Efsubaglutide alfa
A once-weekly GLP-1 fusion protein approved in China for type 2 diabetes and in trials for weight loss
Efsubaglutide alfa, first published as supaglutide, joins GLP-1 analogue chains to the Fc stem of a human antibody so it lasts about a week in the blood. In two phase 2b/3 trials in Chinese adults with type 2 diabetes it lowered HbA1c by 1.3 to 1.7 points more than placebo, and China's NMPA approved it in 2025. It is not approved in the US or the EU.
Used in human trials: 1 mg or 3 mg, Once weekly, Subcutaneous (Trial: type 2 diabetes, drug-naive (SUPER1, phase 3 stage)) Details ↓
Recommended Dosing
Used in human trials
There is no FDA label. A label from outside the US exists (see the regulatory status on this page) but was not read for this page: these are amounts given in published trials, not recommendations.
Work out syringe units → · New to syringes? · All dosing data ↓
What is it?
Efsubaglutide alfa belongs to the GLP-1 receptor agonists, the drug class of semaglutide and dulaglutide. GLP-1 is a gut hormone that makes the pancreas release insulin when blood glucose is high, holds back glucagon and slows eating, but the natural hormone lasts under two minutes. Efsubaglutide alfa solves that the way dulaglutide does: GLP-1 analogue chains are fused to the Fc stem of a human antibody, here immunoglobulin G2, which keeps the drug in circulation for days.
It was first described in mouse and monkey papers under the name supaglutide. In the laboratory it stimulated insulin release from both mouse and human islets, and in diabetic mice one injection lowered glucose for days; in diabetic rhesus monkeys weekly injections lowered glucose and body weight. Later monkey work tested it in fatty-liver disease, and a 40-week toxicity study in monkeys found no organ toxicity beyond injection-site inflammation.
In people, a single-dose phase 1 study in 48 healthy adults found predictable, dose-proportional exposure, a half-life of about 121 hours, and the familiar class side effects, mainly nausea, vomiting and reduced appetite. A population model built from 911 participants later put the half-life in type 2 diabetes at about 182 to 215 hours, long enough to support weekly and possibly two-weekly injections.
Two phase 2b/3 trials carried it to approval. SUPER1 gave 1 or 3 mg weekly to newly diagnosed adults not controlled by diet and exercise; after 24 weeks HbA1c fell 1.73 and 2.15 points, 1.26 and 1.68 more than placebo. SUPER2 added 3 mg to metformin and lowered HbA1c by 1.80 points against 0.74 on placebo; a post-hoc look at people who stayed on 1 mg found a smaller but real effect without significant weight loss. Exposure-response analyses of both trials found more drug meant more glucose lowering and more stomach side effects.
Smaller studies explore how it might be used. Every-two-week injections of 3 mg matched weekly 1 mg over 12 weeks; a drug-free follow-up of SUPER1 found 12 of 20 evaluable participants in remission three months after stopping; and a drug-interaction study found no meaningful change in metformin or digoxin levels. For obesity, the LIGHT 1 phase 2a trial gave 5 to 20 mg weekly to 50 people and reported 7.2% weight loss against 0.9% on placebo over a short course; a larger LIGHT 2 trial is designed.
China's drug regulator announced its approval for blood glucose control in adults with type 2 diabetes on June 11, 2025. Almost all the human data come from Chinese participants, and there are no head-to-head trials against other GLP-1 drugs and no cardiovascular or kidney outcome trials, as a 2026 review points out. It has no FDA or EMA record.
Mechanism of Action
Efsubaglutide alfa activates the GLP-1 receptor, like the body's own GLP-1, but its antibody Fc stem keeps it circulating for about a week.
Glucose-dependent insulin
Stimulates insulin release from beta cells when glucose is high; it did so in human islets in the laboratory.
Appetite and weight
Reduces food intake; weight fell in monkeys and in people at higher doses.
Fc fusion
The IgG2 Fc domain slows clearance, giving a half-life of about 182 to 215 hours in type 2 diabetes.
Beta-cell function
Higher exposure went with better C-peptide responses in the metformin trial.
