Efsubaglutide Alfa_Dosage, benefits & legal status
Also known as Supaglutide, efsubaglutide
A marketed GLP-1 almost nobody outside China has heard of.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is Efsubaglutide Alfa?
Plain language first. The technical label stays, but it never stands alone.Overview
This is a real, approved, prescription GLP-1 medicine, sold in China since early 2025, and it is the kind of compound that gets ignored in English-language coverage because the paperwork is all in Chinese. Structurally it is closer to dulaglutide than to semaglutide: a GLP-1 molecule stitched onto an antibody fragment to make it last a week, rather than a small fatty-acid-modified peptide. Two things make it worth a page. First, it has two published pivotal trials, unusual among recently approved Chinese GLP-1 medicines and to its credit. Second, the weight-loss numbers circulating for it come from a conference poster announced by press release rather than a published trial, at doses far above the approved diabetes range.
Efsubaglutide alfa is a long-acting GLP-1 receptor agonist built as a fusion protein: the FDA substance registry records it as a fusion protein of human sequence origin, assembled as two identical 271-residue subunits with two N-linked mammalian glycosylation sites. That architecture places it alongside dulaglutide, recorded at two 275-residue chains, rather than alongside the short lipidated peptides like semaglutide. It is approved in mainland China for glycemic control in adults with type 2 diabetes at 1 to 3 mg once weekly, and is in combined phase 2b/3 development for obesity at much higher doses. The Fc subclass it uses is not documented in any record we could reach.
What it's used for
Approved in China for blood sugar control in adults with type 2 diabetes. Obesity is in combined phase 2b/3 testing and is not an approved use anywhere.
How does Efsubaglutide Alfa work?
What it does in the body, and where.Two long-acting GLP-1 designs compete. One hangs a fatty acid off a short peptide so it clings to albumin, the semaglutide approach. The other welds the peptide to an antibody fragment so it is simply too large to filter out. This is the second kind.
- 01It is a fusion protein, not a modified peptideThe FDA substance registry records two identical 271-residue chains, of human sequence origin, with two N-linked mammalian glycosylation sites. For scale, dulaglutide is recorded as two 275-residue chains. So this is the dulaglutide architecture at essentially the same size, and it is manufactured in cell culture rather than built by chemical synthesis.
- 02Size is the half-life strategyA bare GLP-1 peptide survives minutes, cut up by the enzyme DPP-4 and filtered by the kidney. Attaching it to an antibody fragment defeats both: the molecule is far too big for the kidney to clear and the fused format shields the cleavage site. That buys weekly dosing without the fatty-acid chemistry other long-acting GLP-1 drugs use.
- 03What that costsProtein drugs made in cell culture cannot be reproduced by solid-phase peptide synthesis, so this is not a molecule that can appear legitimately in a research vial. The trade-off also runs the other way: a large, glycosylated, weekly protein is the kind of molecule most likely to provoke anti-drug antibodies, and no antibody data for this compound could be located.
- 04The receptor work is ordinaryOnce it reaches the GLP-1 receptor the pharmacology is the familiar class story: insulin released in proportion to glucose, glucagon suppressed, stomach emptying slowed and appetite reduced. Nothing about the fusion format changes what the receptor does, so its diabetes results sit in the same range as other weekly GLP-1 drugs.
A schematic of the compound's mechanism, not a diagnostic image.
What else is it used for?
Each group carries its own evidence level.Approved means regulators have cleared it for that purpose. Investigational means it is in trials. Early research means it is being studied and is not established.
What is actually approved, and what is only claimed
Clinical use- RegulatoryA Chinese government list of 2025 reimbursement additions carries it as entry 93 for adult type 2 diabetes, independent confirmation of the listing.
- RegulatoryThe NMPA English page confirms approval but gives no approval date and no approval number, saying only that it was recent.
- No dataThe January 2025 approval month, the February 2025 launch, the Macau dates, the figure of more than 1,900 institutions and the January 2026 reimbursement date all trace to company filings alone.
