What is ecnoglutide?
Ecnoglutide is a novel glucagon-like peptide‑1 (GLP‑1) receptor agonist being developed for type 2 diabetes and obesity. It is also researched for non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease.
Made from natural amino acids, ecnoglutide mimics GLP‑1 like semaglutide (Ozempic, Wegovy) but preferentially increases cyclic AMP (cAMP) production. It stimulates insulin secretion when glucose is elevated and blocks glucagon release, improving glycemic control. For weight loss, it slows gastric emptying and acts on brain receptors to reduce appetite and food intake.
How much weight can you lose with ecnoglutide?
In a placebo‑controlled Phase 3 trial (n=664) in adults with overweight/obesity (BMI ≥ 28 kg/m² or ≥ 24 kg/m² with comorbidity), weekly ecnoglutide injections for 48 weeks achieved:
- 1.2 mg dose: 9.1% weight loss
- 1.8 mg dose: 10.9% weight loss
- 2.4 mg dose: 13.2% weight loss
Versus minimal change with placebo. At 2.4 mg, 92.8% lost ≥ 5% body weight compared to 14% on placebo. Discontinuation rates due to side effects were low and similar across doses.
How well does ecnoglutide work for type 2 diabetes?
In a Phase 2 study (n=145) over 20 weeks in type 2 diabetics:
- 0.4 mg: HbA1c ↓ 1.81%
- 0.8 mg: HbA1c ↓ 1.90%
- 1.2 mg: HbA1c ↓ 2.39% (versus 0.55% with placebo)
At 1.2 mg, 71.9% reached HbA1c ≤ 6.5% (9.1% placebo), and 33.3% lost ≥ 5% body weight (3.0% placebo).
What are the side effects of ecnoglutide?
Ecnoglutide’s safety profile mirrors approved GLP‑1s. The most common adverse events include:
- Diarrhea
- Constipation
- Nausea
- High cholesterol
- Loss of appetite
- Hypoglycemia
Sources
- Zhu D, Wang W, et al. Efficacy and safety of GLP‑1 analog ecnoglutide in adults with type 2 diabetes: a randomized, double‑blind, placebo‑controlled Phase 2 trial. Nat Commun. 2024 Sep 27;15(1):8408. doi:10.1038/s41467-024-52353-y. Accessed June 30, 2025.
- Ji L, Gao L, Xue H, et al. Efficacy and safety of a biased GLP‑1 receptor agonist ecnoglutide in adults with overweight or obesity: a multicentre, randomized, double‑blind, placebo‑controlled Phase 3 trial. Lancet Diabetes Endocrinol. Published online June 21, 2025. Accessed June 30, 2025.