Published Research
Studies naming efsubaglutide alfa or supaglutide, read from their PubMed abstracts on October 29, 2026: the phase 2b/3 diabetes trials and their analyses, the obesity and phase 1 studies, the pharmacokinetic work, a review, then the animal studies that preceded them.
SUPER1: drug-naive type 2 diabetes
In the phase 2b stage 140 adults received 1, 2 or 3 mg weekly or placebo; 1 and 3 mg went forward. In the phase 3 stage 297 adults were randomised. At 24 weeks HbA1c fell 1.73 points on 1 mg and 2.15 on 3 mg, 1.26 and 1.68 more than placebo.
SUPER2: added to metformin
After a 12-week phase 2b stage comparing 1 mg, 3 mg and placebo, 3 mg weekly was taken into phase 3. At 24 weeks HbA1c fell 1.80 points with 3 mg against 0.74 with placebo. Side effects were mostly mild or moderate gastrointestinal events (NCT04998032).
SUPER2: the 1 mg 'overrun' group
In 155 people already randomised to 1 mg when 3 mg was chosen, HbA1c fell 1.69 points against 0.74 on placebo at 24 weeks, and 56% reached HbA1c below 7%; weight loss was small and not significant.
LIGHT 1: overweight and obesity
Fifty adults with overweight or obesity were randomised across five escalating target doses (5 to 20 mg weekly) or placebo. Weight fell 7.16% against 0.86%, and 82.5% on the drug lost at least 5%. Lean mass also fell by 2 kg. Gastrointestinal events, mostly during escalation, were most common.
Every two weeks against weekly
In 59 adults with type 2 diabetes, 3 mg every two weeks lowered HbA1c by 1.45 points and weekly 1 mg by 1.53 over 12 weeks, with similar gains in time in range on continuous glucose monitoring; no hypoglycaemia occurred.
Remission after stopping
Twenty-nine SUPER1 completers with HbA1c at or below 7% stopped all glucose-lowering drugs. Three months later 12 of 20 met the remission definition; 41% kept HbA1c below 7% at 12 months. Weight did not rebound.
Exposure and response in SUPER1
Across 465 participants, higher steady-state drug levels went with larger falls in HbA1c, glucose and weight, and with more nausea and diarrhoea, which eased over time. Neutralising antibodies affected the response.
Exposure and response with metformin
In 406 people from SUPER2, exposure correlated with lower HbA1c, glucose and weight and with better C-peptide response, a marker of beta-cell function; gastrointestinal events rose with exposure.
Phase 1 in healthy adults
Forty-eight adults received single doses from 0.375 to 9 mg or placebo. Exposure rose in proportion to dose, the mean half-life was 121.4 hours, and gastrointestinal events were the main side effects; weight fell up to 4% at the higher doses before recovering.
Population pharmacokinetics
A model built on 4,173 concentrations from 911 people (36 healthy, 875 with type 2 diabetes) estimated a half-life of 182 to 215 hours at 1 to 3 mg; body weight and kidney function changed exposure, but not enough to need dose changes.
Metformin and digoxin interactions
In 32 healthy adults at steady state on 3 mg, digoxin's peak fell about 24% and its total exposure rose about 15%, while metformin's exposure was not meaningfully changed; no dose adjustment was judged necessary.
Pharmacological review
Summarises the pharmacokinetics, exposure-response, interaction and trial data, mostly from Chinese participants, and notes the absence of head-to-head, cardiovascular or kidney outcome trials.
40-week monkey toxicity
Cynomolgus monkeys given 0.3 to 3 mg/kg twice weekly for 40 weeks showed no treatment-related organ toxicity; reduced food intake and reversible injection-site inflammation were the findings.
Steatohepatitis in mice
In mice with diet- and toxin-induced steatohepatitis, six weeks of treatment reduced body and liver weight and liver fat scores in a dose-dependent way; standard fibrosis staining did not change, though imaging-based collagen measures fell.
Fatty liver in monkeys
Rhesus monkeys with biopsy-confirmed steatohepatitis given weekly supaglutide for three months had a 40% drop in MRI liver fat and less steatosis on biopsy than placebo.