Two published pivotal trials, with two internal errors
peer-reviewed-human- Human trialSUPER-1: week 24 HbA1c down 1.73% and 2.15% on 1 and 3 mg, treatment differences 1.26% and 1.68%.
- Human trialSUPER-2 added to metformin: HbA1c down 1.80% against 0.74% on placebo, difference 1.06%, p below 0.001.
- No dataThe SUPER-1 abstract prints a sign error: a weight fall of 0.97% on 1 mg, but the difference against placebo given as a rise of 0.97%.
- No dataSUPER-1 registry enrollment of 547 against 437 randomized in the paper, unexplained.
The obesity story is thinner than it looks
Investigational- Human trialENLIGHT is one seamless phase 2b/3 with 1,003 enrolled and no posted results, not a completed separate phase 3.
- No dataThe circulating weight figures come from a conference poster via press release, with no placebo value, p-value or confidence interval.
- No dataObesity trials dose 5 to 80 mg weekly against 1 to 3 mg weekly on the diabetes label, so cross-indication dose comparisons are badly misleading.
Identity and what is sold under the name
none- lab-analysisTwo identical 271-residue chains with mammalian glycosylation, against dulaglutide's two 275-residue chains. Made in cell culture, so it cannot be produced by peptide synthesis.
- No dataThe Fc subclass is not stated in any reachable record, and the earliest paper describes only an Fc fragment and a size above 60 kDa.
- No dataListings exist only as protein research reagents at microgram to milligram analytical scale, not as injectable vials. Two of those catalog pages wrongly describe it as an anti-GLP-1 receptor antibody; it is an agonist fusion protein.
The most common error is quoting its obesity weight loss as a trial result. Those figures come from a conference poster announced by press release, with no placebo value, p-value or confidence interval, from a study the registry shows as one seamless phase 2b/3 with no posted results rather than a completed phase 3. The second is mixing doses across indications: the approved diabetes range is 1 to 3 mg weekly while the obesity trials run 5 to 80 mg weekly, the same molecule by the same route. The third is treating the approval details as documented. Reimbursement listing is confirmed in a Chinese government list, but the NMPA page carries no approval date or number, so the January 2025 month, the launch dates and the institution count rest on company filings only. The fourth is confusing it with its near-namesakes: efmedaglutide alfa is a different molecule from a different developer and is not approved anywhere, and efpeglenatide is a three-chain aglycosylated molecule built on an exendin-4-type peptide rather than human GLP-1. A database trap compounds this, since searching the name can return a record that actually belongs to efinopegdutide, a different compound again. Finally, the published literature and the trial registry disagree on the name itself: ClinicalTrials.gov still titles both pivotal studies under the older name Supaglutide.
The published record
Papers about Efsubaglutide Alfa
Searched: efsubaglutide, efsubaglutide alfa, supaglutide.
Left out: efinopegdutide (observed contamination: querying this compound's INN surfaced ChEBI 757051 as though it were efsubaglutide, and that record actually belongs to efinopegdutide. A different molecule entirely); efmedaglutide (a different GLP-1-Fc fusion from a different developer, not approved anywhere, with its own slug on this site); efpeglenatide (a three-chain aglycosylated exendin-4-based molecule with its own slug; shares the ef- prefix and nothing else); GLP-1 (the receptor class term, returning tens of thousands of records across the whole drug class); semaglutide (the class benchmark, with an enormous literature that is not about this molecule); Innogen (a company name spanning a portfolio).
22 papers tagged human · 14 not reviews or lab · 11 clinical trial publications
How the compound was given: 5 applied to skin · 14 injected · 2 by mouth or rectal · 8 route not stated in the abstract
Read from each paper's indexing terms and abstract, by rule. A paper that mentions a cream studied a cream, not necessarily the product being sold.
8 registered trials · none with posted results
Furthest stage reached: Approved outside the US, China
Counted from Europe PMC indexing, not read by a person; a human tag can land on reviews, commentary or lab papers; clinical trial publications is the narrower count. A preprint and its journal version count once.
At a glance
Four things to know about Efsubaglutide Alfa
Evidence
Clinical use
Category
Weight loss and metabolic
Common vial
Varies
Half-life
Long enough for weekly dosing; no published figure located
How much, and do you cycle it?
