Bofanglutide Biweekly Dosing Achieves HbA1c Reductions Comparable to Semaglutide 1 mg in Phase 2b Trial

The trial randomized participants at 37 Chinese sites to five arms including three biweekly bofanglutide doses, a weekly bofanglutide comparator, and semaglutide 1 mg. Primary endpoint was change in HbA1c from baseline, with secondary measures of weight and cardiometabolic markers. Reductions reached statistical significance in all bofanglutide groups, and weight loss occurred alongside improvements in blood pressure and lipids.

Bofanglutide addresses adherence barriers for patients averse to weekly injections, yet the semaglutide arm used a submaximal 1 mg dose rather than the approved 2.0-2.4 mg maintenance levels common in Western practice. The exclusively Chinese cohort also started at lower average BMI than typical U.S. or European populations, limiting direct extrapolation. Gastrointestinal adverse events appeared mildly more frequent with bofanglutide but remained mostly transient.

Phase 3 programs must now test durability beyond 24 weeks, evaluate maintenance dosing strategies after initial titration, and include multi-ethnic cohorts with higher baseline BMI. Head-to-head trials against tirzepatide and full-dose semaglutide will determine whether the biweekly schedule delivers clinically meaningful advantages in real-world persistence and cardiometabolic outcomes.