Interim data from a Phase II head-to-head trial reported by China-based Hangzhou Sciwind Biosciences show that ecnoglutide (also known as XW003), the world's first approved cAMP-biased GLP-1 receptor agonist, produced 35% greater mean weight loss than Novo Nordisk's Wegovy (semaglutide) at the same 2.4 mg weekly dose over 20 weeks. The company presents the readout as the first direct clinical evidence that selective cAMP pathway activation at the GLP-1 receptor translates into a measurable efficacy advantage over a conventional, balanced GLP-1 agonist. Ecnoglutide received NMPA approval in China for chronic weight management in March 2026, with Pfizer holding exclusive commercialization rights in mainland China.
Trial data
The SLIMMER-UP-SWITCH trial is a multicenter, randomized, open-label Phase II study enrolling 163 adults with obesity (BMI ≥ 30 kg/m²) across 17 centers in China. Participants were randomized 1:1 to once-weekly subcutaneous ecnoglutide or semaglutide, both at the 2.4 mg maintenance dose. At the pre-specified week 20 interim analysis, the least-squares mean percentage change in body weight was -12.8% for ecnoglutide versus -9.5% for semaglutide (p < 0.0001). The proportion achieving ≥ 10% weight loss was 74% versus 40% (p < 0.001), nearly double the response rate. The gastrointestinal safety profile was consistent with prior ecnoglutide data from the Phase III SLIMMER trial, which demonstrated a treatment discontinuation rate due to gastrointestinal adverse events of just 0.6%, and no new safety signals were identified in the interim analysis.
Competitive context