Pharmacokinetics in rats and monkeys
The half-life was about 36 to 40 hours in rhesus monkeys, with peak levels 8 to 10 hours after injection; one injection lowered blood glucose in monkeys for about three days.
Diabetic monkeys
Weekly supaglutide for four weeks lowered fasting and random glucose, fructosamine, body weight and food intake in diabetic rhesus monkeys in a dose-dependent way.
Insulin release and diabetic mice
Supaglutide stimulated insulin secretion from mouse and human islets and lowered glucose for at least 72 hours after one injection in db/db mice; four weeks of treatment increased beta-cell mass.
Dosing Data
No Chinese label was read for this page. These are the amounts given in published trials, all as injections under the skin.
Educational information, not medical advice. Each dose above is tagged with its source: an approved label, a published human study, animal data, or amounts reported by users. None is a recommendation for you. An unapproved compound has no established safe or effective human dose, and products sold for “research use only” are not made or tested for people. Talk to a doctor before acting on anything on this site, including before you start, stop or change any medicine or dose. Full medical disclaimer.
What a Buyer Needs to Know
What is sold, how it is mixed, stored and taken, and what is known about its safety, quality and legal status. Each part names its source. Where we have none, it says unknown.
What is sold
Unknown: we hold no label and no published test that says what forms or vial sizes Efsubaglutide alfa is sold in. A vial's own label is a seller's claim, not a source.
Mixing a vial: a worked example
An arithmetic example, not a recommendation: a 5 mg vial mixed with 2 mL of bacteriostatic water holds 2,500 mcg per mL, so every 10 units on a U-100 insulin syringe hold 250 mcg. 1 mg, the first amount in the “Trial: type 2 diabetes, drug-naive (SUPER1, phase 3 stage)” row (1 mg or 3 mg) is 40.0 units (0.400 mL). If your vial or water differ, the numbers change: use the reconstitution calculator.
Source: dose: Used in human trials, PMID 41272211 (Dosing Data below); vial and water: the calculator's default example, not a vial size we have a source for.
Storage before and after mixing
Unknown: no label or published stability study on file says how to store Efsubaglutide alfa, before or after mixing. The mixing guide sets out the general rules, with their sources: keep a mixed vial in the fridge, and use it promptly, as the bacteriostatic water label says of any drug dissolved in it. The 28 days often quoted is the limit for an opened multiple-dose vial from a manufacturer, an outer limit set for sterility, not a time a mixed solution has been shown to keep. Nobody has published how long Efsubaglutide alfa stays intact once mixed.
How it is taken
As it was given in human studies: Subcutaneous (Once weekly; Trial: type 2 diabetes, drug-naive (SUPER1, phase 3 stage)).
For injection technique, sites and needle disposal, see the mixing guide.
Source: Used in human trials: the route and frequency of each row in Dosing Data below.
What to expect, and when
How long it stays in the body: a half-life of about 182–215 hours in type 2 diabetes (population model); mean 121 hours after single doses in healthy adults. After about five half-lives almost none is left.
How long the doses were given: Trial: type 2 diabetes, drug-naive (SUPER1, phase 3 stage): 24 weeks double-blind; Trial: type 2 diabetes on metformin (SUPER2, phase 3 stage): 24 weeks double-blind, 28-week extension; Trial: type 2 diabetes, every-two-week dosing: 12 weeks.
When effects appear: unknown; no source on this page gives a time to effect for Efsubaglutide alfa. Results reported in the studies are under Published Research.
Source: half-life: PMID 39961992; Used in human trials, the duration of each row in Dosing Data below.
Side effects, and when to stop or get help
From the Side Effects section: Nausea, vomiting, diarrhoea and decreased appetite, mostly mild to moderate and most common early or during escalation (PMIDs 40470753, 41492234); Gastrointestinal events rose with drug exposure and eased over time (PMID 41107649); No hypoglycaemia in the 12-week every-two-week trial (PMID 41208635); Lean mass fell along with fat in the obesity trial (PMID 41492234). Full list and cautions ↓
When to stop or get help: unknown; no label or trial on file sets rules for stopping Efsubaglutide alfa. Treat a severe or unexpected reaction as a reason to stop and see a doctor.
