Ecnoglutide

BInvestigational (phase 3 published)GLP-1 and incretin agonists →XW003cAMP-biased GLP-1 agonist
In one paragraphEcnoglutide is a once-weekly GLP-1 receptor agonist developed by Sciwind Biosciences in China, engineered to favour the cAMP signalling pathway. In a 664-person phase 3 trial published in 2025, Chinese adults with overweight or obesity lost 13.2% at 40 weeks on the top dose against 0.1% on placebo. Two phase 3 diabetes trials are also published. It is not approved in any region this site covers.
Overall gradeB Probable
Human trials3 phase 3 RCTs published (obesity n=664; two in diabetes)
Outcomes graded3
Last reviewed23 September 2026
EvidenceWhat it isHow it worksUnknownsMolecule & PKRegulationQuestionsReferences

What the human research shows

Phase 3 evidence, published, in one country's population — which puts it a clear step above the press-release compounds and a step below the approved drugs. The 'biased agonist' claim is a mechanism story; the trials do not show that it matters clinically.

MetabolicCardioMuscleHealingNeuroImmuneSexualSkinAgeing

Evidence profile0–5

  • Metabolic & weightB3.5
  • Cardiovascular—0.0
  • Muscle & growth—0.0
  • Healing & repair—0.0
  • Neuro & sleep—0.0
  • Immune & inflammation—0.0
  • Sexual & hormonal—0.0
  • Skin & appearance—0.0
  • Ageing & longevity—0.0
Each score is confidence × effect size, taken from the best-evidenced benefit in that domain: the grade (A–D) sets the confidence, the measured effect sets the size. Hover a domain to see the outcomes behind it. Adverse effects are excluded and listed separately below.
OutcomeGradeEffect sizeHuman studiesWhere the evidence comes from
Body weightBProbableLarge1 phase 3 RCT (n=664, 40 wk)Three doses against placebo across 36 Chinese centres. Loss of 9.1%, 10.9% and 13.2% at 1.2, 1.8 and 2.4 mg against 0.1% on placebo. Shorter than the 68–72-week Western trials, so not directly comparable.1
Blood glucose (HbA1c) in type 2 diabetesBProbableLarge2 phase 3 RCTs (EECOH-1, EECOH-2)A placebo-controlled monotherapy trial and a 52-week non-inferiority trial against dulaglutide, both published in 2025.23
GI side effectsadverseBProbableModerateSame RCTsThe class profile. Ten of 499 people on ecnoglutide stopped for adverse events in the obesity trial.1
AMultiple good human trials, consistentBSome human trials, mostly consistentCFew or weak human studiesDAnimal or anecdotal onlyeffect size · red = adverse

Literature searched to 23 September 2026. Human studies only; animal and cell work informs the mechanism section and nothing else.

Registered trials

ClinicalTrials.gov lists 12 interventional studies naming Ecnoglutide as an intervention — 6 completed, 4 recruiting, and none with results posted to the registry.

A registration is not a result. Anyone can register a study, and many never report — so this list shows what has been attempted, not what has been shown. The graded evidence above is the answer to whether something works.

StudyPhaseStatusParticipantsSponsorResults
A Phase 3 Study to Evaluate the Efficacy of XW003 in Adults With Overweight or ObesityNCT05813795 · started Apr 2023Phase 3Completed664Hangzhou Sciwind Biosciences Co., Ltd.None
A Phase 3 Study to Evaluate the Efficacy of XW003 Compared With Dulaglutide in Participants With T2DMNCT05680129 · started Jan 2023Phase 3Completed623Hangzhou Sciwind Biosciences Co., Ltd.None
A Study of Econoglutide Injection in Obese Participants With Knee Osteoarthritis (KOA)NCT07734311 · started Aug 2026Phase 3Recruiting360*Hangzhou Sciwind Biosciences Co., Ltd.None
A Phase 3 Study to Evaluate the Efficacy of XW003 Compared With Placebo in T2DM PatientsNCT05680155 · started Dec 2022Phase 3Completed211Hangzhou Sciwind Biosciences Co., Ltd.None
A Study of Ecnoglutide Injection in Overweight or Obese Chinese AdolescentsNCT07836270 · started Oct 2026Phase 3Not yet recruiting192*Hangzhou Sciwind Biosciences Co., Ltd.None
A Study of XW003 in Obese Participants With Obstructive Sleep Apnea Receiving Positive Airway Pressure TherapyNCT07434050 · started Mar 2026Phase 3Recruiting140*Hangzhou Sciwind Biosciences Co., Ltd.None
A Study of XW003 in Obese Participants With Obstructive Sleep Apnea But Not Receive Positive Airway Pressure TherapyNCT07387094 · started Feb 2026Phase 3Recruiting140*Hangzhou Sciwind Biosciences Co., Ltd.None
A Study to Compare XW003 Injection and Semaglutide Injection in Chinese Adults With Obesity (SLIMMER-UP-SWITCH)NCT07073417 · started Jul 2025Phase 2Active not recruiting163Hangzhou Sciwind Biosciences Co., Ltd.None

4 further studies are registered. Participant counts marked * are the sponsor's estimate, not a final enrolment. Source: ClinicalTrials.gov, read directly from the registry and refreshed weekly.

What it is

Ecnoglutide is a GLP-1 analogue modified so that receptor activation preferentially triggers cAMP production over β-arrestin recruitment — 'biased agonism', which in theory could mean more efficacy with less receptor desensitisation. It is the first such GLP-1 drug to complete phase 3.

Developed by Hangzhou Sciwind Biosciences; the trials to date are in China.

How it is thought to work

The receptor is the same one semaglutide activates; the difference is which downstream signal dominates. Whether that translates into any clinical advantage is untested — the published trials compare against placebo and dulaglutide, not against semaglutide.

What is still unknown

  • How it performs in non-Chinese populations.
  • Whether biased agonism changes anything a patient would notice.
  • Cardiovascular outcomes: no trial.

The molecule and how long it lasts

Identity
Formula
C194H304N48O61
Molecular weight
4285 g/mol
CAS number
2459531-73-6
PubChem
CID 162625103

PubChem record, read 23 September 2026.

Pharmacokinetics
Route
Subcutaneous, once weekly
Half-life
About 5–6 days at steady state (124–138 hours)

From a published human pharmacokinetic study: Pan H, et al. Discovery of ecnoglutide — a novel, long-acting, cAMP-biased GLP-1 analog. Mol Metab 2023;75:101762

Regulatory status

European Union
Not authorised

No EMA application known at review.

United States
Not approved

Not FDA-approved. Products sold under the name are unlicensed.

United Kingdom
Not licensed

No MHRA licence.

Australia
Not on the ARTG

Not registered.

Canada
Not authorised

No Drug Identification Number.

Sport (WADA)
Prohibited at all times

Not approved by any of the regulators WADA recognises, so S0 (non-approved substances).

Questions people actually ask

What does 'biased' GLP-1 agonist mean?
The molecule is designed to trigger one of the receptor's two signalling pathways (cAMP) more than the other (β-arrestin). The hope is more effect and less receptor fatigue; the trials so far do not test that claim against an unbiased drug.
How does ecnoglutide compare with semaglutide?
13.2% at 40 weeks against semaglutide's 14.9% at 68 weeks — different durations, different populations, no direct trial.
Is ecnoglutide approved?
Not in the EU, US, UK, Australia or Canada. Its development and regulatory review are in China.

One page per claimed effect

References

  1. 1
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  3. 3

Change log

  • 2026-09-23Initial publication from the Lancet Diabetes & Endocrinology phase 3. Grade B: published phase 3, unapproved, single-country.