Glepaglutide dosage and evidence
Written by Aaron CuhaReviewed Sep 2026
The short answer
Glepaglutide is a long-lasting copy of GLP-2, a gut hormone, for people whose short bowel means they need feeding by drip.
Evidence grade for Glepaglutide: Moderate. The rule: at least one finished study in people, and at least 100 people who took it. The sum on this page: 3 completed trials, 230 people given it. A grade counts how much has been done to people, not whether it works.
- People given it
- 230
- Human studies
- 3
- Found nothing
- 2
Dose
No human dose established
Amounts that were given in studies sit in Human evidence on this page. None of them is a personal dose.
3 completed trials, 230 people given it
No first-hand reports gathered yet. That is a gap in what we have collected, not a finding that nothing has been reported.
Goal pages: Fat loss and metabolism, Gut health
In plain English
In plain English, from Aaron
This is how I would explain it to a friend. The evidence, with the numbers, is further down the page.
Glepaglutide is a shot for short bowel syndrome, when most of the small intestine is gone. People with this need feeding through a vein. The drug copies GLP-2, a gut hormone that makes the gut lining grow and absorb more. It lasts long enough to take twice a week. It is not approved anywhere.
What people take it for
- Needing less feeding through a vein.
- Getting some days a week off the drip.
- Coming off drip feeding completely.
What studies in people showed
The main study had 106 adults with short bowel syndrome, for 24 weeks. On 10 mg twice a week, weekly drip feeding fell 5.13 litres. On a dummy shot it fell 2.85 litres. 5 people on twice a week came off drip feeding entirely. Nobody on the dummy shot did. The once-a-week dose did no better than the dummy. An earlier 18 person study found stool output fell 592 to 833 grams a day at the two higher doses. Zealand Pharma paid for all of it. A new large study is now running to confirm the twice-weekly dose.
What people report
Reports, not study results
The good
- Less drip feeding on the twice-weekly dose, and 5 people came off it entirely.
The bad
- In the early study, 72 percent had problems with their stoma, the opening on the belly.
- 61 percent had injection site reactions and 56 percent had swollen legs.
- Once a week did not work.
Where these come from: These come from the studies on this page. We have not collected user reports on this one yet.
My bottom line
For a rare and hard condition, the twice-weekly result is real. It is not approved, and the long-term safety data are not public yet. In my opinion, this is a talk for your gut specialist, not something to hunt down.
An opinion, not a finding. I am a coach, not a doctor.
What it has been measured to do
Measured in people
Goals Glepaglutide has been tested for in people, biggest studies first. We count only what the studies on this page say, so the real numbers may be higher.
- Losing weight18 people · 1 study · 1 found nothing
35 of the 36 indexed goals have no study of any kind behind Glepaglutide
No study in people, animals or cells on this page reports a result for these. That does not prove Glepaglutide does nothing for them. It does mean anything you have heard about Glepaglutide and one of these did not come from a study cited here.
Show full evidence
What is Glepaglutide?
Glepaglutide is a long-lasting copy of GLP-2, a gut hormone, for people whose short bowel means they need feeding by drip. In a 106 person study, 10 mg twice a week cut weekly drip feeding by 5.13 litres, against 2.85 litres on a dummy injection. Once a week did no better than the dummy. It is not approved anywhere as of September 2026, and another large study is now recruiting.
Glepaglutide is a lab-made copy of GLP-2, the gut hormone that makes the gut lining grow and absorb more. Zealand Pharma built it to last long enough for a shot once or twice a week, from a ready-to-use injection. It is being tested for short bowel syndrome with intestinal failure. People with this have lost most of their small intestine. They depend on feeding through a vein (parenteral support) for fluid and nutrition. The approved drug of this kind, teduglutide, is a daily shot.
The main study is EASE SBS-1 (NCT03690206), a large final-stage study run in several countries and published in Gastroenterology in 2025. 106 adults who needed drip feeding at least 3 days a week were split into three equal groups. One got 10 mg twice a week, one got 10 mg once a week, and one got a dummy injection, for 24 weeks. Nobody knew which they had. Twice a week cut weekly drip volume by 5.13 litres, against 2.85 litres on the dummy. That was the main goal, and chance is unlikely to explain it. 65.7 percent cut their drip volume by 20 percent or more, against 38.9 percent. 51.4 percent dropped at least one drip day a week, against 19.4 percent. 5 people (14 percent) on twice a week came off drip feeding entirely, against none on the dummy. The once-a-week group did no better than the dummy on the main goal or the key other measures. So one dose plan failed inside a study that worked, and that shaped what came next. An earlier 18 person study (Lancet Gastroenterology and Hepatology, 2019) had each person try two doses in turn. Daily shots cut the wet weight of stool by 592 g a day at 1 mg and 833 g a day at 10 mg, with no change at 0.1 mg. Side effects were common. 72 percent had problems with their stoma, the opening on the belly where waste leaves. 61 percent had injection site reactions and 56 percent had swollen legs.
Where it stands: not approved. There is no application in the FDA's drug database, and the European Medicines Agency has no page for it as of 11 September 2026. Two long-term follow-on studies (150 and 84 people) finished in April 2026 with no results posted. A new large study, NCT07197944, began recruiting in February 2026. It aims for about 90 people and should reach its main measurement point in October 2028. Its stated purpose is to confirm that 10 mg twice a week works and is safe, and to gather more long-term safety data. Three letters in Gastroenterology and one in Clinical Nutrition ESPEN have raised questions about the dosing plan, whether the results apply to most patients, and how many people dropped out.
How does Glepaglutide work?
