Ecnoglutide

updated

Ecnoglutide is a once-weekly injectable GLP-1 receptor agonist from Hangzhou Sciwind Biosciences, reported by a journal review and company statements as approved in China for type 2 diabetes in January 2026 and for weight management in March 2026. In the peer-reviewed phase 3 trial SLIMMER (664 Chinese adults with overweight or obesity and no diabetes), the 2.4 mg group had a body weight change of -13.2% at week 40, a treatment difference versus placebo of -13.3%. The 15.4% at 48 weeks figure that sellers quote is a company statement, and no FDA application or label turned up on 10 October 2026.

GLP-1 receptor agonist peptide (cAMP-biased)

  • Ecnoglutide is PubChem CID 162625103, C194H304N48O61, 4285 g/mol, CAS 2459531-73-6, with the code XW003 (also XW-003) among its synonyms. The developer is Hangzhou Sciwind Biosciences.
  • In SLIMMER (664 Chinese adults with overweight or obesity and no diabetes, week 40), body weight changed -9.1%, -10.9% and -13.2% at 1.2, 1.8 and 2.4 mg versus 0.1% on placebo, and treatment differences were -9.2%, -11.1% and -13.3% (all p<0.0001).
  • The company reported on 21 June 2025 that the 2.4 mg group reached a mean 15.4% reduction from baseline at week 48 (15.1% placebo-adjusted). That figure is not in the peer-reviewed abstract, which reports week 40.
  • A journal review published online on 7 July 2026 says China approved subcutaneous ecnoglutide for type 2 diabetes in January 2026 and for weight management in March 2026. The regulator's own record is not among the sources reviewed.
  • In a phase 1 study in healthy participants, the steady-state half-life ranged from 124 to 138 hours.
  • An openFDA Drugs@FDA search and a DailyMed search on 10 October 2026 found no FDA application record and no label for ecnoglutide.

What is ecnoglutide, and is it approved anywhere?

Ecnoglutide (code XW003) is a once-weekly injectable GLP-1 receptor agonist from Hangzhou Sciwind Biosciences. A journal review and company statements say China approved it in January 2026 for type 2 diabetes and in March 2026 for weight management. No FDA application record or label turned up on 10 October 2026.

Ecnoglutide is a peptide GLP-1 analog, PubChem CID 162625103, C194H304N48O61, 4285 g/mol, CAS 2459531-73-6. The INN is ecnoglutide, and the development code is XW003 (also XW-003). The discovery paper describes an alanine to valine substitution at position 8 and a gamma-Glu-2xAEEA linked C18 diacid fatty acid. The developer is Hangzhou Sciwind Biosciences, the sponsor of the phase 3 trial SLIMMER and the funder named in the Lancet reports. The studies on this page used the subcutaneous injection. An oral ecnoglutide tablet is a separate formulation registered under XW004 and VRB-101, and no efficacy result for it appears here.

A peer-reviewed journal review published online on 7 July 2026 states that subcutaneous ecnoglutide received its first approval, in China, for glycemic control in adults with type 2 diabetes in January 2026. It states that in March 2026 the drug was approved in China for long-term weight management in adults with obesity, or with overweight and one or more weight-related comorbidity, together with diet control and increased physical activity. Sciwind press releases dated 30 January 2026 and 6 March 2026 say China's National Medical Products Administration approved ecnoglutide injection for both uses. Reuters, in a report dated 6 March 2026, gave the Chinese product name as Xianweiying, said Pfizer announced the weight-management approval, and said no price or launch date was given. The Reuters text does not name the NMPA.

The regulator's own approval record is not among the sources reviewed, and the review states the dates to the month only. The approval is regional. On 10 October 2026 an openFDA Drugs@FDA search by generic name returned no application records and a DailyMed search returned 0 labels, so ecnoglutide is not an FDA product. No EMA record was searched.

PubChem: ecnoglutide identity

Chemical identity record

National Library of Medicine. PubChem compound record CID 162625103 (ecnoglutide).

Ecnoglutide is PubChem CID 162625103, C194H304N48O61, 4285 g/mol, CAS 2459531-73-6, listed as an INN with the code XW003 (also XW-003) among its synonyms. The developer is Hangzhou Sciwind Biosciences, the registry sponsor of the phase 3 trial NCT05813795 and the funder named in the Lancet reports. The discovery paper describes a GLP-1 analog with an alanine to valine substitution at position 8 and a gamma-Glu-2xAEEA linked C18 diacid fatty acid. The studies on this page used the subcutaneous injection.

Participants / model
Chemical identity, not a clinical population
Treatment
Defined peptide; subcutaneous injection
Follow-up
Not applicable
Study design
NLM chemical record, with registry sponsor information
Funding
not stated in the source

An oral ecnoglutide tablet is a separate formulation registered under XW004 and VRB-101. No efficacy result for it appears on this page.

Read the original source
Journal review, published online 7 July 2026: China approvals in January and March 2026

Narrative review

Shirley M. Drugs. 2026;86(9):1563-1570. PMID 42412371.

The review, published online 7 July 2026, states that subcutaneous ecnoglutide received its first approval, in China, for glycemic control in adults with type 2 diabetes in January 2026, and that in March 2026 it was approved in China for long-term weight management in adults with obesity, or with overweight and one or more weight-related comorbidity (together with diet control and increased physical activity). It also states the compound is under clinical evaluation in adolescents with obesity, adults with obesity and obstructive sleep apnoea, and adults with obesity and knee osteoarthritis, and that an oral tablet is in development.

Participants / model
Adults in China with type 2 diabetes, or with obesity or overweight
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Approvals in January 2026 and March 2026
Study design
Journal summary of regulatory milestones
Funding
not stated in the source

The regulator's own approval record is not among the sources reviewed, and the review states the approval dates to the month only.

Read the original source
Company statements, 30 January and 6 March 2026, with a Reuters report

Regulatory record

Hangzhou Sciwind Biosciences press releases dated 30 January 2026 and 6 March 2026 (weight-management release on BioSpace); Reuters report dated 6 March 2026, read via Yahoo Finance.

Sciwind press releases dated 30 January 2026 and 6 March 2026 say China's National Medical Products Administration approved ecnoglutide injection for glycemic control in adults with type 2 diabetes and for chronic weight management in Chinese adults with overweight or obesity. Reuters (dateline 6 March 2026) reported that Pfizer announced the weight-management approval on WeChat for Xianweiying, also known as ecnoglutide, and that Pfizer had not given a price or launch date. The Reuters text read does not name the NMPA.

Participants / model
Adults in China
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Statements dated 30 January 2026 and 6 March 2026
Study design
Company press releases and a news report; not a regulator record
Funding
not stated in the source

Approval is regional: this does not make ecnoglutide an FDA or EMA product. No license terms or price are stated on this page.

Read the original source
US searches, 10 October 2026: no application records and no labels

Regulatory record

DailyMed, U.S. National Library of Medicine, search for ecnoglutide; openFDA Drugs@FDA search by generic name. Both run on 10 October 2026.

An openFDA Drugs@FDA search by generic name ecnoglutide returned no application records, and a DailyMed search for ecnoglutide returned 0 labels. No FDA label or application exists in those sources, and no EMA record was searched.

