Ecnoglutide is a GLP-1 receptor agonist from China's Sciwind Biosciences. It is described as cAMP-biased, meaning it favors one of the receptor's internal signaling pathways, an approach the company says can sustain weight loss.
China approved subcutaneous ecnoglutide for blood-sugar control in adults with type 2 diabetes in January 2026, then for long-term weight management in adults with obesity, or overweight plus a weight-related condition, in March 2026. Pfizer holds commercialization rights in mainland China. The Phase 3 EECOH-2 trial, published in The Lancet Diabetes & Endocrinology, found ecnoglutide noninferior to dulaglutide on HbA1c in type 2 diabetes.
At EASD 2026 on September 30, Sciwind reported a 20-week Phase 1b trial in 48 adolescents with obesity, in which BMI fell 11.2% to 12.6% versus no change on placebo, and said a Phase 3 adolescent trial has started. An oral tablet version is also in development.
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Sciwind Biosciences reported at EASD on Wednesday, September 30, 2026 a Phase 1b, randomized, double-blind, placebo-controlled trial of ecnoglutide, its cAMP-biased GLP-1 receptor agonist approved in China for adults, in 48 adolescents aged 12 to 17 with obesity whose BMI had fallen less than 5% after at least 12 weeks of diet and exercise. After 20 weeks on 1.2, 1.8, or 2.4 mg, BMI fell 11.2% to 12.6% and body weight 10.4% to 12.1%, versus 0.0% and a 1.2% gain on placebo. There were no treatment-related serious adverse events, most side effects were mild, transient gastrointestinal reactions, and drug exposure resembled that in adults; Sciwind said a Phase 3 adolescent trial has begun.
Following the August 22 Lancet Diabetes & Endocrinology publication of the full EECOH-2 Phase 3 trial results for Xianweida's ecnoglutide (XW003, a first-in-class cAMP-biased GLP-1 receptor agonist that preferentially activates the cAMP signaling pathway over β-arrestin recruitment), Chinese biotech peptide activity continued through end of August into September. Ecnoglutide received its Chinese NMPA approval for type 2 diabetes January 30, 2026, followed by the March 6, 2026 approval for weight management in adults with overweight or obesity; the Lancet publication supplies the peer-reviewed data package supporting global regulatory submissions. Ecnoglutide is licensed to Pfizer under the up-to-$495 million partnership announced in 2024 for ex-China commercialization. The biased-agonism concept (selective signaling pathway activation to separate efficacy from tolerability) is now being pursued by CSPC (SYH2069 GLP-1/GIP dual-biased agonist) and other Chinese biotech peptide developers.
The Lancet Diabetes & Endocrinology published Saturday August 22, 2026 the full EECOH-2 Phase 3 trial results for Xianweida's ecnoglutide (XW003), a first-in-class cAMP-biased GLP-1 receptor agonist. Mechanism: ecnoglutide preferentially activates the cAMP intracellular signaling pathway over β-arrestin recruitment when it binds the GLP-1 receptor. This biased-agonism concept selects one downstream signaling arm over the other, with the theoretical potential to separate the therapeutic effects (glucose lowering via cAMP-mediated insulin secretion) from the side-effect burden (some of which may be β-arrestin-mediated). Trial design: 52-week open-label non-inferiority Phase 3 across 52 Chinese hospitals. Adults aged 18-75 years with BMI 20-35 kg/m2, type 2 diabetes diagnosis, and elevated glucose concentrations on metformin monotherapy. Randomized to subcutaneous ecnoglutide 0.6 mg or 1.2 mg once weekly, or dulaglutide 1.5 mg once weekly (active comparator). Primary results: both ecnoglutide doses met the non-inferiority endpoint on HbA1c reduction versus dulaglutide 1.5 mg. Both doses were well tolerated with a safety profile broadly consistent with the GLP-1 receptor agonist class. Ecnoglutide is the first global cAMP-biased GLP-1 receptor agonist to reach Phase 3 publication. The biased-agonism approach could inform next-generation GLP-1 drug design and offers a differentiated tolerability profile if the concept holds in larger populations.