Weight & Metabolic
Ecnoglutide
aka XW003 · XW-003 · XW 003 · XW004 · VRB-101 · ecno · ecnoglutide injection · sciwind glp-1 · chinese glp-1 · econoglutide · ecnoglutid · ecnaglutide · egnoglutide
Grade
A weekly GLP-1 injection from China's Sciwind Biosciences, approved in China in 2026 for weight loss and type 2 diabetes. It has solid trial results in Chinese adults, but it is not licensed in the UK, EU or US.
- Class
- GLP-1 receptor agonist peptide (cAMP-biased GLP-1 analogue); weekly injection, with an oral tablet in development
- Evidence
- Grade B · Promising human evidence
- Sport / WADA
- Not prohibited. Because China's NMPA has approved it for human therapeutic use, it falls outside S0 (non-approved substances), which covers only substances with no current approval by any governmental regulatory health authority. GLP-1 receptor agonists are not listed in any other section of the WADA 2026 Prohibited List.
- Last reviewed
- 2026-10
Grade B · Promising human evidence
Why this grade
Strong human evidence and an approved medicine, but in China only. China's NMPA approved it for type 2 diabetes in January 2026 and for long-term weight management in March 2026. This rests on three published randomised Phase 3 trials: SLIMMER in obesity (Lancet Diabetes & Endocrinology 2025, 664 adults; 13.2% weight loss at the top dose at 40 weeks versus a 0.1% gain on placebo, counting everyone who started), and EECOH-1 and EECOH-2 in type 2 diabetes (Nature Communications 2026; Lancet Diabetes & Endocrinology 2025). The grade stops at B because, as with mazdutide, all the trials were in Chinese adults and funded by the manufacturer, there is no UK, EU or US marketing authorisation, and there is no long-term cardiovascular outcome trial. On this site, Grade A is reserved for medicines with robust human trials that are also approved in major Western markets with mature outcome data.
What is it?
Why people buy it
People take it to lose weight. In China it is an approved medicine for weight loss and type 2 diabetes.
What we actually know
- •It works like semaglutide (Wegovy). It copies a gut hormone that makes you feel full.
- •In a large study, people on the top dose lost about 13% of their weight in 40 weeks.
- •People on a dummy treatment stayed about the same. All the people in the studies were Chinese.
- •It is approved in China only. It is not a licensed medicine in the UK.
What might happen
- •Weight loss is likely. Stomach side effects were common, mostly mild to moderate.
- •Drugs like this carry warnings about a swollen pancreas (pancreatitis) and gallbladder problems.
- •Nobody knows the long-term effects on the heart. That study has not been done yet.
- •In studies, doctors watched people closely. Taking it on your own skips that safety net.
- •In the UK, anything sold under this name is unlicensed. Nobody checks what is in it.
Bottom line
A real weight-loss medicine with strong studies, but approved only in China. In the UK, any supply is unlicensed.
Know someone taking this?
Send on WhatsAppEcnoglutide is like a car that has passed its road test in one country. The test was thorough and it is on sale there, but it has not been tested or approved for UK roads, and any copy sold here is not the inspected car.
How is it meant to work?
Activates the GLP-1 receptor, enhancing glucose-dependent insulin release, suppressing glucagon, slowing gastric emptying and reducing appetite through central GLP-1 signalling. It is described as cAMP-biased: it favours the cAMP signalling route over beta-arrestin recruitment, which in lab studies reduces receptor desensitisation. Whether this bias gives any clinical advantage over other GLP-1 medicines has not been shown in head-to-head trials. Given by once-weekly subcutaneous injection.
What's it studied for?
Research contexts. Not proven uses, and not recommendations.
Does the human evidence stack up?