Participants / model
Records reviewed, not a population
Treatment
Not applicable
Follow-up
Searches run on 10 October 2026
Study design
Dated regulatory search
Funding
not stated in the source

A search result shows what the databases held on that date.

Read the original source

What did the phase 3 study in obesity find?

In SLIMMER, 664 Chinese adults with overweight or obesity and no diabetes had body weight changes of -9.1%, -10.9% and -13.2% at week 40 on ecnoglutide 1.2, 1.8 and 2.4 mg, versus 0.1% on placebo. Treatment differences versus placebo were -9.2%, -11.1% and -13.3%.

SLIMMER was a randomized double-blind placebo-controlled phase 3 trial at 36 centers in China, registered as NCT05813795 and funded by Hangzhou Sciwind Biosciences. It assigned 664 adults with a BMI of at least 28, or at least 24 with a weight-related comorbidity, and no diabetes, to ecnoglutide 1.2 mg (n=166), 1.8 mg (n=166), 2.4 mg (n=167) or placebo (n=165), all once weekly by subcutaneous injection.

At week 40, the co-primary time point, the least-squares mean change in body weight was -9.1%, -10.9% and -13.2% versus 0.1% on placebo. These are changes from baseline. Treatment differences versus placebo were -9.2% (97% CI -11.0 to -7.5), -11.1% (-13.1 to -9.1) and -13.3% (-15.3 to -11.3), all p<0.0001, so they are the placebo-adjusted numbers. At least 5% weight loss was reached by 77%, 84% and 87% of participants versus 16% on placebo.

The population is Chinese adults, and the sponsor ran the trial. The full paper is not open access and is not among the sources reviewed, so this page relies on the abstract.

SLIMMER: 664 Chinese adults, 40 weeks, placebo-controlled

Randomized controlled trial

Ji L et al. Lancet Diabetes Endocrinol. 2025;13(9):777-789. PMID 40555243.

At week 40, the least-squares mean change in body weight was -9.1%, -10.9%, and -13.2% at 1.2, 1.8, and 2.4 mg versus 0.1% on placebo. Treatment differences versus placebo were -9.2% (97% CI -11.0 to -7.5), -11.1% (-13.1 to -9.1), and -13.3% (-15.3 to -11.3), all p<0.0001. At least 5% weight loss was reached by 77%, 84%, and 87% versus 16% on placebo. Treatment-emergent adverse events occurred in 93%, 93%, and 93% versus 84% on placebo, mostly mild to moderate gastrointestinal events, and ten participants on ecnoglutide discontinued for adverse events.

Participants / model
664 Chinese adults with overweight or obesity and no diabetes (BMI of at least 28, or at least 24 with a weight-related comorbidity), at 36 centers: ecnoglutide 1.2 mg (n=166), 1.8 mg (n=166), 2.4 mg (n=167), placebo (n=165)
Treatment
Ecnoglutide 1.2, 1.8, or 2.4 mg subcutaneously once weekly, or placebo
Follow-up
Week 40 (co-primary time point)
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05813795)
Funding
Funded by Hangzhou Sciwind Biosciences

Week 40 is the co-primary time point in the abstract. The full paper is not open access and is not among the sources reviewed, so whether week 48 figures appear in it is not established here.

Read the original source

Did ecnoglutide lower HbA1c in type 2 diabetes?

Yes, in two peer-reviewed phase 3 trials in Chinese adults. In EECOH-1 (211 adults, 24 weeks) HbA1c fell 1.09% and 1.56% more than placebo at 0.6 and 1.2 mg. In EECOH-2 (623 adults on metformin, week 32) HbA1c fell 1.91% and 1.89% versus 1.65% on dulaglutide.

EECOH-1 (NCT05680155) was a 24-week randomized double-blind placebo-controlled phase 3 trial at 32 centers in China. It randomized 211 adults with type 2 diabetes on diet and exercise or one oral agent. At week 24, HbA1c changed -1.96% at 0.6 mg and -2.43% at 1.2 mg versus -0.87% on placebo, which are changes from baseline. Treatment differences versus placebo were -1.09% (95% CI -1.40 to -0.77) and -1.56% (-1.87 to -1.24). The sponsor's 30 January 2026 release cites a 2.43% reduction at 1.2 mg; in the paper that figure is the change from baseline, and the difference versus placebo is -1.56%.

EECOH-2 (NCT05680129) was a 52-week open-label non-inferiority phase 3 trial at 52 hospitals in China. It randomized 623 adults with type 2 diabetes on metformin alone (BMI 20 to 35) to ecnoglutide 0.6 mg, 1.2 mg or dulaglutide 1.5 mg weekly. At week 32, HbA1c fell 1.91%, 1.89% and 1.65%. Differences versus dulaglutide were -0.26% (95% CI -0.39 to -0.13) and -0.24% (-0.38 to -0.11; p=0.0002 for superiority at 1.2 mg). The authors say the 1.2 mg difference was not considered clinically relevant.

EECOH-1: 211 adults with type 2 diabetes, HbA1c at week 24 versus placebo

Randomized controlled trial

Zhu D et al. Nat Commun. 2026;17(1):1420. PMID 41501026.

At week 24, HbA1c changed -1.96% at 0.6 mg and -2.43% at 1.2 mg versus -0.87% on placebo (changes from baseline). Treatment differences versus placebo were -1.09% (95% CI -1.40 to -0.77) and -1.56% (-1.87 to -1.24). The sponsor's 30 January 2026 release cites a 2.43% reduction at 1.2 mg; in the paper that figure is the change from baseline, and the difference versus placebo is -1.56%.

Participants / model
211 Chinese adults with type 2 diabetes on diet and exercise or one oral agent, at 32 centers
Treatment
Ecnoglutide 0.6 or 1.2 mg subcutaneously once weekly, or placebo
Follow-up
24 weeks
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05680155)
Funding
not stated in the source

The change from baseline and the placebo difference are different numbers; 2.43% is the former.

Read the original source
EECOH-2: 623 adults with type 2 diabetes, HbA1c at week 32 versus dulaglutide

Randomized controlled trial

He Y et al. Lancet Diabetes Endocrinol. 2025;13(10):863-873. PMID 40854315.

At week 32, HbA1c fell 1.91% (0.6 mg), 1.89% (1.2 mg), and 1.65% (dulaglutide 1.5 mg). Differences versus dulaglutide were -0.26% (95% CI -0.39 to -0.13) and -0.24% (-0.38 to -0.11; p=0.0002 for superiority at 1.2 mg). The authors say the 1.2 mg difference was not considered clinically relevant. Discontinuation for adverse events was 3%, 4%, and 3%.

Participants / model
623 Chinese adults with type 2 diabetes on metformin alone (BMI 20 to 35), at 52 hospitals
Treatment
Ecnoglutide 0.6 or 1.2 mg versus dulaglutide 1.5 mg, subcutaneously once weekly
Follow-up
52-week trial; HbA1c reported at week 32
Study design
Randomized open-label non-inferiority phase 3 trial (NCT05680129)
Funding
not stated in the source

Open-label, with an active comparator and no placebo arm.

Read the original source

What has the company reported that the papers do not show?

Two figures come only from company statements. The 15.4% at week 48 figure (from baseline, 2.4 mg, 15.1% placebo-adjusted) was reported on 21 June 2025. An interim week 20 comparison with semaglutide in 163 adults, -12.8% versus -9.5%, was reported on 7 June 2026. Neither is peer reviewed.

