Peptide & Experimental

Ecnoglutide

cAMP-biased GLP-1 receptor agonist, approved in China · Ecnoglutide, XW003, VRB-101 (tablet)

Ecnoglutide is a once-weekly GLP-1 peptide from the Chinese company Sciwind Biosciences that preferentially triggers the cAMP signal at the receptor. In a phase 3 trial with 664 adults, body weight fell by 9.1 to 13.2 percent after 40 weeks; in type 2 diabetes it clearly lowered blood sugar in two phase 3 trials, even slightly more than dulaglutide. It has been approved in China since 2026, but not in the EU.

What ecnoglutide is

Ecnoglutide belongs to the substance class of GLP-1 receptor agonists, like semaglutide and liraglutide. It is a peptide with an attached fatty acid chain that is injected under the skin once a week. A tablet form is being tested by a partner under the name VRB-101.

In January 2026, ecnoglutide received its first approval in China for type 2 diabetes; in March 2026 approval followed for long-term weight management in obesity or overweight with a comorbidity. This makes it, alongside mazdutide, another weight-loss drug that was approved first in China.

How it works

Like all GLP-1 agonists, ecnoglutide slows gastric emptying, strengthens the feeling of satiety and increases insulin release after meals. In phase 1 the half-life was 124 to 138 hours, consistent with once-weekly dosing.

What is special is the signal weighting, known in technical jargon as “biased agonism”. After activation, a receptor can trigger different signaling pathways. In the laboratory, ecnoglutide triggered the cAMP signal very strongly but caused hardly any uptake of the receptor into the cell. The idea: the receptor stays responsive for longer. In rats and mice, body weight fell more than under semaglutide. Whether this advantage holds in humans has not yet been published in a head-to-head comparison.

What is well supported

Clear weight loss in phase 3. 664 adults without diabetes lost 9.1 to 13.2 percent of their body weight after 40 weeks; under placebo it rose by 0.1 percent. 77 to 87 percent of those treated lost at least 5 percent, compared with 16 percent.
Blood sugar on a par with established drugs. In 621 patients with type 2 diabetes on metformin, ecnoglutide lowered HbA1c by 1.91 and 1.89 percentage points, dulaglutide by 1.65. Non-inferiority was shown; the higher dose was statistically superior, but according to the authors not better to a clinically relevant degree.
Few discontinuations. Because of side effects, 10 of 499 treated participants left the obesity trial early; in the diabetes trial it was 3 and 4 percent, and 3 percent under dulaglutide.
Reviewed and approved by a regulator. The Chinese drug regulator approved ecnoglutide in 2026 for type 2 diabetes and for weight management.

What the studies show

Phase 3 in overweight and obesity

Ji 2025 (Lancet Diabetes Endocrinol) randomized 664 adults without diabetes at 36 centers in China, with a BMI of at least 28, or at least 24 with a comorbidity. After 40 weeks, body weight fell by 9.1, 10.9 and 13.2 percent in the three dose groups; under placebo it rose by 0.1 percent. The differences from placebo were 9.2 to 13.3 percentage points, all p less than 0.0001. Both co-primary endpoints were met.

Adverse events occurred in 93 percent of those treated and 84 percent under placebo, mainly mild to moderate gastrointestinal complaints. Note: the BMI inclusion thresholds were lower than in Western approval trials, and the trial lasted 40 weeks instead of the 68 to 72 weeks usual there.

EECOH-2: against dulaglutide

He 2025 (Lancet Diabetes Endocrinol) compared, open-label, that is without blinding, two ecnoglutide doses with dulaglutide in 621 people with type 2 diabetes inadequately controlled on metformin, over 52 weeks. After 32 weeks, HbA1c fell by 1.91 and 1.89 compared with 1.65 percentage points. The reduction persisted until week 52.

EECOH-1: against placebo

Zhu 2026 (Nat Commun) randomized 211 people with type 2 diabetes who were not adequately controlled with diet, exercise or one oral drug. After 24 weeks, HbA1c fell by 1.96 and 2.43 percentage points compared with 0.87 under placebo.

The discovery

Guo 2023 (Mol Metab) describes the development: a series of GLP-1 variants from which ecnoglutide was selected because of its signaling profile, plus animal experiments and a phase 1 study with healthy volunteers over up to 6 weeks. Adverse events were decreased appetite, nausea and headache.

