Evidence reference only. Not medical advice, not a dosing guide, and not a recommendation to use any drug.
Echo The Echo Compendium
<- All drugs
Investigational and unapproved. Findings below describe what trials and reports have observed. Nothing here is an endorsement, a claim of safety or effectiveness, or a clinical recommendation.

Ecnoglutide

INVESTIGATIONAL

GLP-1 receptor agonist (cAMP-biased)

5
graded findings
4
effect domains
Evidence spread
High evidence 0Moderate evidence 4Low evidence 0Very low evidence 1

Ecnoglutide is shown as an investigational or pipeline evidence record. Findings describe what studies and reports observed; they do not endorse use or establish personal suitability.

Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Ecnoglutide INVESTIGATIONAL
Pharmacology and mechanism Decrease
Moderate evidence

CLARIFICATION RECORD: ecnoglutide (XW003, Sciwind Biosciences) is NOT an oral small-molecule GLP-1RA. It is an injectable long-acting modified GLP-1(7-37) PEPTIDE...

Zhang et al., Nat Commun 2024;15:8408 (phase 2 T2D); Lancet Diabetes Endocrinol 2025 (pha... Source
Full findingCLARIFICATION RECORD: ecnoglutide (XW003, Sciwind Biosciences) is NOT an oral small-molecule GLP-1RA. It is an injectable long-acting modified GLP-1(7-37) PEPTIDE (Ala8->Val8 plus C18 fatty-acid conjugation at Lys30), once-weekly s.c., and a cAMP signalling-BIASED GLP-1R agonist. Phase 2 (T2D, N=145, China, 20 wk): HbA1c -1.81/-1.90/-2.39% (0.4/0.8/1.2 mg) vs -0.55% placebo; 33.3% of 1.2 mg achieved >=5% weight loss vs 3.0% placebo. Phase 3 obesity and T2D (EECOH/EECOH-1) reported.
PopulationPhase 2 T2D: 145 adults, China, once-weekly s.c., 20 wk, placebo-controlled; phase 3 obesity and T2D (EECOH/EECOH-1)
Fundingindustry - Hangzhou Sciwind Biosciences (sponsor of record; disclosed)
Scope limitsMECHANISM CLARIFICATION: peptide, injectable (once-weekly s.c.), cAMP-biased GLP-1R agonist - NOT an oral small molecule. Roster listed it under oral small-molecule GLP-1 but identity does not match; recorded here with corrected classification. cAMP bias hypothesised to reduce receptor internalisation and enhance insulin secretion.
Comparatorsplacebo
Ecnoglutide INVESTIGATIONAL
Pharmacology and mechanism Not directional
Very low evidence

cAMP-biased GLP-1 analog (Ala8Val + C18 diacid fatty-acid acylation): potent cAMP induction with minimal receptor internalisation; long half-life supporting...

Guo W et al. Discovery of ecnoglutide - a novel, long-acting, cAMP-biased GLP-1 analog. M... Source
Full findingcAMP-biased GLP-1 analog (Ala8Val + C18 diacid fatty-acid acylation): potent cAMP induction with minimal receptor internalisation; long half-life supporting once-weekly dosing.
PopulationIn vitro, db/db mice, DIO rats, phase 1 humans (NCT04389775)
Fundingacademic/independent analysis (manufacturer not study sponsor; per-study COI not individually audited)
Scope limitsanimal data; human relevance uncertain
Comparatorssemaglutide (preclinical)
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Ecnoglutide INVESTIGATIONAL
Glycaemic control Decrease
Moderate evidence

The cAMP-biased GLP-1 agonist ecnoglutide lowered HbA1c by up to ~2.4% in phase-2 type-2 diabetes.

Ecnoglutide in type 2 diabetes, phase-2, Nat Commun 2024 Source
PopulationPeer-reviewed RCT / meta-analysis
FundingSciwind Biosciences
Scope limitsPhase-2; China-only; injectable. The ecnoglutide phase-3 OBESITY result (PMID 40555243) is already in the corpus (C2-ECNO-WL-01).
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Ecnoglutide INVESTIGATIONAL
Gastrointestinal tolerability Increase
Moderate evidence

Most adverse events mild-to-moderate GI; few discontinuations.

Ji L et al. Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults ... Source
PopulationPhase 3 N=664 (NCT05813795); 40 wk; placebo comparator
Fundingindustry - Hangzhou Sciwind Biosciences (trial sponsor, disclosed in publication)
Comparatorsplacebo
Thin or bounded evidence here means uncertainty remains visible. It is not evidence that an effect has been ruled out.
Ecnoglutide INVESTIGATIONAL
Weight change Decrease
Moderate evidence

Phase 3 (China): superior, sustained weight reduction vs placebo at 40 weeks in overweight/obese adults without diabetes.

Ji L et al. Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults ... Source
PopulationPhase 3 RCT (NCT05813795), N=664, 36 Chinese centres, overweight/obese without diabetes; 40 wk; once-weekly SC; placebo comparator
Fundingindustry - Hangzhou Sciwind Biosciences (trial sponsor, disclosed in publication)
Scope limitsVERIFIED INJECTABLE: ecnoglutide is a once-weekly SUBCUTANEOUS peptide GLP-1 analog (Sciwind), NOT an oral small molecule — it sits outside the oral-small-molecule subclass and is captured here for completeness with correct route. Sciwind also has an oral ecnoglutide formulation in earlier development, but the pivotal data here are injectable.
Comparatorsplacebo