Metabolic & weight

Ecnoglutide

Also called XW003, Xianyida (China, type 2 diabetes)

Ecnoglutide is a once-weekly GLP-1 injection made by Sciwind Biosciences in China. In 2026 China approved it for type 2 diabetes and for long-term weight management in adults with obesity or overweight. It is described as a 'biased' GLP-1 drug, meaning it is designed to switch on only part of the receptor's signaling. It is not approved in the US or Europe.

Late-stage trialsTested in large human trials (phase 2b/3) but not yet approved in the US.

New · under editorial review. Added October 29, 2026 by our automated research, with every claim sourced. A person has not checked this page yet; treat it with extra care. How we research

All printable flashcards

Drawn from its published sequence: 31 residues, one bead each.

Overview

How it works

Established: ecnoglutide activates the GLP-1 receptor, which lowers blood sugar and promotes fullness ⁸. Proposed: it is 'cAMP-biased' — in lab tests it strongly triggered the cAMP signal (EC50 0.018 nM) but did not cause the receptor to be pulled into the cell, and the company says it minimizes beta-arrestin recruitment ⁵⁷. The idea is that avoiding receptor internalization may keep the drug working longer, but whether this bias gives a real advantage in people is still being studied ⁵. Its half-life in healthy volunteers was about 124–138 hours, which supports weekly dosing ⁵.

What research shows

SLIMMER (human phase 3 RCT, n=664 Chinese adults with overweight or obesity and no diabetes): at week 40, weight fell 9.1%, 10.9% and 13.2% on 1.2, 1.8 and 2.4 mg vs a 0.1% gain on placebo; 77–87% lost at least 5% vs 16% on placebo ¹. The company reports 15.4% average loss on 2.4 mg at week 48 (company press release, not peer reviewed) ⁷.
EECOH-2 (human phase 3 RCT, n=621 adults with type 2 diabetes on metformin, open-label, 52 weeks): HbA1c fell 1.91% (0.6 mg) and 1.89% (1.2 mg) vs 1.65% on dulaglutide 1.5 mg at week 32, meeting non-inferiority; the 1.2 mg dose was statistically better than dulaglutide, but the authors judged the difference not clinically relevant ².
EECOH-1 (human phase 3 RCT, n=211 adults with type 2 diabetes, 24 weeks): HbA1c fell 1.96% (0.6 mg) and 2.43% (1.2 mg) vs 0.87% on placebo ³.
Phase 2 (human RCT, n=145 adults with type 2 diabetes, 20 weeks): HbA1c fell 1.81–2.39% vs 0.55% on placebo ⁴.
SLIMMER-UP-SWITCH (human phase 2, open-label, n=163, interim week-20 result presented at ADA 2026 and reported in trade press): weight fell 12.8% on ecnoglutide 2.4 mg vs 9.5% on semaglutide 2.4 mg; the trial is ongoing and not yet peer reviewed ¹¹.
Animal studies (db/db mice, obese rats): lowered blood sugar and caused more weight loss than semaglutide ⁵.

Doses studied in people

Study or label	Dose used	Source
SLIMMER phase 3 RCT in overweight/obesity (n=664)	1.2 mg, 1.8 mg or 2.4 mg once weekly, subcutaneous, vs placebo	¹
EECOH-2 phase 3 RCT in type 2 diabetes on metformin (n=621)	0.6 mg or 1.2 mg once weekly vs dulaglutide 1.5 mg once weekly	²
EECOH-1 phase 3 RCT in type 2 diabetes (n=211)	0.6 mg or 1.2 mg once weekly vs placebo	³
Phase 2 RCT in type 2 diabetes (n=145, 20 weeks)	0.4 mg, 0.8 mg or 1.2 mg once weekly by injection, vs placebo	⁴
Phase 1 study in healthy volunteers	Single doses 0.03–1.0 mg; multiple doses 0.2–0.6 mg once weekly for 6 weeks, subcutaneous	⁵

Doses shown are from published human trials only and are reported, not recommended. The Chinese prescribing label was not available to review.

Read this first: these are the amounts given to participants in published studies or written on official prescribing labels, reported for reference. They are not recommendations. Trial doses were chosen for specific patients under medical supervision, and a dose that is safe in one person can be harmful in another.

