourth quarter 2026.

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Durable Obesity Therapies And GLP 1 Trends Will Drive Long Term Upside

Post GLP 1 Weight Maintenance And Gene Therapy Will Reshape Long Term Metabolic Care

Long-Term GLP-1 Discontinuation Trend Will Challenge Pivotal Risks Yet Ultimately Support Durable Therapies

Post GLP 1 Weight Maintenance And Gene Therapy Will Reshape Long Term Metabolic Care

Long-Term GLP-1 Discontinuation Trend Will Challenge Pivotal Risks Yet Ultimately Support Durable Therapies

Durable Obesity Therapies And GLP 1 Trends Will Drive Long Term Upside

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