On 21 June 2025 the company reported that by week 48 the SLIMMER 2.4 mg group reached a mean 15.4% reduction from baseline, or 15.1% placebo-adjusted, under the treatment policy estimand. It reported that 92.8% of participants reached at least 5%, 79.6% at least 10% and 63.5% at least 15% weight loss. The peer-reviewed abstract reports week 40 as the co-primary time point. Whether the week 48 figures appear in the full paper is not established here, so this page treats week 48 as a company statement.

On 7 June 2026 the company reported an interim result from SLIMMER-UP-SWITCH, an open-label phase 2 trial at 17 centers in China in 163 adults with a BMI of at least 30, randomized to ecnoglutide or semaglutide 2.4 mg weekly for 60 weeks. At a pre-specified interim analysis at week 20, the least-squares mean weight change was -12.8% versus -9.5% (P<0.0001). The release calls this a 35% greater reduction, which is a relative difference of 3.3 percentage points by arithmetic. The release does not state the estimand and gives no registry number.

The study is registered as NCT07073417, sponsored by Hangzhou Sciwind Biosciences, with masking none and primary completion on 27 February 2027. Its registry title describes a treatment switching design, so the release's head-to-head description is not treated as settled here. The result is interim, open-label, company-reported and not peer reviewed.

Company statement, 21 June 2025: 15.4% at week 48, not peer reviewed

Regulatory record

Hangzhou Sciwind Biosciences press release, 21 June 2025, republished on BioPharma Dive.

The company said that by week 48 the 2.4 mg dose reached a mean 15.4% reduction from baseline (placebo-adjusted 15.1%) under the treatment policy estimand, with 92.8% of participants reaching at least 5%, 79.6% at least 10%, and 63.5% at least 15% weight loss. So 15.4% is the sponsor's from-baseline value at 2.4 mg at week 48, and 15.1% is the placebo-adjusted value.

Participants / model
664 Chinese adults in SLIMMER
Treatment
Ecnoglutide 2.4 mg subcutaneously once weekly
Follow-up
Week 48 (secondary time point)
Study design
Company press release; not peer reviewed
Funding
not stated in the source

The peer-reviewed abstract reports week 40 as the co-primary time point (-13.2% at 2.4 mg, treatment difference -13.3%). The page cites the paper's week 40 figures and labels week 48 as a company statement.

Read the original source
Company statement, 7 June 2026: interim week 20 versus semaglutide, not peer reviewed

Regulatory record

Hangzhou Sciwind Biosciences press release, 7 June 2026, on BioSpace.

The company reported interim results of SLIMMER-UP-SWITCH, an open-label phase 2 trial at 17 centers in China that randomized adults with BMI of at least 30 to ecnoglutide or semaglutide 2.4 mg weekly for 60 weeks. At a pre-specified interim analysis at week 20, the least-squares mean weight change was -12.8% versus -9.5% (P<0.0001). The release calls this a 35% greater reduction, which is a relative difference (3.3 percentage points by arithmetic). The study is registered as NCT07073417 (sponsor Hangzhou Sciwind Biosciences, n=163, masking none, primary completion 2027-02-27).

Participants / model
163 Chinese adults with obesity (BMI of at least 30)
Treatment
Ecnoglutide versus semaglutide 2.4 mg subcutaneously once weekly
Follow-up
Interim analysis at week 20 of a 60-week study
Study design
Company press release on an interim, open-label phase 2 analysis; not peer reviewed
Funding
not stated in the source

The release does not state the estimand and gives no registry number. The registry title describes a treatment switching design, so the head-to-head description is not treated as settled here.

Read the original source

Which other ecnoglutide studies are registered, and do they have results?

On 10 October 2026, ClinicalTrials.gov returned 15 records for ecnoglutide, including phase 3 studies in obesity with sleep apnea, obesity with knee osteoarthritis and adolescents, and a completed oral phase 2. None has posted results, so none is an outcome.

The query ecnoglutide on ClinicalTrials.gov on 10 October 2026 returned 15 records. They include phase 3 studies in obesity with obstructive sleep apnea (NCT07434050 and NCT07387094, recruiting, 140 participants each), in obesity with knee osteoarthritis (NCT07734311, recruiting, 360) and in adolescents (NCT07836270, not yet recruiting, 192). A completed oral ecnoglutide phase 2 (NCT07281937, 206 participants, sponsor Verdiva Bio Dev Limited) is also listed. None of these has posted results.

The journal review also says the compound is under clinical evaluation in these populations and that an oral tablet is in development. A registration describes a plan or a completed study, not a result. No oral ecnoglutide result appears in any source reviewed.

Registry search, 10 October 2026: 15 records, none with posted results

Trial registry record

ClinicalTrials.gov search for ecnoglutide, run on 10 October 2026.

On 10 October 2026 the ClinicalTrials.gov query ecnoglutide returned 15 records, including phase 3 studies in obesity with obstructive sleep apnea (NCT07434050 and NCT07387094, recruiting, n=140 each), in obesity with knee osteoarthritis (NCT07734311, recruiting, n=360), and in adolescents (NCT07836270, not yet recruiting, n=192), plus a completed oral ecnoglutide phase 2 (NCT07281937, n=206, sponsor Verdiva Bio Dev Limited). These records have no posted results.

Participants / model
Registered participants, not a clinical population
Treatment
Ecnoglutide subcutaneous and oral
Follow-up
Search run on 10 October 2026
Study design
Registry search
Funding
not stated in the source

Registrations are not outcomes. A completed registration with no posted results has no reportable result here.

Read the original source
Journal review, published online 7 July 2026: China approvals in January and March 2026

Narrative review

Shirley M. Drugs. 2026;86(9):1563-1570. PMID 42412371.

The review, published online 7 July 2026, states that subcutaneous ecnoglutide received its first approval, in China, for glycemic control in adults with type 2 diabetes in January 2026, and that in March 2026 it was approved in China for long-term weight management in adults with obesity, or with overweight and one or more weight-related comorbidity (together with diet control and increased physical activity). It also states the compound is under clinical evaluation in adolescents with obesity, adults with obesity and obstructive sleep apnoea, and adults with obesity and knee osteoarthritis, and that an oral tablet is in development.

Participants / model
Adults in China with type 2 diabetes, or with obesity or overweight
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Approvals in January 2026 and March 2026
Study design
Journal summary of regulatory milestones
Funding
not stated in the source

The regulator's own approval record is not among the sources reviewed, and the review states the approval dates to the month only.

Read the original source

Did ecnoglutide produce 15.4% weight loss at 48 weeks, and is it approved in China?

The 15.4% figure is real as a sponsor statement: a from-baseline result at 2.4 mg at week 48, with 15.1% placebo-adjusted, dated 21 June 2025. The peer-reviewed co-primary figure is -13.2% at week 40 (treatment difference -13.3%). The China approval claim rests on company statements and a peer-reviewed journal review.

Sellers describe ecnoglutide as a cAMP-biased GLP-1 receptor agonist from Sciwind that produced 15.4% weight loss at 48 weeks in a phase 3 trial and may have Chinese approval.

