Head to head
Apraglutide against Glepaglutide
The two long-acting GLP-2 analogues chasing the same indication, neither approved. The practical question for patients is dosing frequency and the evidence question is which trials have actually read out.
Column A
ApraglutideApraglutide (FE 203799), once-weekly GLP-2 analogue
A once-weekly GLP-2 analogue for short bowel syndrome, where teduglutide requires a daily injection. Improved fluid absorption in its phase 2 metabolic balance studies.
Column B
GlepaglutideGlepaglutide (ZP1848), long-acting GLP-2 receptor agonist
A long-acting GLP-2 analogue for short bowel syndrome with intestinal failure. In a 106 person phase 3, 10 mg twice weekly cut weekly parenteral support volume by 5.13 litres against 2.85 on placebo; the once-weekly arm did not separate from placebo. Not approved anywhere as of September 2026, with a further phase 3 recruiting.
Side by side, on the facts we can check
| Attribute | Apraglutide | Glepaglutide |
|---|---|---|
| Category | Healing & Recovery | Metabolic |
| FDA status | Investigational for short bowel syndrome. Not approved at the time of this review. | Not FDA approved. No application in Drugs@FDA and no EMA medicine page as of 11 September 2026. Phase 3 EASE SBS-1 completed; a further confirmatory phase 3 (NCT07197944) recruiting since February 2026. |
| Half-life | Long-acting, engineered for once-weekly subcutaneous dosing. No specific figure resolved in the sources loaded. | Not reported |
| Molecular weight | Modified GLP-2 analogue peptide. No mass asserted; no source loaded states one. | Not reported |
| Mechanism | A long-acting analogue of glucagon-like peptide-2, a 33-amino-acid proglucagon product released from intestinal L cells. GLP-2 acts on the intestinal epithelium to increase mucosal growth, villus height and crypt depth, slow gastric emptying and transit, and increase intestinal blood flow, which together raise absorptive capacity. Structural modification gives it a half-life long enough for weekly dosing, against teduglutide's daily schedule. | GLP-2 is released by intestinal L cells after meals and acts on the GLP-2 receptor to increase villus height and crypt depth, slow gastric emptying, raise intestinal blood flow and improve absorption of fluid and nutrients. People who have lost their terminal ileum and colon lose most of their GLP-2 producing cells, which is part of why the remaining bowel adapts poorly. Glepaglutide is a GLP-2 receptor agonist modified for slow release from the injection site and a long circulating half-life, which is what allows twice-weekly dosing where native GLP-2 lasts minutes and teduglutide is dosed daily. In people, the measurable effects are on absorption. The phase 2 trial measured intestinal wet weight and energy absorption by metabolic balance studies and found dose-dependent improvements at 1 and 10 mg. A 10 person open-label study reported a mean increase in wet weight absorption of 398 g per day at 24 weeks that did not reach significance (P equals 0.0585) and an energy absorption gain of 1,038 kJ per day that did (P equals 0.0215). The clinically relevant endpoint in phase 3, reduction in parenteral support volume, is downstream of these absorption changes. |
| Human studies cited | 2 | 6 |
| Legal status, US | Investigational, not approved | Investigational, not approved |
Frequently asked questions
What is the difference between Apraglutide and Glepaglutide?
Apraglutide: A once-weekly GLP-2 analogue for short bowel syndrome, where teduglutide requires a daily injection. Improved fluid absorption in its phase 2 metabolic balance studies. Glepaglutide: A long-acting GLP-2 analogue for short bowel syndrome with intestinal failure. In a 106 person phase 3, 10 mg twice weekly cut weekly parenteral support volume by 5.13 litres against 2.85 on placebo; the once-weekly arm did not separate from placebo. Not approved anywhere as of September 2026, with a further phase 3 recruiting.
Which has stronger research evidence, Apraglutide or Glepaglutide?
This database does not grade compounds. It counts what was run in people: 2 of the 2 studies cited on the Apraglutide profile were human work, against 6 of 8 for Glepaglutide. Those counts are of our own citation lists and understate any larger literature, and neither is a recommendation.
Are Apraglutide and Glepaglutide FDA-approved?
Apraglutide: Investigational for short bowel syndrome. Not approved at the time of this review.. Glepaglutide: Not FDA approved. No application in Drugs@FDA and no EMA medicine page as of 11 September 2026. Phase 3 EASE SBS-1 completed; a further confirmatory phase 3 (NCT07197944) recruiting since February 2026..
Reviewed Sep 2026. This page sets two published records side by side. It is educational, it is not medical advice, and it contains no dosing protocols or recommendations for personal use.