A new injectable diabetes drug called bofanglutide lowered blood sugar slightly more than semaglutide in a head-to-head trial, and it did so while being dosed only once every two weeks. The catch sits in the side-effect column. Gastrointestinal complaints ran about 30 percentage points higher on bofanglutide than on its rival.

The results, published June 30 in the Annals of Internal Medicine ↗, come from a Phase 2b trial run across 37 sites in China. Phase 2b means mid-stage: large enough to compare doses and read a real efficacy signal, too small and too short to settle whether a drug is better in the way that matters to patients over years. The trial enrolled 272 adults with type 2 diabetes, average age 50.8, who were either newly diagnosed or already on stable oral diabetes pills.

What the trial measured

Bofanglutide is a GLP-1 receptor agonist, the same drug class as semaglutide ↗, the molecule sold as Ozempic and Wegovy. These drugs mimic a gut hormone that tells the pancreas to release insulin and tells the brain the body is full. The receptor they act on, the GLP-1 receptor ↗, is the most commercially important target in metabolic medicine right now.

The trial's main yardstick was HbA1c, the standard blood test that reflects average blood sugar over roughly three months. Every point of HbA1c reduction is a meaningful move. Participants were split into five groups: bofanglutide titrated to 12, 18, or 24 mg given once every two weeks, bofanglutide 24 mg given once a week, or semaglutide 1 mg once a week.

At 24 weeks, semaglutide 1 mg cut HbA1c by 1.60 percent. The bofanglutide arms cut it by 1.87 to 2.32 percent, with the once-weekly 24 mg dose and the biweekly 18 mg dose landing deepest. The treatment differences against semaglutide ran from 0.27 to 0.72 percentage points in bofanglutide's favor, though the 24 mg biweekly arm's advantage was small enough that its confidence interval crossed zero, meaning that particular arm did not clearly beat the comparator.

The number the headline hides

Two things complicate the simple reading that bofanglutide won.

First, the comparator was semaglutide at 1 mg, the lower of its two common maintenance doses. Semaglutide is also approved at 2 mg, which lowers HbA1c further. A drug that edges the 1 mg dose has not necessarily edged the molecule at its full strength.

Second, the tolerability gap. Gastrointestinal side effects, mostly nausea and the mild-to-moderate stomach upset that defines this drug class, occurred in 81.8 to 87.3 percent of the bofanglutide groups against 51.9 percent on semaglutide. Most events were grade 1 or 2, the two mildest tiers, and severe low blood sugar did not occur in any group. But a 30-point spread in how many people feel sick is the kind of difference that drives patients to quit a drug they otherwise tolerate, and a 24-week open-label trial, where everyone knew which drug they were taking, is not built to capture how that plays out over real-world years.

Why a biweekly shot matters

The reason a company builds another GLP-1 drug into an already crowded field is convenience and supply. A genuinely effective injection taken once every two weeks halves the number of shots a patient gives themselves, and the biweekly 18 mg arm here roughly matched the once-weekly 24 mg arm on blood sugar, which is the early evidence that the two-week interval can hold its effect. The trial was funded by Gan and Lee Pharmaceuticals, the Chinese manufacturer developing the drug, a detail worth holding alongside an open-label design.

On peptidemodel, semaglutide is one of the most-referenced cards in the GLP-1 corpus, and bofanglutide enters the same receptor lane that semaglutide, tirzepatide, and the triple agonists already crowd. The honest summary of this readout is narrow: a real but modest glucose edge over a deliberately mid-strength comparator, bought with a meaningfully higher rate of feeling unwell, on a dosing schedule that could matter if the larger trials confirm it. The authors flagged the limits themselves. Open-label, short, and Chinese-only. The next trial, longer and blinded against semaglutide at full dose, is the one that decides whether the convenience is worth the stomach.