The 15.4% is the sponsor's mean reduction from baseline at 2.4 mg at week 48, stated in a company release on 21 June 2025, with 15.1% as the placebo-adjusted value. The peer-reviewed abstract reports week 40 as the co-primary time point, at -13.2% for 2.4 mg and a treatment difference of -13.3%. A reader comparing the two should note that week 48 is a company figure and week 40 is the peer-reviewed one.

The China approval claim is supported by a peer-reviewed journal review published online on 7 July 2026 and by Sciwind press releases dated 30 January 2026 and 6 March 2026. The regulator's own approval record is not among the sources reviewed.

Company statement, 21 June 2025: 15.4% at week 48, not peer reviewed

Regulatory record

Hangzhou Sciwind Biosciences press release, 21 June 2025, republished on BioPharma Dive.

The company said that by week 48 the 2.4 mg dose reached a mean 15.4% reduction from baseline (placebo-adjusted 15.1%) under the treatment policy estimand, with 92.8% of participants reaching at least 5%, 79.6% at least 10%, and 63.5% at least 15% weight loss. So 15.4% is the sponsor's from-baseline value at 2.4 mg at week 48, and 15.1% is the placebo-adjusted value.

Participants / model
664 Chinese adults in SLIMMER
Treatment
Ecnoglutide 2.4 mg subcutaneously once weekly
Follow-up
Week 48 (secondary time point)
Study design
Company press release; not peer reviewed
Funding
not stated in the source

The peer-reviewed abstract reports week 40 as the co-primary time point (-13.2% at 2.4 mg, treatment difference -13.3%). The page cites the paper's week 40 figures and labels week 48 as a company statement.

Read the original source
SLIMMER: 664 Chinese adults, 40 weeks, placebo-controlled

Randomized controlled trial

Ji L et al. Lancet Diabetes Endocrinol. 2025;13(9):777-789. PMID 40555243.

At week 40, the least-squares mean change in body weight was -9.1%, -10.9%, and -13.2% at 1.2, 1.8, and 2.4 mg versus 0.1% on placebo. Treatment differences versus placebo were -9.2% (97% CI -11.0 to -7.5), -11.1% (-13.1 to -9.1), and -13.3% (-15.3 to -11.3), all p<0.0001. At least 5% weight loss was reached by 77%, 84%, and 87% versus 16% on placebo. Treatment-emergent adverse events occurred in 93%, 93%, and 93% versus 84% on placebo, mostly mild to moderate gastrointestinal events, and ten participants on ecnoglutide discontinued for adverse events.

Participants / model
664 Chinese adults with overweight or obesity and no diabetes (BMI of at least 28, or at least 24 with a weight-related comorbidity), at 36 centers: ecnoglutide 1.2 mg (n=166), 1.8 mg (n=166), 2.4 mg (n=167), placebo (n=165)
Treatment
Ecnoglutide 1.2, 1.8, or 2.4 mg subcutaneously once weekly, or placebo
Follow-up
Week 40 (co-primary time point)
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05813795)
Funding
Funded by Hangzhou Sciwind Biosciences

Week 40 is the co-primary time point in the abstract. The full paper is not open access and is not among the sources reviewed, so whether week 48 figures appear in it is not established here.

Read the original source
Journal review, published online 7 July 2026: China approvals in January and March 2026

Narrative review

Shirley M. Drugs. 2026;86(9):1563-1570. PMID 42412371.

The review, published online 7 July 2026, states that subcutaneous ecnoglutide received its first approval, in China, for glycemic control in adults with type 2 diabetes in January 2026, and that in March 2026 it was approved in China for long-term weight management in adults with obesity, or with overweight and one or more weight-related comorbidity (together with diet control and increased physical activity). It also states the compound is under clinical evaluation in adolescents with obesity, adults with obesity and obstructive sleep apnoea, and adults with obesity and knee osteoarthritis, and that an oral tablet is in development.

Participants / model
Adults in China with type 2 diabetes, or with obesity or overweight
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Approvals in January 2026 and March 2026
Study design
Journal summary of regulatory milestones
Funding
not stated in the source

The regulator's own approval record is not among the sources reviewed, and the review states the approval dates to the month only.

Read the original source
Company statements, 30 January and 6 March 2026, with a Reuters report

Regulatory record

Hangzhou Sciwind Biosciences press releases dated 30 January 2026 and 6 March 2026 (weight-management release on BioSpace); Reuters report dated 6 March 2026, read via Yahoo Finance.

Sciwind press releases dated 30 January 2026 and 6 March 2026 say China's National Medical Products Administration approved ecnoglutide injection for glycemic control in adults with type 2 diabetes and for chronic weight management in Chinese adults with overweight or obesity. Reuters (dateline 6 March 2026) reported that Pfizer announced the weight-management approval on WeChat for Xianweiying, also known as ecnoglutide, and that Pfizer had not given a price or launch date. The Reuters text read does not name the NMPA.

Participants / model
Adults in China
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Statements dated 30 January 2026 and 6 March 2026
Study design
Company press releases and a news report; not a regulator record
Funding
not stated in the source

Approval is regional: this does not make ecnoglutide an FDA or EMA product. No license terms or price are stated on this page.

Read the original source

How does ecnoglutide work, and how long does it last in the body?

Ecnoglutide is a GLP-1 receptor agonist that, in cell assays, drove cAMP signaling potently with little receptor internalization. In healthy participants at steady state its half-life ranged from 124 to 138 hours, which supports weekly dosing.

In cell assays, ecnoglutide induced cAMP potently (EC50 = 0.018 nM) but not GLP-1 receptor internalization (EC50 > 10 uM). This is the basis for the description of it as cAMP-biased. In db/db mice and diet-induced obese rats it reduced blood glucose and body weight, with more pronounced weight reduction than semaglutide according to the authors. The sources reviewed give no dose or route for the animal studies. These are cell and animal findings, not evidence of a clinical benefit.

In a phase 1 randomized placebo-controlled study in healthy participants (single doses 0.03 to 1.0 mg; weekly doses 0.2 to 0.6 mg for 6 weeks; NCT04389775), the steady-state half-life ranged from 124 to 138 hours, which the authors say supports weekly dosing. The abstract gives no Tmax value.

Discovery paper: cell assays, rodents and phase 1 half-life of 124 to 138 hours

Human study

Guo W et al. Mol Metab. 2023;75:101762. PMID 37364710.

In vitro, ecnoglutide induced cAMP potently (EC50 = 0.018 nM) but not GLP-1 receptor internalization (EC50 > 10 uM). In db/db mice and diet-induced obese rats it reduced blood glucose and body weight, with more pronounced weight reduction than semaglutide according to the authors. In a phase 1 randomized placebo-controlled study in healthy participants (single doses 0.03 to 1.0 mg; weekly doses 0.2 to 0.6 mg for 6 weeks; NCT04389775), the steady-state half-life ranged from 124 to 138 hours, supporting weekly dosing. Adverse events included decreased appetite, nausea, and headache.

Participants / model
Cell assays, db/db mice, diet-induced obese rats, and healthy human participants
Treatment
Ecnoglutide, subcutaneous injection (cell assays in vitro)
Follow-up
Single doses; weekly doses for 6 weeks in the phase 1 multiple-dose part
Study design
Original preclinical and phase 1 study (phase 1 was randomized and placebo-controlled)
Funding
not stated in the source

The receptor-bias data are cell-assay findings, not evidence of a clinical benefit. The animal findings come from the same paper, and the sources reviewed give no dose or route for them.

