What it is
Ecnoglutide is a GLP-1 receptor agonist — the same drug class as semaglutide — given as a once-weekly injection. It was developed by Sciwind Biosciences in Hangzhou and first registered under the code XW003 in 2020.
Its distinguishing claim is in the chemistry of signalling. When a drug binds the GLP-1 receptor, the receptor can signal through more than one route. Ecnoglutide is designed to be cAMP-biased: it favours the cAMP pathway over beta-arrestin recruitment, the process that draws the receptor back into the cell. The developers' rationale is a more sustained signal. That is a design intention; the trials below are the test of whether it matters.
Where it stands
China approved it twice in 2026: in January for glycaemic control in adults with type 2 diabetes, and in March for long-term weight management alongside diet and exercise. The source is the Drugs "First Approvals" review (2026), which also notes trials in adolescents, in obstructive sleep apnoea and in knee osteoarthritis.
The United States has no record of it. No ecnoglutide application appears in Drugs@FDA on 2026-09-21. A semaglutide query on the same endpoint returned its products, so the database was answering; the absence is real.
That makes ecnoglutide the clearest example in this library of a GLP-1 drug that is approved and on the market in one country and unknown to the regulator of another. Anything sold under its name in the US is not an approved product.
The three phase 3 trials
All three were run in China, sponsored by Sciwind, and published in 2025–2026.
| Trial | Who | Comparison | Result at primary endpoint |
|---|---|---|---|
| Obesity phase 3 (NCT05813795) | 664 adults without diabetes, 36 centres | 1.2 / 1.8 / 2.4 mg vs placebo, 40 weeks | Weight −9.1% / −10.9% / −13.2% vs +0.1% on placebo |
| EECOH-2 (NCT05680129) | 621 adults with type 2 diabetes on metformin, 52 hospitals | 0.6 / 1.2 mg vs dulaglutide 1.5 mg, 32 weeks | HbA1c −1.91% / −1.89% vs −1.65% |
| EECOH-1 (NCT05680155) | 211 registered, type 2 diabetes | monotherapy vs placebo | Published in Nature Communications, 2026 |
Two things are worth reading off that table.
The weight-loss figures sit inside the range of the approved class, not above it. Thirteen per cent at 40 weeks at the top dose is a real effect, measured against placebo in a properly randomised trial of 664 people, and it is in the same territory as the established drugs.
The "better than" claim is not supported by its own trial. Against dulaglutide, the 1.2 mg dose was statistically superior on HbA1c by 0.24 points. The authors write that the difference was not considered clinically relevant. A head-to-head against semaglutide (NCT07073417, 163 participants) is registered and active, with no result posted.
On safety, the obesity trial recorded adverse events in 93% of each ecnoglutide group against 84% on placebo — mostly mild-to-moderate gastrointestinal effects, the class's familiar pattern — and ten people on the drug stopped because of them.
The oral version is a separate programme
A tablet form is in development under two codes: XW004, in Sciwind's phase 1 in 87 healthy adults, and VRB-101, licensed to Verdiva Bio, which has registered a 206-person phase 2 in obesity (completed) and a 120-person phase 2 on keeping weight off. No oral form is approved anywhere. Oral GLP-1 development elsewhere is covered in the entry on orforglipron, a non-peptide oral candidate.
Where this entry stops
This is the compound record. What a GLP-1 costs, how the approved drugs compare, and how people get them are questions for GLP1Ledger, which covers the class for patients. The broader multi-receptor class is in the entries on the triple agonist retatrutide and the dual agonist tirzepatide, and the recurring confusion over a "third" GLP is untangled in the GLP-3 misnomer entry.
Last checked
2026-09-21. Approval history from the Drugs review (PMID 42412371); trial designs and results from the published abstracts (PMIDs 40555243, 40854315) and the ClinicalTrials.gov v2 API; US status from Drugs@FDA through the openFDA API.