Source: the Side Effects section below (“From the trials above”).
Interactions
- digoxin, metformin: at steady state on 3 mg, digoxin's peak fell about 24% and its AUC rose about 15%, metformin was not noticeably affected; the authors judged neither clinically significant and saw no need to adjust doses
Every peptide's record, with its source: the interaction matrix.
Source: human study, PMID 40587051.
Checking what you bought
Unknown: no published independent test of Efsubaglutide alfa products is in our lab-results database yet, so how products sold under this name measure up is not known.
To read a certificate of analysis, paste it into the COA decoder. Trust & Verification explains what independent testing can and cannot show.
Legal status
US: Not FDA Approved (China (NMPA): approved for blood glucose control in adults with type 2 diabetes). Sport: Unsettled (S0 may apply).
Country by country ↓ · Regulatory tracker
Source: this entry's approval status and the WADA Prohibited List, as in Legal Status below.
Side Effects & Contraindications
Reported Side Effects
From the trials above.
Contraindications & Cautions
No Chinese label was read for this page. These cautions follow from the evidence.
Legal Status
Efsubaglutide alfa is approved in China for type 2 diabetes and not in the US or the EU.
Frequently Asked Questions
?What is efsubaglutide alfa?
A once-weekly GLP-1 receptor agonist made by fusing GLP-1 analogue chains to the Fc part of a human IgG2 antibody. Earlier papers call it supaglutide.
?Is it approved?
In China, yes: the NMPA announced approval for type 2 diabetes in June 2025. It has no FDA or EMA approval.
?How well does it lower blood sugar?
In SUPER1, HbA1c fell 1.26 (1 mg) and 1.68 (3 mg) points more than placebo at 24 weeks; in SUPER2, with metformin, 3 mg lowered it 1.80 points against 0.74 on placebo.
?Does it cause weight loss?
At diabetes doses, modestly. At higher doses in the LIGHT 1 obesity trial, 50 people lost 7.2% of body weight against 0.9% on placebo over a short course.
?How is it different from dulaglutide?
Both are GLP-1 fusions to an antibody Fc domain given weekly. Efsubaglutide alfa uses an IgG2 Fc with two GLP-1 chains. There is no head-to-head trial.
?What are the side effects?
The usual GLP-1 class effects: nausea, vomiting, diarrhoea and reduced appetite, mostly mild to moderate and most frequent early on.
References
- [news-release] National Medical Products Administration (China). "Efsubaglutide Alfa Injection approved for marketing" (trade name 怡诺轻; Shanghai Yinnuo Pharmaceutical Technology Co., Ltd.; indication: blood glucose control in adults with type 2 diabetes), NMPA English news, June 11, 2025. Read October 29, 2026. https://subsites.chinadaily.com.cn/nmpa/2025-06/11/c_1101539.htm
- [clinical-trial] Zhu D, et al. "Efficacy and safety of efsubaglutide alfa in individuals with type 2 diabetes (SUPER1): a randomised, double-blind, placebo-controlled, Phase IIb/III trial." Diabetologia, 2026;69(6):1494-1507. PMID: 41272211.
- [clinical-trial] Jia W, et al. "Efsubaglutide alfa added to metformin improves glycaemia with β-cell functional responses in type 2 diabetes: a randomised, double-blind, placebo-controlled, two-stage adaptive phase 2b/3 trial (SUPER 2)." Nat Commun, 2026;17(1). PMID: 42103705.
- [clinical-trial] Jia W, et al. "Efficacy and safety of Efsubaglutide Alfa in "overrun" patients in the SUPER2 trial: A post-hoc analysis for comprehensive evaluation." Diabetes Obes Metab, 2025;27(12):7123-7132. PMID: 40977363.
- [clinical-trial] Gao F, et al. "Efficacy, tolerability, and safety of Efsubaglutide Alfa in participants with obesity or overweight (LIGHT 1): A randomized, double-blind, placebo-controlled, ascending-dose phase 2a trial." Diabetes Obes Metab, 2026;28(3):2339-2349. PMID: 41492234.