Read the original source

What adverse effects and drug interactions have been reported?

Adverse events were mostly mild to moderate gastrointestinal events. In SLIMMER, treatment-emergent adverse events occurred in 93% on each ecnoglutide dose versus 84% on placebo, and ten participants on ecnoglutide discontinued for adverse events. A drug interaction study advises monitoring during digoxin co-administration, especially in renal impairment.

In SLIMMER, treatment-emergent adverse events occurred in 93%, 93% and 93% of participants on 1.2, 1.8 and 2.4 mg versus 84% on placebo, mostly mild to moderate gastrointestinal events, and ten participants on ecnoglutide discontinued for adverse events. In EECOH-2, discontinuation for adverse events was 3%, 4% and 3% across the three arms. In the phase 1 study in healthy participants, adverse events included decreased appetite, nausea and headache.

A single-sequence phase 1 drug interaction study in 28 healthy volunteers found that steady-state ecnoglutide 1.2 mg did not change rosuvastatin or digoxin exposure to a clinically relevant degree. The geometric mean ratio of AUC0-inf (with versus without ecnoglutide) was 106% (90% CI 94 to 120) for rosuvastatin and 84% (76 to 94) for digoxin, and digoxin Cmax fell from 1.39 to 1.31 ng/mL. The most common adverse events were weight loss and gastrointestinal events, and no serious adverse events were reported. The authors advise monitoring during digoxin co-administration, especially in renal impairment. The 11.2% mean weight decrease over 14 weeks in this uncontrolled study of healthy volunteers is not an efficacy result.

Serious adverse events in the phase 3 trials, pancreatitis, gallbladder and thyroid findings, and long-term or outcomes data are not described in the sources reviewed.

SLIMMER: 664 Chinese adults, 40 weeks, placebo-controlled

Randomized controlled trial

Ji L et al. Lancet Diabetes Endocrinol. 2025;13(9):777-789. PMID 40555243.

At week 40, the least-squares mean change in body weight was -9.1%, -10.9%, and -13.2% at 1.2, 1.8, and 2.4 mg versus 0.1% on placebo. Treatment differences versus placebo were -9.2% (97% CI -11.0 to -7.5), -11.1% (-13.1 to -9.1), and -13.3% (-15.3 to -11.3), all p<0.0001. At least 5% weight loss was reached by 77%, 84%, and 87% versus 16% on placebo. Treatment-emergent adverse events occurred in 93%, 93%, and 93% versus 84% on placebo, mostly mild to moderate gastrointestinal events, and ten participants on ecnoglutide discontinued for adverse events.

Participants / model
664 Chinese adults with overweight or obesity and no diabetes (BMI of at least 28, or at least 24 with a weight-related comorbidity), at 36 centers: ecnoglutide 1.2 mg (n=166), 1.8 mg (n=166), 2.4 mg (n=167), placebo (n=165)
Treatment
Ecnoglutide 1.2, 1.8, or 2.4 mg subcutaneously once weekly, or placebo
Follow-up
Week 40 (co-primary time point)
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05813795)
Funding
Funded by Hangzhou Sciwind Biosciences

Week 40 is the co-primary time point in the abstract. The full paper is not open access and is not among the sources reviewed, so whether week 48 figures appear in it is not established here.

Read the original source
EECOH-2: 623 adults with type 2 diabetes, HbA1c at week 32 versus dulaglutide

Randomized controlled trial

He Y et al. Lancet Diabetes Endocrinol. 2025;13(10):863-873. PMID 40854315.

At week 32, HbA1c fell 1.91% (0.6 mg), 1.89% (1.2 mg), and 1.65% (dulaglutide 1.5 mg). Differences versus dulaglutide were -0.26% (95% CI -0.39 to -0.13) and -0.24% (-0.38 to -0.11; p=0.0002 for superiority at 1.2 mg). The authors say the 1.2 mg difference was not considered clinically relevant. Discontinuation for adverse events was 3%, 4%, and 3%.

Participants / model
623 Chinese adults with type 2 diabetes on metformin alone (BMI 20 to 35), at 52 hospitals
Treatment
Ecnoglutide 0.6 or 1.2 mg versus dulaglutide 1.5 mg, subcutaneously once weekly
Follow-up
52-week trial; HbA1c reported at week 32
Study design
Randomized open-label non-inferiority phase 3 trial (NCT05680129)
Funding
not stated in the source

Open-label, with an active comparator and no placebo arm.

Read the original source
Discovery paper: cell assays, rodents and phase 1 half-life of 124 to 138 hours

Human study

Guo W et al. Mol Metab. 2023;75:101762. PMID 37364710.

In vitro, ecnoglutide induced cAMP potently (EC50 = 0.018 nM) but not GLP-1 receptor internalization (EC50 > 10 uM). In db/db mice and diet-induced obese rats it reduced blood glucose and body weight, with more pronounced weight reduction than semaglutide according to the authors. In a phase 1 randomized placebo-controlled study in healthy participants (single doses 0.03 to 1.0 mg; weekly doses 0.2 to 0.6 mg for 6 weeks; NCT04389775), the steady-state half-life ranged from 124 to 138 hours, supporting weekly dosing. Adverse events included decreased appetite, nausea, and headache.

Participants / model
Cell assays, db/db mice, diet-induced obese rats, and healthy human participants
Treatment
Ecnoglutide, subcutaneous injection (cell assays in vitro)
Follow-up
Single doses; weekly doses for 6 weeks in the phase 1 multiple-dose part
Study design
Original preclinical and phase 1 study (phase 1 was randomized and placebo-controlled)
Funding
not stated in the source

The receptor-bias data are cell-assay findings, not evidence of a clinical benefit. The animal findings come from the same paper, and the sources reviewed give no dose or route for them.

Read the original source
Drug interaction study: 28 healthy volunteers, rosuvastatin and digoxin exposure

Clinical trial

Li F et al. Diabetes Obes Metab. 2026;28(9):8128-8135. PMID 42310888.

At steady state, ecnoglutide 1.2 mg did not change rosuvastatin or digoxin exposure to a clinically relevant degree: the geometric mean ratio of AUC0-inf (with versus without ecnoglutide) was 106% (90% CI 94 to 120) for rosuvastatin and 84% (76 to 94) for digoxin, and digoxin Cmax fell from 1.39 to 1.31 ng/mL. The most common adverse events were weight loss and gastrointestinal events and no serious adverse events were reported. The authors advise monitoring during digoxin co-administration, especially in renal impairment. The 11.2% mean weight decrease over 14 weeks in this uncontrolled study is not an efficacy result.

Participants / model
28 healthy adult volunteers
Treatment
Ecnoglutide 1.2 mg subcutaneously at steady state, with single oral doses of rosuvastatin and digoxin
Follow-up
14 weeks
Study design
Single-sequence phase 1 drug interaction study, uncontrolled
Funding
not stated in the source

Uncontrolled and in healthy volunteers, so the weight change is not an efficacy result.

Read the original source

Why does ecnoglutide sit in A tier?