Where the data stop

Only Chinese trials. All phase 3 data come from China. How well the results transfer to people in Europe has not been tested.
The advantage of signal weighting. It has been shown in the laboratory and in animals. A head-to-head comparison with semaglutide has been running in a phase 2 trial since 2025; results are pending.
Duration and endpoints. The longest trial ran for 52 weeks. Data on cardiovascular events, on muscle mass and on the weight course after stopping are missing.
Products from the gray market. What is offered under this name outside China is not the approved medicine.

Status, approval and legal

Ecnoglutide has been approved in China since January 2026 for type 2 diabetes and since March 2026 for long-term weight management. In Germany, the EU and the US it is not approved and not regularly available. Online offers are neither tested nor legally marketable as medicines; for that reason we give no dosage information.

Ecnoglutide is not named on the WADA 2026 Prohibited List. Because of the Chinese approval, it does not fall under the catch-all class S0 for substances not approved anywhere. Anyone who competes under doping control should nonetheless clarify this in advance with their anti-doping agency.

Safety

The tolerability profile matches that of the substance class: mainly nausea, decreased appetite and other gastrointestinal complaints, mostly mild to moderate. Discontinuation rates due to side effects were low and, in the diabetes trial, comparable to dulaglutide.

Controlled data are available for around 1,000 treated participants over up to 52 weeks. A trial on cardiovascular endpoints is missing, and rare risks of the kind known for GLP-1 agonists from large programs cannot be assessed independently from these data.

BK-Score Well supported

Human evidence		8
Mechanism		7
Safety data		6
Hype gap		6
Track record of use		4

Evidence 8, because three published phase 3 trials met their primary endpoints: 9.1 to 13.2 percent weight loss after 40 weeks versus plus 0.1 percent under placebo in 664 adults (Ji 2025), an HbA1c reduction that was non-inferior to dulaglutide and, at the higher dose, statistically superior, in 621 patients (He 2025), and a placebo-controlled diabetes trial with 211 patients (Zhu 2026); not 9, because all trials ran only in China, the longest lasted 52 weeks and hard endpoints are missing. Mechanism 7, because the GLP-1 chain of action is well established in humans, but the core of the concept, cAMP weighting without receptor internalization, has only been shown in the laboratory (Guo 2023) and its benefit in humans has not been published in a head-to-head comparison with semaglutide. Safety 6, because controlled data are available for around 1,000 treated participants over up to 52 weeks, with few discontinuations due to side effects (10 of 499 in the obesity trial, 3 to 4 percent in diabetes) and mostly mild gastrointestinal complaints, but without a cardiovascular outcomes trial. Hype 6, because the published figures match the company’s statements and the substance is barely promoted outside China; a deduction for the as yet unproven narrative of an advantage from signal weighting. Use 4, because ecnoglutide has been approved as a medicine in China since January 2026 (Shirley 2026), but experience outside trials has existed for only a few months. Direction positive.

The score rates the state of knowledge, not the substance. “Safety data 9” means well studied – not harmless.
Subjective assessment by Biohacking Kompakt based on published scoring rules – not a scientific rating and not a medical recommendation. Rules and all ratings (German)

Frequently asked questions about ecnoglutide

What is ecnoglutide?

Ecnoglutide is a GLP-1 receptor agonist from the Chinese company Sciwind Biosciences that is injected once a week. It has been approved in China since 2026 for type 2 diabetes and for weight management, but not in the EU.

How much weight do people lose with ecnoglutide?

In the phase 3 trial with 664 adults in China, body weight fell by 9.1 to 13.2 percent after 40 weeks; under placebo it rose by 0.1 percent. 77 to 87 percent of those treated lost at least 5 percent.

What does cAMP-biased mean?

The GLP-1 receptor can trigger several signaling pathways. In the laboratory, ecnoglutide preferentially activates the cAMP signal and causes hardly any uptake of the receptor into the cell. Whether this brings an advantage over semaglutide in humans has not yet been established.

Is ecnoglutide better than semaglutide?

That is open. A head-to-head comparison is running in a phase 2 trial in China; results are not yet available. Against dulaglutide, ecnoglutide lowered blood sugar slightly more, but according to the authors not to a clinically relevant extent.

Is ecnoglutide available in Germany?

No. It is approved only in China. In Germany it is not an approved medicine; online offers are neither tested nor legally marketable.

Related topicMazdutide
Related topicPetrelintide
Related topicLiraglutide (Saxenda / Victoza)
Related topicVK2735
Related topicOrforglipron (Foundayo)
Related topicMariTide (Maridebart Cafraglutide)

Sources

Open in the database – with search, filters and comparison (German app)

Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-10-07.