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Core Viewpoint - The article discusses the approval of Ecnoglutide injection, a cAMP biased GLP-1 receptor agonist, for the treatment of type 2 diabetes in adults, highlighting its unique mechanism and clinical efficacy in managing blood sugar levels and weight loss [6][7][9][10]. Group 1: Product Approval and Market Context - Ecnoglutide injection received approval from the National Medical Products Administration (NMPA) in China, marking it as the first cAMP biased GLP-1 receptor agonist to be approved globally for blood sugar control in adults with type 2 diabetes [6]. - The number of diabetes patients in China is projected to reach approximately 148 million by 2024, indicating a growing market for diabetes treatments [6]. Group 2: Mechanism and Clinical Efficacy - Ecnoglutide operates by preferentially activating the cAMP signaling pathway while minimizing β-arrestin recruitment, which helps maintain receptor presence on the cell surface and enhances therapeutic signaling [7]. - Two pivotal Phase III clinical studies demonstrated that Ecnoglutide injection provides comprehensive benefits, including significant reductions in HbA1c levels and weight loss over a 52-week period, with good safety and tolerability profiles [9][10]. - In the EECOH-1 study, Ecnoglutide at doses of 0.6mg and 1.2mg showed a significant HbA1c reduction of 2.43% in the 1.2mg group compared to placebo, with an 80.3% achievement rate of HbA1c < 7.0% [9]. - The EECOH-2 study indicated that Ecnoglutide outperformed Dulaglutide in HbA1c reduction, with the 0.6mg group achieving an average reduction of 1.91% from baseline [10].