Ecnoglutide has three peer-reviewed phase 3 programs and reported approvals in China. It is not S because every phase 3 trial is Chinese and sponsor-run, there is no outcomes trial, no FDA record exists, and the approval rests on company statements and a journal summary rather than a regulator record in the sources reviewed.

A fits a compound with published phase 3 results in obesity (SLIMMER, 664 patients) and in type 2 diabetes (EECOH-1 and EECOH-2, 211 and 623 patients), and reported approvals in China for type 2 diabetes in January 2026 and weight management in March 2026.

It stops short of S because every phase 3 trial is Chinese and sponsor-run, there is no outcomes trial, there is no FDA label or application, and the approval rests on company statements and a journal summary rather than a regulator record in the sources reviewed. The week 48 and semaglutide comparison figures sellers quote are company statements and are not peer reviewed.

SLIMMER: 664 Chinese adults, 40 weeks, placebo-controlled

Randomized controlled trial

Ji L et al. Lancet Diabetes Endocrinol. 2025;13(9):777-789. PMID 40555243.

At week 40, the least-squares mean change in body weight was -9.1%, -10.9%, and -13.2% at 1.2, 1.8, and 2.4 mg versus 0.1% on placebo. Treatment differences versus placebo were -9.2% (97% CI -11.0 to -7.5), -11.1% (-13.1 to -9.1), and -13.3% (-15.3 to -11.3), all p<0.0001. At least 5% weight loss was reached by 77%, 84%, and 87% versus 16% on placebo. Treatment-emergent adverse events occurred in 93%, 93%, and 93% versus 84% on placebo, mostly mild to moderate gastrointestinal events, and ten participants on ecnoglutide discontinued for adverse events.

Participants / model
664 Chinese adults with overweight or obesity and no diabetes (BMI of at least 28, or at least 24 with a weight-related comorbidity), at 36 centers: ecnoglutide 1.2 mg (n=166), 1.8 mg (n=166), 2.4 mg (n=167), placebo (n=165)
Treatment
Ecnoglutide 1.2, 1.8, or 2.4 mg subcutaneously once weekly, or placebo
Follow-up
Week 40 (co-primary time point)
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05813795)
Funding
Funded by Hangzhou Sciwind Biosciences

Week 40 is the co-primary time point in the abstract. The full paper is not open access and is not among the sources reviewed, so whether week 48 figures appear in it is not established here.

Read the original source
EECOH-1: 211 adults with type 2 diabetes, HbA1c at week 24 versus placebo

Randomized controlled trial

Zhu D et al. Nat Commun. 2026;17(1):1420. PMID 41501026.

At week 24, HbA1c changed -1.96% at 0.6 mg and -2.43% at 1.2 mg versus -0.87% on placebo (changes from baseline). Treatment differences versus placebo were -1.09% (95% CI -1.40 to -0.77) and -1.56% (-1.87 to -1.24). The sponsor's 30 January 2026 release cites a 2.43% reduction at 1.2 mg; in the paper that figure is the change from baseline, and the difference versus placebo is -1.56%.

Participants / model
211 Chinese adults with type 2 diabetes on diet and exercise or one oral agent, at 32 centers
Treatment
Ecnoglutide 0.6 or 1.2 mg subcutaneously once weekly, or placebo
Follow-up
24 weeks
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05680155)
Funding
not stated in the source

The change from baseline and the placebo difference are different numbers; 2.43% is the former.

Read the original source
EECOH-2: 623 adults with type 2 diabetes, HbA1c at week 32 versus dulaglutide

Randomized controlled trial

He Y et al. Lancet Diabetes Endocrinol. 2025;13(10):863-873. PMID 40854315.

At week 32, HbA1c fell 1.91% (0.6 mg), 1.89% (1.2 mg), and 1.65% (dulaglutide 1.5 mg). Differences versus dulaglutide were -0.26% (95% CI -0.39 to -0.13) and -0.24% (-0.38 to -0.11; p=0.0002 for superiority at 1.2 mg). The authors say the 1.2 mg difference was not considered clinically relevant. Discontinuation for adverse events was 3%, 4%, and 3%.

Participants / model
623 Chinese adults with type 2 diabetes on metformin alone (BMI 20 to 35), at 52 hospitals
Treatment
Ecnoglutide 0.6 or 1.2 mg versus dulaglutide 1.5 mg, subcutaneously once weekly
Follow-up
52-week trial; HbA1c reported at week 32
Study design
Randomized open-label non-inferiority phase 3 trial (NCT05680129)
Funding
not stated in the source

Open-label, with an active comparator and no placebo arm.

Read the original source
Journal review, published online 7 July 2026: China approvals in January and March 2026

Narrative review

Shirley M. Drugs. 2026;86(9):1563-1570. PMID 42412371.

The review, published online 7 July 2026, states that subcutaneous ecnoglutide received its first approval, in China, for glycemic control in adults with type 2 diabetes in January 2026, and that in March 2026 it was approved in China for long-term weight management in adults with obesity, or with overweight and one or more weight-related comorbidity (together with diet control and increased physical activity). It also states the compound is under clinical evaluation in adolescents with obesity, adults with obesity and obstructive sleep apnoea, and adults with obesity and knee osteoarthritis, and that an oral tablet is in development.

Participants / model
Adults in China with type 2 diabetes, or with obesity or overweight
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Approvals in January 2026 and March 2026
Study design
Journal summary of regulatory milestones
Funding
not stated in the source

The regulator's own approval record is not among the sources reviewed, and the review states the approval dates to the month only.

Read the original source
Company statements, 30 January and 6 March 2026, with a Reuters report

Regulatory record

Hangzhou Sciwind Biosciences press releases dated 30 January 2026 and 6 March 2026 (weight-management release on BioSpace); Reuters report dated 6 March 2026, read via Yahoo Finance.

Sciwind press releases dated 30 January 2026 and 6 March 2026 say China's National Medical Products Administration approved ecnoglutide injection for glycemic control in adults with type 2 diabetes and for chronic weight management in Chinese adults with overweight or obesity. Reuters (dateline 6 March 2026) reported that Pfizer announced the weight-management approval on WeChat for Xianweiying, also known as ecnoglutide, and that Pfizer had not given a price or launch date. The Reuters text read does not name the NMPA.

Participants / model
Adults in China
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Statements dated 30 January 2026 and 6 March 2026
Study design
Company press releases and a news report; not a regulator record
Funding
not stated in the source

Approval is regional: this does not make ecnoglutide an FDA or EMA product. No license terms or price are stated on this page.

Read the original source
US searches, 10 October 2026: no application records and no labels

Regulatory record

DailyMed, U.S. National Library of Medicine, search for ecnoglutide; openFDA Drugs@FDA search by generic name. Both run on 10 October 2026.

An openFDA Drugs@FDA search by generic name ecnoglutide returned no application records, and a DailyMed search for ecnoglutide returned 0 labels. No FDA label or application exists in those sources, and no EMA record was searched.

Participants / model
Records reviewed, not a population
Treatment
Not applicable
Follow-up
Searches run on 10 October 2026
Study design
Dated regulatory search
Funding
not stated in the source

A search result shows what the databases held on that date.

Read the original source
Company statement, 21 June 2025: 15.4% at week 48, not peer reviewed

Regulatory record

Hangzhou Sciwind Biosciences press release, 21 June 2025, republished on BioPharma Dive.