Solid but all Chinese. The SLIMMER Phase 3 obesity trial (Lancet Diabetes Endocrinol 2025, n=664) showed 13.2% weight loss at the top dose at 40 weeks versus a 0.1% gain on placebo, counting everyone who started. Two Phase 3 diabetes trials (EECOH-1, Nat Commun 2026, n=211; EECOH-2, Lancet Diabetes Endocrinol 2025, n=623) showed clear blood-sugar improvements versus placebo and non-inferiority to dulaglutide. Gastrointestinal side effects were the most common and mostly mild to moderate. All trials were run in China and funded by Sciwind, and there is no long-term cardiovascular outcome trial.
What could go wrong?
- !Approved only in China. It has no MHRA, EMA or FDA authorisation, so it is unlicensed in the UK
- !Common gastrointestinal side effects (nausea, vomiting, diarrhoea), mostly mild to moderate
- !Pancreatitis and gallbladder disease are class warnings for GLP-1 medicines
- !All trial participants were Chinese adults; results may differ in other populations
- !The 'cAMP-biased' design has not been shown to beat other GLP-1 medicines in head-to-head weight-loss trials
- !No long-term cardiovascular outcome data
- !GREY MARKET: anything sold to UK buyers as 'ecnoglutide' or 'XW003' is unlicensed and of unknown content
Is it legal in the UK?
Not a licensed medicine in the UK. Ecnoglutide holds marketing approval only from China's NMPA (type 2 diabetes, January 2026; long-term weight management, March 2026). It has no MHRA, EMA or FDA authorisation. In UK terms it is an unlicensed medicine: it is not available on the NHS or by private prescription, and any material sold online to UK buyers is outside MHRA quality oversight.
Key trials
- NCT05813795· Phase 3· Completed
SLIMMER: XW003 in adults with overweight or obesity
664 participants; 13.2% weight loss at the top dose at 40 weeks vs +0.1% placebo.
- NCT05680155· Phase 3· Completed
EECOH-1: XW003 versus placebo in type 2 diabetes
211 participants; 24 weeks.
- NCT05680129· Phase 3· Completed
EECOH-2: XW003 versus dulaglutide in type 2 diabetes
623 participants; 52 weeks; non-inferior to dulaglutide.
Sources
- 01Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults with overweight or obesity: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial — Ji L, et al., The Lancet Diabetes & Endocrinology (2025)
SLIMMER, n=664; -9.1% to -13.2% vs +0.1% placebo at 40 weeks (treatment-policy estimand); mostly mild-to-moderate GI events.
- 02Ecnoglutide: First Approvals — Shirley M, Drugs (2026)
First approval in China January 2026 (type 2 diabetes); weight management approval March 2026; oral tablet in development.
- 03Efficacy and safety of cAMP signalling-biased GLP-1 analogue ecnoglutide monotherapy versus placebo in patients with type 2 diabetes (EECOH-1) — Zhu D, et al., Nature Communications (2026)
n=211; HbA1c -1.96 and -2.43 points vs -0.87 placebo at 24 weeks.
- 04Efficacy and safety of cAMP-biased GLP-1 receptor agonist ecnoglutide versus dulaglutide in patients with type 2 diabetes on metformin (EECOH-2) — He Y, et al., The Lancet Diabetes & Endocrinology (2025)
n=623; non-inferior to dulaglutide; superiority of the higher dose judged not clinically relevant.
- 05Sciwind Biosciences announces ecnoglutide injection approved by China's NMPA for chronic weight management, Sciwind Biosciences press release (PR Newswire) (2026)
NMPA approval for weight management; company-reported 15.4% weight loss at 48 weeks on the top dose.
- 06World Anti-Doping Code International Standard: Prohibited List 2026, World Anti-Doping Agency (2026)
S0 covers only substances with no current approval by any governmental regulatory health authority; GLP-1 receptor agonists are not listed.
Related
Before you trust a vial
Peptides are freeze-dried for a reason. If you have seen Ecnoglutide sold pre-mixed in a ready-to-use pen or syringe, here is why that is a red flag for potency, sterility and dosing.
Storage & stability →Stay posted
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