Apraglutide
Apraglutide (FE 203799), once-weekly GLP-2 analogue
Written by Aaron CuhaReviewed Sep 2026
Also known as: FE 203799
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.
Overview
GLP-2 is the gut's own repair signal, and it is the one proglucagon product with an approved drug behind it: teduglutide, for short bowel syndrome with intestinal failure. The limitation is that teduglutide is injected daily, in a population already managing parenteral nutrition.
Apraglutide is engineered for weekly dosing. Its published human work sits in metabolic balance studies, which is the right design for this condition because the endpoint that matters is how much fluid and nutrition the remaining bowel can absorb rather than a symptom score.
It is on this site because GLP-2 is the receptor the other half of dapiglutide targets, and because a reader tracking that dual agonist should be able to see what the GLP-2 pathway alone actually achieves when it is the point of the drug rather than an add-on.
Mechanism of action
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.
Human evidence
Two published metabolic balance studies in short bowel syndrome with intestinal failure, including one in a specific anatomical subgroup. Open-label designs.
- Phase 2 metabolic balance study reported improved fluid absorption in short bowel syndrome with intestinal failure.
- A multicentre open-label metabolic balance study examined the colon-in-continuity anatomy specifically.
- Dosing is once weekly, against teduglutide's daily injection, which in this population is a meaningful practical difference rather than a marketing one.
What this does not tell you: Open-label metabolic balance studies in a rare disease, with small numbers by necessity. Fluid absorption is the mechanistically right endpoint and it is not the same as the outcome patients care about most, which is reducing or ending parenteral support. Nothing here compares apraglutide to teduglutide directly, so the weekly schedule is a known advantage and the relative efficacy is not established.
Reading the research record
This page is here partly for its own sake and partly to anchor a comparison. Dapiglutide, also in this batch, pairs GLP-1 with GLP-2 and its obesity trial missed. A reader could reasonably conclude the GLP-2 half does nothing. Apraglutide shows that is the wrong conclusion: GLP-2 receptor agonism produces real, measurable changes in intestinal absorption in people, and there is an approved drug in the class.
The distinction is what the pathway is being asked to do. Repairing and expanding absorptive surface in a patient with surgically shortened bowel is a demonstrated effect. Improving gut barrier function enough to change body weight in obesity is a different and so far unsupported claim.
The evidence, charted
Fig. 1 · evidence composition
2of 2 citations (100%) are in people
Every citation cited here is Human work; no other study type is cited on this page. This count is of our own citation list and understates any literature larger than the sources we cite.
Fig. 2 · evidence over time
Citations here span just two years, 2022 and 2024.
Too few distinct publication years on this page to plot as a timeline.
Fig. 3 · legal status at a glance
US
Not approved
UK
Approved
AU
Approved
CA
Not approved
Approved in 2 of 4, prescription route in 0, not approved in 2. A jurisdiction's classification is a regulatory fact, not a verdict on the science; see Legal status below for the full text and any notes.
Fig. 4 · dose response
No human dose response curve exists
We draw this figure where the data supports it. For this compound in humans it does not, so the panel stays empty rather than borrowing an animal curve and implying it transfers.
Key studies & citations
- Human2022
Apraglutide, a novel glucagon-like peptide-2 analog, improves fluid absorption in patients with short bowel syndrome intestinal failure
A phase 2 metabolic balance study in patients with short bowel syndrome and intestinal failure, reporting improved fluid absorption. Metabolic balance is the appropriate design here because absorptive capacity, not a symptom score, is the outcome that determines whether a patient can reduce parenteral support.
Journal of Parenteral and Enteral Nutrition - Human2024
Efficacy and safety of apraglutide in short bowel syndrome with intestinal failure and colon-in-continuity: a multicenter, open-label, metabolic balance study
A multicentre open-label metabolic balance study in the colon-in-continuity anatomy specifically. Anatomy matters in this disease: how much colon remains changes both the absorptive baseline and the expected response, so studying that subgroup separately is a meaningful design choice rather than a subgroup analysis after the fact.
Clinical Nutrition
Frequently asked questions
How is apraglutide different from teduglutide?
Both are GLP-2 analogues for short bowel syndrome. Teduglutide is approved and requires a daily injection; apraglutide is engineered for once weekly. In a population already managing parenteral nutrition and daily infusions, that schedule difference matters. No head to head trial compares their efficacy.
Does GLP-2 help with weight loss?
Nothing supports that. GLP-2's demonstrated effect is on intestinal absorption and mucosal growth, which is why it treats intestinal failure. The one obesity trial of a GLP-2-containing drug, dapiglutide, missed its primary endpoint, and its gut barrier rationale has not been tested against a clinical endpoint in people.
What is a metabolic balance study?
A design where everything going in and coming out is measured, so absorption can be calculated directly rather than inferred. For short bowel syndrome it is the right approach, because the question is literally how much the remaining bowel can absorb.