The company said that by week 48 the 2.4 mg dose reached a mean 15.4% reduction from baseline (placebo-adjusted 15.1%) under the treatment policy estimand, with 92.8% of participants reaching at least 5%, 79.6% at least 10%, and 63.5% at least 15% weight loss. So 15.4% is the sponsor's from-baseline value at 2.4 mg at week 48, and 15.1% is the placebo-adjusted value.

Participants / model
664 Chinese adults in SLIMMER
Treatment
Ecnoglutide 2.4 mg subcutaneously once weekly
Follow-up
Week 48 (secondary time point)
Study design
Company press release; not peer reviewed
Funding
not stated in the source

The peer-reviewed abstract reports week 40 as the co-primary time point (-13.2% at 2.4 mg, treatment difference -13.3%). The page cites the paper's week 40 figures and labels week 48 as a company statement.

Read the original source

Studies and sources

PubChem: ecnoglutide identity

Chemical identity record

National Library of Medicine. PubChem compound record CID 162625103 (ecnoglutide).

Ecnoglutide is PubChem CID 162625103, C194H304N48O61, 4285 g/mol, CAS 2459531-73-6, listed as an INN with the code XW003 (also XW-003) among its synonyms. The developer is Hangzhou Sciwind Biosciences, the registry sponsor of the phase 3 trial NCT05813795 and the funder named in the Lancet reports. The discovery paper describes a GLP-1 analog with an alanine to valine substitution at position 8 and a gamma-Glu-2xAEEA linked C18 diacid fatty acid. The studies on this page used the subcutaneous injection.

Participants / model
Chemical identity, not a clinical population
Treatment
Defined peptide; subcutaneous injection
Follow-up
Not applicable
Study design
NLM chemical record, with registry sponsor information
Funding
not stated in the source

An oral ecnoglutide tablet is a separate formulation registered under XW004 and VRB-101. No efficacy result for it appears on this page.

Read the original source
Discovery paper: cell assays, rodents and phase 1 half-life of 124 to 138 hours

Human study

Guo W et al. Mol Metab. 2023;75:101762. PMID 37364710.

In vitro, ecnoglutide induced cAMP potently (EC50 = 0.018 nM) but not GLP-1 receptor internalization (EC50 > 10 uM). In db/db mice and diet-induced obese rats it reduced blood glucose and body weight, with more pronounced weight reduction than semaglutide according to the authors. In a phase 1 randomized placebo-controlled study in healthy participants (single doses 0.03 to 1.0 mg; weekly doses 0.2 to 0.6 mg for 6 weeks; NCT04389775), the steady-state half-life ranged from 124 to 138 hours, supporting weekly dosing. Adverse events included decreased appetite, nausea, and headache.

Participants / model
Cell assays, db/db mice, diet-induced obese rats, and healthy human participants
Treatment
Ecnoglutide, subcutaneous injection (cell assays in vitro)
Follow-up
Single doses; weekly doses for 6 weeks in the phase 1 multiple-dose part
Study design
Original preclinical and phase 1 study (phase 1 was randomized and placebo-controlled)
Funding
not stated in the source

The receptor-bias data are cell-assay findings, not evidence of a clinical benefit. The animal findings come from the same paper, and the sources reviewed give no dose or route for them.

Read the original source
SLIMMER: 664 Chinese adults, 40 weeks, placebo-controlled

Randomized controlled trial

Ji L et al. Lancet Diabetes Endocrinol. 2025;13(9):777-789. PMID 40555243.

At week 40, the least-squares mean change in body weight was -9.1%, -10.9%, and -13.2% at 1.2, 1.8, and 2.4 mg versus 0.1% on placebo. Treatment differences versus placebo were -9.2% (97% CI -11.0 to -7.5), -11.1% (-13.1 to -9.1), and -13.3% (-15.3 to -11.3), all p<0.0001. At least 5% weight loss was reached by 77%, 84%, and 87% versus 16% on placebo. Treatment-emergent adverse events occurred in 93%, 93%, and 93% versus 84% on placebo, mostly mild to moderate gastrointestinal events, and ten participants on ecnoglutide discontinued for adverse events.

Participants / model
664 Chinese adults with overweight or obesity and no diabetes (BMI of at least 28, or at least 24 with a weight-related comorbidity), at 36 centers: ecnoglutide 1.2 mg (n=166), 1.8 mg (n=166), 2.4 mg (n=167), placebo (n=165)
Treatment
Ecnoglutide 1.2, 1.8, or 2.4 mg subcutaneously once weekly, or placebo
Follow-up
Week 40 (co-primary time point)
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05813795)
Funding
Funded by Hangzhou Sciwind Biosciences

Week 40 is the co-primary time point in the abstract. The full paper is not open access and is not among the sources reviewed, so whether week 48 figures appear in it is not established here.

Read the original source
Company statement, 21 June 2025: 15.4% at week 48, not peer reviewed

Regulatory record

Hangzhou Sciwind Biosciences press release, 21 June 2025, republished on BioPharma Dive.

The company said that by week 48 the 2.4 mg dose reached a mean 15.4% reduction from baseline (placebo-adjusted 15.1%) under the treatment policy estimand, with 92.8% of participants reaching at least 5%, 79.6% at least 10%, and 63.5% at least 15% weight loss. So 15.4% is the sponsor's from-baseline value at 2.4 mg at week 48, and 15.1% is the placebo-adjusted value.

Participants / model
664 Chinese adults in SLIMMER
Treatment
Ecnoglutide 2.4 mg subcutaneously once weekly
Follow-up
Week 48 (secondary time point)
Study design
Company press release; not peer reviewed
Funding
not stated in the source

The peer-reviewed abstract reports week 40 as the co-primary time point (-13.2% at 2.4 mg, treatment difference -13.3%). The page cites the paper's week 40 figures and labels week 48 as a company statement.

Read the original source
Journal review, published online 7 July 2026: China approvals in January and March 2026

Narrative review

Shirley M. Drugs. 2026;86(9):1563-1570. PMID 42412371.

The review, published online 7 July 2026, states that subcutaneous ecnoglutide received its first approval, in China, for glycemic control in adults with type 2 diabetes in January 2026, and that in March 2026 it was approved in China for long-term weight management in adults with obesity, or with overweight and one or more weight-related comorbidity (together with diet control and increased physical activity). It also states the compound is under clinical evaluation in adolescents with obesity, adults with obesity and obstructive sleep apnoea, and adults with obesity and knee osteoarthritis, and that an oral tablet is in development.

Participants / model
Adults in China with type 2 diabetes, or with obesity or overweight
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Approvals in January 2026 and March 2026
Study design
Journal summary of regulatory milestones
Funding
not stated in the source

The regulator's own approval record is not among the sources reviewed, and the review states the approval dates to the month only.

Read the original source
Company statements, 30 January and 6 March 2026, with a Reuters report

Regulatory record

Hangzhou Sciwind Biosciences press releases dated 30 January 2026 and 6 March 2026 (weight-management release on BioSpace); Reuters report dated 6 March 2026, read via Yahoo Finance.

Sciwind press releases dated 30 January 2026 and 6 March 2026 say China's National Medical Products Administration approved ecnoglutide injection for glycemic control in adults with type 2 diabetes and for chronic weight management in Chinese adults with overweight or obesity. Reuters (dateline 6 March 2026) reported that Pfizer announced the weight-management approval on WeChat for Xianweiying, also known as ecnoglutide, and that Pfizer had not given a price or launch date. The Reuters text read does not name the NMPA.

