Biweekly Bofanglutide vs Semaglutide for Type 2 Diabetes: Phase 2b Clinical Trial Results on Efficacy, Safety, and HbA1c Reduction

Introduction: New GLP-1 Therapy Research for Type 2 Diabetes

A recent phase 2b randomized clinical trial published in a leading medical journal evaluated a new GLP-1 receptor agonist called bofanglutide compared with semaglutide in adults with type 2 diabetes mellitus. The study focused on glycemic control, safety outcomes, and potential advantages of extended dosing intervals such as once every two weeks administration.

The trial involved multiple clinical sites in China and assessed whether bofanglutide could provide comparable or improved blood sugar control compared with an established therapy, semaglutide.

This article summarizes the findings in a clear format for educational purposes.

What Was Studied in This Clinical Trial?

The study was a phase 2b randomized, open-label, active controlled trial involving 272 participants with type 2 diabetes. Patients were either treatment naive or already on stable oral antidiabetic medications.

Participants were divided into five groups:

• Bofanglutide 12 mg every 2 weeks
• Bofanglutide 18 mg every 2 weeks
• Bofanglutide 24 mg every 2 weeks
• Bofanglutide 24 mg once weekly
• Semaglutide 1 mg once weekly

The main goal was to measure changes in HbA1c levels after 24 weeks of treatment.

Key Result: HbA1c Reduction and Blood Sugar Control

HbA1c reduction was the primary outcome used to measure long-term glucose control.

All treatment groups showed significant improvement in blood sugar levels over 24 weeks.

HbA1c changes observed:

• Bofanglutide 12 mg Q2W: reduction of 1.87 percent
• Bofanglutide 18 mg Q2W: reduction of 2.28 percent
• Bofanglutide 24 mg Q2W: reduction of 1.94 percent
• Bofanglutide 24 mg QW: reduction of 2.32 percent
• Semaglutide 1 mg QW: reduction of 1.60 percent

The data suggests that bofanglutide achieved slightly greater HbA1c reduction than semaglutide in most dosing groups.

The strongest result was seen in the weekly 24 mg bofanglutide group.

Weight Loss and Metabolic Improvements

In addition to improved glycemic control, participants experienced improvements in metabolic health markers.

Observed benefits included:

• Reduction in body weight across all treatment groups
• Decrease in waist circumference
• Improved fasting plasma glucose levels
• Improvements in lipid profiles such as cholesterol and triglycerides
• Improvements in some liver enzyme markers

These effects are consistent with the known benefits of GLP-1 receptor agonist therapies, which support both blood sugar regulation and weight reduction.

Safety and Side Effects

The safety profile of bofanglutide was similar to other drugs in its class, although gastrointestinal side effects were more frequent.

Most common side effects included:

• Nausea
• Vomiting
• Diarrhea
• Reduced appetite
• Abdominal discomfort

These effects were generally mild to moderate and mostly occurred during early dose escalation.

Other safety findings:

• No deaths occurred during the study
• Severe hypoglycemia was not reported
• Injection site reactions were more common with bofanglutide
• A small number of serious adverse events occurred but were resolved
• Antibody formation was detected in some patients but did not reduce treatment effectiveness

Overall, discontinuation rates were higher in higher dose groups due to gastrointestinal intolerance.

Once Every Two Weeks Dosing: Why It Matters

A major focus of this research was whether bofanglutide could support extended dosing schedules, such as once every two weeks.

Longer dosing intervals may offer potential advantages:

• Improved patient convenience
• Better treatment adherence
• Reduced injection burden
• Potential for improved long-term persistence on therapy

The study showed that biweekly dosing still produced strong HbA1c reductions, especially at higher doses.

This makes bofanglutide a potential candidate for future long-acting diabetes treatments if confirmed in larger phase 3 trials.

Comparison With Semaglutide

Semaglutide is currently one of the most widely used GLP-1 receptor agonists for type 2 diabetes.

In this study:

• Bofanglutide showed slightly greater HbA1c reduction in most dosing groups
• Weight loss effects were broadly similar
• Gastrointestinal side effects were somewhat more frequent with bofanglutide
• Glycemic target achievement rates were comparable between treatments

However, semaglutide remains better studied with long-term cardiovascular outcomes already established, while bofanglutide is still in early clinical development.

Study Limitations

Several limitations were noted by researchers:

• The study was open-label, which may introduce bias
• Duration was relatively short at 24 weeks
• All participants were from China, limiting global generalizability
• Phase 2b design means results are exploratory rather than confirmatory
• Long term safety and durability of effects were not assessed

Because of these limitations, further phase 3 trials are required before drawing definitive clinical conclusions.

Clinical Significance and Future Outlook

The results suggest that bofanglutide could become a promising next-generation GLP-1 receptor agonist with strong glucose-lowering effects and potential for extended dosing intervals.

If future studies confirm these findings, potential clinical benefits could include:

• Strong HbA1c reduction comparable or superior to existing therapies
• Meaningful weight loss support in patients with type 2 diabetes
• Less frequent injections, possibly improving adherence
• Broader options for personalized diabetes treatment

Ongoing phase 3 trials will be important to confirm efficacy, safety, and long-term outcomes.

Source

Annals of Internal Medicine, 2026, DOI: 10.7326/ANNALS-25-04623, Study: Bofanglutide vs Semaglutide in Type 2 Diabetes Patients

Disclaimer

This article is a written summary created for educational and informational purposes only. It does not provide medical advice, diagnosis, or treatment recommendations.