The range, and whether you take breaks.1 to 3 mg weekly for type 2 diabetes; 5 to 80 mg weekly in obesity trials, once weekly. Continuous weekly dosing FDA label
A chronic diabetes medicine taken indefinitely, titrated upward rather than cycled.
How long does it stay in the body?
The half-life, and where the figure comes from.Long enough for weekly dosing; no published figure locatedNo figure
Approved for once-weekly use, so the half-life must be of the order of days, but no numerical value appears in a source we could reach. Fusion to an antibody fragment is the mechanism: the molecule is too large for kidney filtration, the same strategy dulaglutide uses.
You can compare this against the whole library to see where it sits.
How is it given?
Dosing context and source notes.Supplied as a finished prescription product rather than a research vial, so no vial draw can be shown and the calculator does not apply. The approved diabetes range is 1 to 3 mg once weekly. Obesity trials run 5 to 80 mg once weekly, the same molecule by the same route at doses far above the diabetes range, so the two sets of numbers must not be mixed.
How do you store it?
Before mixing, and after.Follow the storage on the product label.
Efsubaglutide Alfa is supplied as a finished product, so its label sets the storage. Pens, prefilled syringes, implants, tablets and ready-made solutions are used as supplied. Kits that include a powder are mixed just before the dose and usually used straight away, not kept for weeks. Many injectable products go in the fridge and must not be frozen, while others are kept at room temperature, so check the pack or ask the pharmacist.
What are the side effects and cautions?
Known cautions and warnings for this compound.Who should avoid it
- Reading the obesity weight-loss figures as trial results: they come from a conference poster released through a press announcement, with no placebo value, p-value or confidence interval given
- Comparing its doses with its diabetes label, since the obesity trials use 5 to 80 mg weekly against 1 to 3 mg weekly for diabetes
- Treating it as interchangeable with efmedaglutide alfa or efpeglenatide, two different molecules from different developers
Stop and get help
- Severe or persistent abdominal pain, a possible sign of pancreatitis in this drug class
- Signs of an allergic reaction, including rash, swelling or difficulty breathing
- Persistent vomiting with an inability to keep fluids down
Common effects
- Nausea and other gastrointestinal effects, as with every GLP-1 receptor agonist.
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is Efsubaglutide Alfa approved?
And where the numbers on this page come from.Not in the United States. Efsubaglutide Alfa has no FDA approval. It is approved in China.
- Approval statusClinical use
- RouteUnder the skin (subcutaneous injection, once weekly)
- Checked2 November 2026
- Approved outside the USChina.This does not change the United States position above.
- DoseFrom the drug label. The manufacturer tested this range and a regulator reviewed it.
- Vial sizeFrom what vendors typically list; not a recommendation.
- SourcesDiabetologia, efficacy and safety of efsubaglutide alfa in type 2 diabetes (SUPER-1)Nature Communications, efsubaglutide alfa added to metforminFrontiers in Physiology, novel GLP-1 analog supaglutide stimulates insulin secretionFDA substance registration record for efsubaglutide alfaClinicalTrials.gov record NCT06921486, the ENLIGHT obesity program
What has happened recently
The approval is real and better documented than the details around it. A Chinese government list of medicines newly added to the 2025 national reimbursement catalog carries it as entry 93, 依苏帕格鲁肽α注射液, added by negotiation, for glycemic control in adults with type 2 diabetes. That is independent confirmation of reimbursement listing rather than a company claim. An NMPA English page also confirms the approval, naming the applicant and the Chinese trade name, but it gives no approval date and no approval number and says only that the approval was recent. Everything more specific traces to company filings alone: the January 2025 approval month, the February 2025 launch, the Macau approval and launch dates, the figure of more than 1,900 Chinese medical institutions, and the January 1, 2026 effective date for reimbursement. None of those could be corroborated outside the company. There is no US approval and no US label: an openFDA query returned nothing for this compound while the same query returned seven records for dulaglutide as a control. One naming trap is worth knowing about: ClinicalTrials.gov still titles both pivotal trials under the old development name Supaglutide, while the publications those same records list use efsubaglutide alfa.