Participants / model
Adults in China
Treatment
Ecnoglutide subcutaneous injection
Follow-up
Statements dated 30 January 2026 and 6 March 2026
Study design
Company press releases and a news report; not a regulator record
Funding
not stated in the source

Approval is regional: this does not make ecnoglutide an FDA or EMA product. No license terms or price are stated on this page.

Read the original source
EECOH-2: 623 adults with type 2 diabetes, HbA1c at week 32 versus dulaglutide

Randomized controlled trial

He Y et al. Lancet Diabetes Endocrinol. 2025;13(10):863-873. PMID 40854315.

At week 32, HbA1c fell 1.91% (0.6 mg), 1.89% (1.2 mg), and 1.65% (dulaglutide 1.5 mg). Differences versus dulaglutide were -0.26% (95% CI -0.39 to -0.13) and -0.24% (-0.38 to -0.11; p=0.0002 for superiority at 1.2 mg). The authors say the 1.2 mg difference was not considered clinically relevant. Discontinuation for adverse events was 3%, 4%, and 3%.

Participants / model
623 Chinese adults with type 2 diabetes on metformin alone (BMI 20 to 35), at 52 hospitals
Treatment
Ecnoglutide 0.6 or 1.2 mg versus dulaglutide 1.5 mg, subcutaneously once weekly
Follow-up
52-week trial; HbA1c reported at week 32
Study design
Randomized open-label non-inferiority phase 3 trial (NCT05680129)
Funding
not stated in the source

Open-label, with an active comparator and no placebo arm.

Read the original source
EECOH-1: 211 adults with type 2 diabetes, HbA1c at week 24 versus placebo

Randomized controlled trial

Zhu D et al. Nat Commun. 2026;17(1):1420. PMID 41501026.

At week 24, HbA1c changed -1.96% at 0.6 mg and -2.43% at 1.2 mg versus -0.87% on placebo (changes from baseline). Treatment differences versus placebo were -1.09% (95% CI -1.40 to -0.77) and -1.56% (-1.87 to -1.24). The sponsor's 30 January 2026 release cites a 2.43% reduction at 1.2 mg; in the paper that figure is the change from baseline, and the difference versus placebo is -1.56%.

Participants / model
211 Chinese adults with type 2 diabetes on diet and exercise or one oral agent, at 32 centers
Treatment
Ecnoglutide 0.6 or 1.2 mg subcutaneously once weekly, or placebo
Follow-up
24 weeks
Study design
Randomized double-blind placebo-controlled phase 3 trial (NCT05680155)
Funding
not stated in the source

The change from baseline and the placebo difference are different numbers; 2.43% is the former.

Read the original source
Company statement, 7 June 2026: interim week 20 versus semaglutide, not peer reviewed

Regulatory record

Hangzhou Sciwind Biosciences press release, 7 June 2026, on BioSpace.

The company reported interim results of SLIMMER-UP-SWITCH, an open-label phase 2 trial at 17 centers in China that randomized adults with BMI of at least 30 to ecnoglutide or semaglutide 2.4 mg weekly for 60 weeks. At a pre-specified interim analysis at week 20, the least-squares mean weight change was -12.8% versus -9.5% (P<0.0001). The release calls this a 35% greater reduction, which is a relative difference (3.3 percentage points by arithmetic). The study is registered as NCT07073417 (sponsor Hangzhou Sciwind Biosciences, n=163, masking none, primary completion 2027-02-27).

Participants / model
163 Chinese adults with obesity (BMI of at least 30)
Treatment
Ecnoglutide versus semaglutide 2.4 mg subcutaneously once weekly
Follow-up
Interim analysis at week 20 of a 60-week study
Study design
Company press release on an interim, open-label phase 2 analysis; not peer reviewed
Funding
not stated in the source

The release does not state the estimand and gives no registry number. The registry title describes a treatment switching design, so the head-to-head description is not treated as settled here.

Read the original source
Drug interaction study: 28 healthy volunteers, rosuvastatin and digoxin exposure

Clinical trial

Li F et al. Diabetes Obes Metab. 2026;28(9):8128-8135. PMID 42310888.

At steady state, ecnoglutide 1.2 mg did not change rosuvastatin or digoxin exposure to a clinically relevant degree: the geometric mean ratio of AUC0-inf (with versus without ecnoglutide) was 106% (90% CI 94 to 120) for rosuvastatin and 84% (76 to 94) for digoxin, and digoxin Cmax fell from 1.39 to 1.31 ng/mL. The most common adverse events were weight loss and gastrointestinal events and no serious adverse events were reported. The authors advise monitoring during digoxin co-administration, especially in renal impairment. The 11.2% mean weight decrease over 14 weeks in this uncontrolled study is not an efficacy result.

Participants / model
28 healthy adult volunteers
Treatment
Ecnoglutide 1.2 mg subcutaneously at steady state, with single oral doses of rosuvastatin and digoxin
Follow-up
14 weeks
Study design
Single-sequence phase 1 drug interaction study, uncontrolled
Funding
not stated in the source

Uncontrolled and in healthy volunteers, so the weight change is not an efficacy result.

Read the original source
Registry search, 10 October 2026: 15 records, none with posted results

Trial registry record

ClinicalTrials.gov search for ecnoglutide, run on 10 October 2026.

On 10 October 2026 the ClinicalTrials.gov query ecnoglutide returned 15 records, including phase 3 studies in obesity with obstructive sleep apnea (NCT07434050 and NCT07387094, recruiting, n=140 each), in obesity with knee osteoarthritis (NCT07734311, recruiting, n=360), and in adolescents (NCT07836270, not yet recruiting, n=192), plus a completed oral ecnoglutide phase 2 (NCT07281937, n=206, sponsor Verdiva Bio Dev Limited). These records have no posted results.

Participants / model
Registered participants, not a clinical population
Treatment
Ecnoglutide subcutaneous and oral
Follow-up
Search run on 10 October 2026
Study design
Registry search
Funding
not stated in the source

Registrations are not outcomes. A completed registration with no posted results has no reportable result here.

Read the original source
US searches, 10 October 2026: no application records and no labels

Regulatory record

DailyMed, U.S. National Library of Medicine, search for ecnoglutide; openFDA Drugs@FDA search by generic name. Both run on 10 October 2026.

An openFDA Drugs@FDA search by generic name ecnoglutide returned no application records, and a DailyMed search for ecnoglutide returned 0 labels. No FDA label or application exists in those sources, and no EMA record was searched.

Participants / model
Records reviewed, not a population
Treatment
Not applicable
Follow-up
Searches run on 10 October 2026
Study design
Dated regulatory search
Funding
not stated in the source

A search result shows what the databases held on that date.

Read the original source

Why is Ecnoglutide in A tier?

A fits a compound with three peer-reviewed phase 3 programs (SLIMMER in obesity, EECOH-1 and EECOH-2 in type 2 diabetes) and reported approvals in China. It is not S because every phase 3 trial is Chinese and sponsor-run, there is no outcomes trial, no FDA record exists, and the approval rests on company statements and a journal summary rather than a regulator record in the sources reviewed.