Vial math

Many research vials hold 5 or 10 mg of powder. This table shows how much ends up in each mark on a U-100 insulin syringe for common amounts of added liquid. It is arithmetic only, not a dose.

Vial	Liquid added	Concentration	Per unit (0.01 mL)
5 mg	1 mL	5 mg/mL	50 mcg	Open in calculator
5 mg	2 mL	2.5 mg/mL	25 mcg	Open in calculator
5 mg	3 mL	1.67 mg/mL	16.7 mcg	Open in calculator
10 mg	1 mL	10 mg/mL	100 mcg	Open in calculator
10 mg	2 mL	5 mg/mL	50 mcg	Open in calculator
10 mg	3 mL	3.33 mg/mL	33.3 mcg	Open in calculator

More sizes: all vial sizes · How this works: Syringes and units · Reconstitution guide.

Safety

In SLIMMER, 93% in each ecnoglutide group reported a side effect vs 84% on placebo; most were mild-to-moderate stomach and gut problems, and 10 people on ecnoglutide stopped because of side effects ¹.
In EECOH-2, 3–4% stopped due to side effects, similar to dulaglutide (3%) ².
In the phase 1 study, reported effects included decreased appetite, nausea and headache ⁵.
Long-term safety is unknown: published trials last up to about one year, and data come mostly from Chinese participants ¹².

Report side effects of any drug or product to the FDA through MedWatch. For a possible poisoning in the US, call Poison Control at 1-800-222-1222.

Legal status

FDA: Not FDA-approved; no US marketing application was found in the sources reviewed.
Compounding: No FDA compounding listing or action specific to ecnoglutide was found in the sources reviewed.
Sports (WADA): Not prohibited as of the 2026 list. GLP-1 receptor agonists are not listed and remain off the 2027 list ¹³¹⁴. Because it is approved in China, the S0 'non-approved substance' class does not appear to apply ¹³.
Other: Approved in China by the NMPA: type 2 diabetes in adults (January 2026, brand Xianyida) and chronic weight management in adults with obesity, or overweight plus a weight-related condition (March 2026) ⁶⁷⁸. Not covered by China's state insurance for diabetes at launch ⁸. Studies in adolescents, sleep apnea, knee osteoarthritis and an oral tablet form are under way ⁶.

Rules change often. See Legal status of peptides for how these categories work.

History

Discovered and developed by Hangzhou Sciwind Biosciences; its discovery and first-in-human study were published in 2023 ⁵. A phase 2 trial in type 2 diabetes was published in 2024 ⁴, and phase 3 trials in obesity (SLIMMER) and type 2 diabetes (EECOH-1 and EECOH-2) were published in 2025–2026 ¹²³. In January 2025 Sciwind licensed rights outside Greater China and South Korea for an oral form (XW004) to Verdiva Bio ¹⁰. China's NMPA approved the injection (brand Xianyida) for type 2 diabetes in January 2026 ⁶⁸ and for chronic weight management in March 2026 ⁶⁷. Pfizer China holds mainland China commercial rights, announced in February 2026 ⁹.

Common questions

Is ecnoglutide approved?

Yes, in China only. The NMPA approved it for type 2 diabetes in January 2026 and for chronic weight management in March 2026 ⁶⁷. It is not FDA-approved.

How much weight loss did it cause in trials?

In the 664-person SLIMMER trial, the 2.4 mg dose lowered weight by about 13% at 40 weeks vs no change on placebo ¹; the company reports about 15% at 48 weeks, a figure not yet peer reviewed ⁷.

What does 'biased' GLP-1 agonist mean?

It means the drug was designed to trigger mainly one signal (cAMP) from the GLP-1 receptor while causing little receptor pull-in, which in lab tests may help it keep working ⁵. Whether this matters for patients is not yet proven.

What are the known risks?

Most side effects in trials were mild-to-moderate nausea and other gut problems, and few people stopped treatment because of them ¹². Long-term safety beyond about a year is not known.

Is ecnoglutide banned in sport?

No. GLP-1 drugs are not on WADA's Prohibited List and remain off it for 2027 ¹³¹⁴.

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Sources

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Last reviewed 2026-10-29 · How we research · Found an error? See our corrections policy.