You can compare this against the whole library, or read how to check a seller.
What else is like Efsubaglutide Alfa?
Others in GLP-1 agonists, side by side.If you're weighing Efsubaglutide Alfa, it's worth reading Exenatide (Byetta / Bydureon), GZC8072, and KAI-4729 in the same class.
A marketed GLP-1 almost nobody outside China has heard of.
- Dose
- 1 to 3 mg weekly for type 2 diabetes; 5 to 80 mg weekly in obesity trials
- How often
- Once weekly
The first GLP-1 drug, found in lizard venom, now mostly retired.
- Dose
- 2 mg per week (the weekly form)
- How often
- Weekly
An experimental weekly GLP-1 pill from China, made from a modified GLP-1 peptide, with no human results yet.
- Dose
- No dose disclosed
- How often
- Weekly (intended)
An experimental weekly GLP-1/GIP/glucagon triple agonist, not to be confused with retatrutide.
- Dose
- 1 up to 12 mg per week (trial doses)
- How often
- Weekly
Guides for this compound
- How to Reconstitute a Peptide
Mix peptide powder with bacteriostatic water, step by step.
- How to Read an Insulin Syringe
Read the units, convert to millilitres, and draw the exact dose.
- mcg vs mg: The Peptide Dosing Mistake to Avoid
Your vial says mg and your protocol says mcg. Here is the conversion and how to check it.
- Semaglutide vs Tirzepatide vs Retatrutide
One receptor, two, or three. Mechanism, trial weight loss, side effects, and real cost.
Sources
- Diabetologia, efficacy and safety of efsubaglutide alfa in type 2 diabetes (SUPER-1)(2025)Volume 69, pages 1494 to 1507. Registered as NCT04994288. At week 24, HbA1c fell 1.73% on 1 mg and 2.15% on 3 mg, with estimated treatment differences against placebo of 1.26% and 1.68%. Weight changed by 0.97% and 3.14%. Two internal problems are worth noting: the abstract reports the 1 mg weight change as a fall of 0.97% but prints the difference against placebo as a rise of 0.97%, a sign error; and the registry lists 547 enrolled where the paper reports 437 randomized, unexplained.
- Nature Communications, efsubaglutide alfa added to metformin(2026)Volume 17, open access. Registered as NCT04998032, the SUPER-2 trial. At week 24, HbA1c fell 1.80% against 0.74% on placebo, an estimated treatment difference of 1.06%, p below 0.001. Having two peer-reviewed pivotal publications is unusual among recently approved Chinese GLP-1 medicines and is a genuine point in this compound's favor.
- Frontiers in Physiology, novel GLP-1 analog supaglutide stimulates insulin secretion(2019)Volume 10. The earliest paper naming the compound, from the originating laboratory. It is cited here for what it does not say: it describes only an immunoglobulin constant region Fc fragment, covalent binary GLP-1 molecules and a size above 60 kDa, without identifying the Fc subclass. A precursor molecule from the same laboratory was named for an IgG2 Fc, but that is inference about a different molecule, so no subclass is stated on this page.
- FDA substance registration record for efsubaglutide alfa(2026)Substance class protein, protein type fusion protein, sequence origin human, approval identifier 7MFJ5FK8CF. Two subunits of 271 residues each, with two N-linked glycosylation sites of mammalian type and no O-linked or C-linked sites. The record carries no CAS number, so none is given here. This is the source for the structural comparison with dulaglutide at two 275-residue chains.
- ClinicalTrials.gov record NCT06921486, the ENLIGHT obesity program(2026)The obesity program is widely described as a separate phase 3. The registry shows one seamless phase 2b/3 study with 1,003 participants enrolled and no posted results. The weight-loss figures in circulation, around 10.58% and 9.70%, come from a 2026 conference poster announced by press release, with no placebo value, no p-value and no confidence interval, so they are not comparable with published trial results for other compounds.
Beyond these, 31 records are indexed. Browse the records