Could This Be the New Ozempic?

A new drug has shown promise as a type 2 diabetes and weight loss treatment—potentially offering an new rival to drugs like Ozempic.

Ecnoglutide—a new once-weekly GLP-1 receptor agonist injection similar to both semaglutide (Ozempic) and dulaglutide (Trulicity)—appears to be effective for diabetes management.

In a Phase 3 randomized controlled trial, researchers at Fudan University and Hangzhou Sciwind Biosciences in China discovered that ecnoglutide it works as well as dulaglutide (a commonly prescribed once-a-week injection to manage diabetes) in lowering blood sugar levels.

Moreover, ecnoglutide may help patients lose more weight than dulaglutide, the researchers said.

In the U.S., more than 38 million Americans have diabetes (about 1 in 10), of which some 90–95 percent have type 2, in which the body either can’t use insulin effectively, or does not produce enough of it to regulate blood sugar levels.

Ecnoglutide—which is not yet licensed—and dulaglutide both help manage blood sugar levels by acting on the same receptor in the body, known as the GLP-1 receptor.

Ecnoglutide targets specific pathways in the body that enhance insulin production and lower blood sugar, while avoiding another pathway that can sometimes reduce the receptor’s activity, the researchers explained.

Dulaglutide, on the other hand, turns on both pathways the same amount.

“Ecnoglutide demonstrates a better efficacy of weight loss and blood sugar control compared to existing medications in the trials,” study author Feifei Jiang told Newsweek.

In the 52-week study of more than 600 adults in China with type 2 diabetes, participants who received ecnoglutide saw their average blood sugar drop by about 1.9 percent, compared to a 1.65 percent drop in participants who received dulaglutide.

People taking ecnoglutide also lost nearly twice as much weight as those on dulaglutide, experiencing an average body weight reduction of 5.2–5.7 percent compared to an average weight loss of 2.8 percent for those taking dulaglutide.

The additional weight loss seen in participants taking ecnoglutide could further help diabetes management and reduce risks of heart disease, according to the authors.

“Based on currently available information (primarily from clinical trials), the types of side effects associated with ecnoglutide are expected to be similar to those of existing GLP-1 receptor agonists (such as semaglutide or dulaglutide), primarily including gastrointestinal disorders (diarrhea, nausea, vomiting) and decreased appetite. Most cases were mild to moderate side effects and tended to decrease gradually with prolonged treatment,” Jiang explained.

Ecnoglutide is also simpler to produce than other GLP-1 receptor agonists, the study highlights. This means it can be manufactured more quickly and at a lower cost than other weight loss medications currently available.

This adds to the growing body of evidence that suggests ecnoglutide could be a valuable new treatment option for people with type 2 diabetes, offering effective blood sugar control and weight loss, the researchers said.

In terms of how it comparises to Ozempic, the researchers wrote in the paper: “Ecnoglutide, a novel GLP-1 receptor agonist, is composed entirely of natural amino acids with chemical modifications to enhance stability and activity, differing from semaglutide by four amino acids.”

They explained these modifications not only improve how the drug works but the manufacturing process in this case too. Unlike semaglutide, which requires extra chemical steps to attach additional amino acids, ecnoglutide can be made more directly through genetically engineered cells.

“Although this study presents a valuable comparison of ecnoglutide with dulaglutide, comparisons with semaglutide are also of clinical interest due to the structural similarity between ecnoglutide and semaglutide, and the greater glycemic and weight-lowering effects reported with semaglutide versus dulaglutide,” they wrote.

“However, at the time of study conduct, limited availability of semaglutide in China made its inclusion as a comparator unfeasible.”

For now, the researchers said side-by-side consideration with the Phase 3 SUSTAIN-China study of semaglutide might offer some insight.

“Although no direct comparison has been conducted, these findings indirectly suggest that their efficacy might be similar. Future head-to-head trials will be required to confirm this,” the authors wrote.

Jiang explained that SUSTAIN-China showed average blood sugar was reduced by 1.4 percent to 1.7 percent with semaglutide after 30 weeks, whereas with ecnoglutide it dropped by 1.89 percent to 1.91 percent after 32 weeks (shown in the separate study).

Similarly, body weight was reduced by 5.2 percent to 5.7 percent with ecnoglutide after 52 weeks, while it was reduced by 3.9 percent to 5.7 percent with semaglutide after 30 weeks.

“Those results suggest that the efficacy of ecnoglutide might be similar or even better than semaglutide in glycemic control,” Jiang said.

Further studies are needed to explore ecnoglutide’s efficacy across diverse populations and in combination with other antidiabetic agents.

While ecnoglutide has not yet received formal marketing authorization for any indication in any country or region worldwide, in China, new drug applications (NDAs) are under review.

“Ecnoglutide is expected to achieve optimal efficacy when combined with behavioral and lifestyle support interventions. Lifestyle guidance like dietary planning and exercise recommendations helps patients establish sustainable healthy habits,” said Jiang.

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Reference

He, Y., Mi, N., Cheng, Z., Xue, H., Han, J., Wang, H., Wang, H., Wu, J., Shi, X., Zhao, S., Duan, B., Zhu, Y., Zhou, Y., Li, F., Wang, X., Ling, H., Wang, S., Li, Q., Jiang, F., … Li, X. (2025). Efficacy and safety of cAMP-biased GLP-1 receptor agonist ecnoglutide versus dulaglutide in patients with type 2 diabetes and elevated glucose concentrations on metformin monotherapy (EECOH-2): A 52-week, multicentre, open-label, non-inferiority, randomised, phase 3 trial. The Lancet Diabetes & Endocrinology. https://doi.org/10.1016/S2213-8587(25)00196-2