Apraglutide is a glp-2 receptor agonist (modified peptide). Glepaglutide is a glp-2 receptor agonist (peptide with a six-lysine tail).
| Comparison | Apraglutide FE 203799 · FE203799 | Glepaglutide (Zeydovio) Zeydovio · ZP1848 |
|---|---|---|
| How it works | How it works Apraglutide copies GLP-2, the gut hormone that tells the intestine to grow its lining and absorb more, and is changed to last a week. | How it works Glepaglutide copies GLP-2, a gut hormone that tells the intestine to absorb more, and is built to release slowly from under the skin. |
| What it is | GLP-2 with four changed amino acids that stretch it to a weekly shot, with no fatty chain or PEG. In phase 3 it cut intravenous support by 25.5% against 12.5% on placebo, but not significantly in people whose colon is still connected. | A GLP-2 with a six-lysine tail that is released slowly from a depot under the skin, so it can be given twice a week. Recommended for EU approval in September 2026; the FDA asked for another trial. |
| Status | In trialsInvestigational | In trialsInvestigational |
| Typical dose | 2.5–5 mg per week | 10 mg per dose |
| How often | Once weekly | Twice weekly |
| Stays active | About 30 hours (healthy volunteers, single dose) | About 88 hours (effective, after injection under the skin) |
| Dose comes from | Clinical trial protocol | Clinical trial protocol |
| Cycled? | Continuous in the trials Clinical trial protocol | Continuous in the trials Clinical trial protocol |
| What it does | ||
| Drug class | GLP-2 receptor agonist (modified peptide) | GLP-2 receptor agonist (peptide with a six-lysine tail) |
| Used for | An experimental once-weekly injection for adults with short bowel syndrome who need intravenous nutrition or fluids. It is not approved anywhere. | An experimental twice-weekly injection for adults with short bowel syndrome who depend on intravenous nutrition or fluids. Recommended for EU approval in September 2026, but not approved anywhere yet. |
| Receptors hit | — | — |
| Numbers | ||
| Full dose line | 2.5 or 5 mg once weekly, by body weight (phase 3 trial) | 10 mg twice weekly (phase 3 trial) |
| Why that cycle | Given weekly for 24 weeks in STARS, for 48 weeks in people with the colon connected, and longer in the open-label STARS Extend, with no planned breaks. | Given twice weekly for 24 weeks in EASE SBS 1, then in extension trials of up to 104 weeks with no planned breaks; in interim company analyses of the extensions, reductions in intravenous support were generally maintained. |
| Weight / effect | Intravenous support volume down 25.5% against 12.5% on placebo at 24 weeks (STARS) | Intravenous support down 5.13 L a week against 2.85 L on placebo with twice-weekly dosing (EASE SBS 1) |
| Chain length | 33 residues | 39 residues |
| Common vial | — | — |
| Before you start | ||
| Route | Under the skin (subcutaneous) | Under the skin (subcutaneous) |
| Do not use if | Not studied in children: STARS enrolled adults 18 and over Not studied in pregnancy or breastfeeding Not studied in anyone with cancer, including colon cancer, within the past 5 years Not studied in active inflammatory gut disease, major abdominal surgery in the past 6 months, decompensated heart failure, or severe kidney or liver impairment Use outside a clinical trial: it is not approved anywhere | Not studied in children: the phase 3 enrolled adults aged 18 to 90 Not studied in bowel obstruction, radiation damage to the bowel, or moderately to severely active inflammatory bowel disease Not studied in anyone with a history of colon cancer, or another cancer within the past 5 years Not studied in pregnancy or breastfeeding, decompensated heart failure, or severe liver impairment Use outside a clinical trial: it is not approved anywhere yet |
What people actually report
Apraglutide
- Described as generally well tolerated in phase 3, with 3.6% stopping for side effects against 1.9% on placebo; rates of individual side effects by group were not available in the sources checked.
- Phase 2 effects included more urine, less thirst, swelling and stoma problems; teduglutide, the approved GLP-2 drug, carries warnings for bowel blockage and fluid overload.
Stop and get help if
- Swelling of the legs, breathlessness or rapid weight gain, possible fluid overload
- Severe abdominal pain, bloating or vomiting with little or no stool or stoma output, a possible bowel or stoma blockage
Glepaglutide (Zeydovio)
- Injection-site reactions in 25.7% against 2.8% on placebo, nausea in 20.0% against 2.8% and abdominal pain in 14.3% against 5.6% on 10 mg twice weekly over 24 weeks.
- Antibodies against the drug formed in 30 of 35 people on twice-weekly dosing and none on placebo, including antibodies that neutralized the main active form in 10 of 35, with unknown effect on benefit; teduglutide, the approved GLP-2 drug, carries warnings for bowel blockage and fluid overload.
Stop and get help if
- Swelling of the legs, breathlessness or rapid weight gain: fluid retention or overload is among its most common side effects
- Severe abdominal pain, bloating or vomiting with little or no stool or stoma output, a possible bowel or stoma blockage
Side effects are what users and trials report most often, not a complete list. Anything sudden, spreading, or breathing-related is an emergency regardless of which compound caused it.
People also compare
This comparison does not cover cost, long-term safety, or how you personally will respond. Effect figures come from separate trials in different populations and are not always directly comparable to each other. Nothing here is medical advice or a recommendation to use any of these. Talk to a clinician about your own situation.