Ecnoglutide
Ecnoglutide (XW003); modified GLP-1(7-37) peptide with Ala8Val substitution and γ-Glu-2xAEEA-linked C18 diacid fatty acid at Lys30
Clinical trials are ongoing or recently completed. Final approval has not been granted.
A once-weekly injection approved in China for type 2 diabetes and obesity that works by mimicking a natural gut hormone to lower blood sugar and reduce appetite. Clinical trials showed up to 13.2% body weight loss over about 10 months. This medication is not yet available in the US or Europe.
This entry is a cited research summary, not an established treatment reference. Dosing language is included as source context, not as medical instruction.
Safety Summary
Across Phase 2 and Phase 3 injectable studies, most adverse events were transient mild-to-moderate gastrointestinal events. In Phase 2 (n=145), ecnoglutide-treated participants had diarrhea in 14.7%, nausea in 11.9%, constipation in 7.3%, decreased appetite in 6.4%, lipase increase in 5.5%, and hypoglycemia in 5.5% (mild, non-dose-dependent, mainly due to skipped meals), with no treatment-related grade 3 or higher adverse events and no treatment-related serious adverse events (PMID 39333121). In EECOH-1 (Phase 3, n=211), TEAEs occurred in 78.3% (0.6 mg) and 77.5% (1.2 mg) vs. 63.4% placebo; no severe hypoglycemia, pancreatitis, or gallbladder-related disorders were reported (PMID 41501026). In EECOH-2 (Phase 3, n=621), discontinuation due to adverse events was 3% (ecnoglutide 0.6 mg), 4% (1.2 mg), and 3% (dulaglutide) over 52 weeks (PMID 40854315). In the SLIMMER obesity trial (Phase 3, n=664), TEAEs occurred in 93% of ecnoglutide-treated participants vs. 84% placebo; 10 ecnoglutide-treated participants discontinued due to adverse events; most common AEs were mild-to-moderate gastrointestinal events (PMID 40555243). In Phase 1, adverse events included decreased appetite, nausea, and headache (PMID 37364710). No signal of pancreatitis, severe hypoglycemia, or thyroid C-cell pathology has emerged across the clinical program.
Clinical check-in
If real-world use or exposure is being considered, review potential interactions, contraindications, and monitoring needs with a licensed clinician rather than relying on summary copy alone.
Sources: [1-17]