- [clinical-trial] Sun R, et al. "Biweekly dosing of efsubaglutide alfa maintains glycaemic and continuous glucose monitoring control in type 2 diabetes: A randomised multicentre trial." Diabetes Obes Metab, 2026;28(2):925-934. PMID: 41208635.
- [pubmed] Sun R, et al. "Diabetes Remission in Drug-Naïve Patients with Type 2 Diabetes After Efsubaglutide Alfa Treatment." Adv Ther, 2026;43(3):1098-1108. PMID: 41498879.
- [pubmed] Wang Q, et al. "Exposure-Response Analysis of Efsubaglutide Alfa in Patients with Type 2 Diabetes Mellitus." Clin Pharmacokinet, 2025;64(12):1785-1797. PMID: 41107649.
- [pubmed] Wang Q, et al. "Exposure-Response Analysis of Efsubaglutide Alfa in Patients with Type 2 Diabetes Treated with Metformin." Clin Pharmacokinet, 2025;64(12):1799-1809. PMID: 40991141.
- [clinical-trial] Wang Q, et al. "Safety, pharmacokinetics and pharmacodynamics of Efsubaglutide Alfa in healthy participants: A randomised, dose-escalation phase 1 study." Diabetes Obes Metab, 2025;27(8):4220-4228. PMID: 40470753.
- [pubmed] Lou YR, et al. "Population Pharmacokinetics of Efsubaglutide Alfa in Healthy Subjects and Subjects with Type 2 Diabetes." Clin Pharmacokinet, 2025;64(4):533-552. PMID: 39961992.
- [clinical-trial] Wu X, et al. "Effect of Efsubaglutide Alfa on the Pharmacokinetics of Metformin and Digoxin in Healthy Participants." Clin Pharmacokinet, 2025;64(9):1367-1377. PMID: 40587051.
- [review] Zheng H, et al. "Efsubaglutide Alfa: A Comprehensive Pharmacological Review." Clin Pharmacokinet, 2026. PMID: 42870102.
- [pubmed] Wang Y, et al. "40-week repeat-dose toxicity, toxicokinetics, and immunogenicity of efsubaglutide alfa following subcutaneous administration in cynomolgus monkeys." Regul Toxicol Pharmacol, 2026;172:106192. PMID: 42532462.
- [pubmed] Wang Y, et al. "Efsubaglutide Alfa attenuates metabolic dysfunction-associated steatohepatitis in mice with improvements in second harmonic generation-derived fibrosis features." Diabetes Obes Metab, 2026;28(4):3070-3081. PMID: 41555840.
- [pubmed] Wang Q, et al. "Supaglutide alleviates hepatic steatosis in monkeys with spontaneous MASH." Diabetol Metab Syndr, 2024;16(1):303. PMID: 39695722.
- [pubmed] Liao Y, et al. "Pharmacokinetic and pharmacodynamic studies of supaglutide in rats and monkeys." Eur J Pharm Sci, 2022;175:106218. PMID: 35618199.
- [pubmed] Cui Q, et al. "Novel GLP-1 analog supaglutide improves glucose homeostasis in diabetic monkeys." J Endocrinol, 2021;248(2):145-154. PMID: 33258802.
- [pubmed] Ren L, et al. "Novel GLP-1 Analog Supaglutide Stimulates Insulin Secretion in Mouse and Human Islet Beta-Cells and Improves Glucose Homeostasis in Diabetic Mice." Front Physiol, 2019;10:930. PMID: 31404283.
Sources & Citations
Studies were read from their PubMed abstracts on October 29, 2026; the approval from the NMPA's English news page, read the same day; FDA and EMA status from Drugs@FDA and the EMA medicines list, read October 28, 2026. Grey Peptides sells nothing and links to no vendor.
Medical Disclaimer: This content is for educational and informational purposes only. It is not medical advice, and nothing here is an instruction to obtain or use any compound. Talk to a licensed clinician about your own situation.