The gut releases GLP-2 after meals. It makes the tiny finger-like folds of the gut lining taller and deeper, slows how fast the stomach empties, boosts blood flow to the gut, and helps it absorb fluid and food. People who have lost the end of the small intestine and the colon lose most of the cells that make GLP-2. That is part of why the gut they have left adapts poorly. Glepaglutide switches on the GLP-2 receptor. It is built to release slowly from the injection site and last a long time in the blood. That allows twice-weekly shots. Natural GLP-2 lasts minutes, and teduglutide is given daily. In people, the effects you can measure are on absorption. The earlier study measured stool wet weight and energy absorbed, using careful in-and-out balance tests. Both got better with dose at 1 and 10 mg. In a 10 person study where everyone got the drug, fluid absorption rose 398 g a day at 24 weeks, but chance could explain that. Energy absorbed rose 1,038 kJ a day, which chance is unlikely to explain. The result that matters to patients in the big study, less drip feeding, follows from these absorption changes.
What have studies in people found about Glepaglutide?
One large study of 106 people over 24 weeks against a dummy injection. One 18 person study where each person tried two doses. One 10 person absorption study with no comparison group. And two long-term follow-on studies, 234 people in total, that finished in 2026 with no posted results. Zealand Pharma paid for all of them.
- EASE SBS-1: 106 adults, 24 weeks. 10 mg twice a week cut weekly drip feeding by 5.13 litres, against 2.85 on the dummy injection. 14 percent came off drip feeding entirely, against none on the dummy.
- EASE SBS-1, once-a-week group: no clear difference from the dummy on the main goal or the key other measures.
- Earlier 18 person study: stool output fell 592 g a day at 1 mg and 833 g a day at 10 mg daily. Nothing changed at 0.1 mg. Side effects were common: stoma problems 72 percent, injection site reactions 61 percent, swollen legs 56 percent.
- 10 person study where everyone got the drug: energy absorbed up 1,038 kJ a day at 24 weeks. The change in fluid absorbed could have been chance. Drip feeding down 800 mL a day at 52 weeks. No comparison group.
- Follow-on studies NCT03905707 (150 people) and NCT04881825 (84 people): finished April 2026, no results posted.
- New large study NCT07197944 (about 90 people) recruiting from February 2026, main measurement point October 2028.
What this does not tell you: One positive large study in a rare disease, with one of its two dose plans failing, is the whole controlled record. The main goal is drip feeding volume. The study rules cut drip feeding when urine output rose, so it is a managed number rather than a hard health result. Nobody has compared glepaglutide with teduglutide, the approved drug of this kind, in a head-to-head study. So nothing here says whether twice a week is better, worse or the same as daily teduglutide. Long-term safety data exist in two finished follow-on studies, but they have not been published or posted. GLP-2 drugs make the gut lining grow. So there is a possible worry that they could speed the growth of polyps or tumours, and 24 week studies cannot answer that.
The state of the research
Glepaglutide's record is the story of one company developing a drug for very few people. Short bowel syndrome with intestinal failure affects a few thousand people in each large country. So studies are small by necessity, and 106 people is a big final-stage study in this field. The study hit its main goal with one of its two dose plans and missed with the other. The once-a-week failure is the fact most worth carrying forward. It shows the time between doses matters, and that a long-acting peptide is not always long-acting enough.
What happened after the big study shows up only in the registry. The research notes this page was first built from said all registered large studies were complete. That was true when written and is no longer true. A new study (NCT07197944) started in February 2026, with about 90 people and a main measurement point in late 2028. The company says it will confirm the twice-weekly plan works and is safe, and gather more long-term safety data. No regulator has announced a decision. No application appears in the FDA's database or on the European Medicines Agency website. No primary source says whether a regulator asked for the new study or the company chose it, and this page does not guess. The two finished follow-on studies, 234 people in total, have posted no results. Until they do, that silence is a finding in itself.
The evidence, in charts
Fig. 1a · how many people
240people, across 4 studies in people cited here
| Study | People | Share |
|---|---|---|
| Gastroenterology 2025 | 106 | 44% |
| ClinicalTrials.gov 2024 | 106 | 44% |
| Lancet Gastroenterology and Hepatology 2019 | 18 | 8% |
| NCT04991311, Clinical Nutrition ESPEN 2025 | 10 | 4% |
Counts are the number of people each study on this page says it signed up. That includes studies that only watched people and gave nobody the compound. 2 more studies in people give no headcount and are not counted here. Studies still signing people up are left out, and only studies cited on this page are counted.
Fig. 1b · evidence mix
6 of 8 sources here are studies in people. The rest are not.
- Study in people · done in people675%
- Review of studies · sums up other studies225%
Counted from the list of sources on this page. It counts only what we cite, so there may be more studies out there. A review counts once, however many studies it sums up.
Fig. 2 · evidence over time
The studies cover 4 different years, 2019 to 2026, counted from the list of sources on this page.
Fig. 3 · legal status at a glance
US
Not approved
UK
Not approved
AU
Not approved
CA
Not approved
Not approved in any of the four countries shown. This is what the law says, not a verdict on the science. See Legal status below for the full text and any notes.
Fig. 4 · how much does what
Nobody has tested different amounts in people
This chart would show how the effect changes as the amount goes up. For this compound, nobody has measured that in people. So we leave it empty. We will not borrow an animal chart and pretend it works the same in people.
Fig. 5 · what the molecule is
- Kind of compound
- Peptide
- Molecule weight
- Not on file
- Half-life
- None on file
- Chain length
- None on file
No amino acid sequence is on file for Glepaglutide, so none is drawn rather than guessed from a name.
The studies we cite
- Study in people2025Glepaglutide, a Long-Acting Glucagon-like Peptide-2 Analogue, Reduces Parenteral Support in Patients With Short Bowel Syndrome: A Phase 3 Randomized Controlled Trial
Twice-weekly glepaglutide cut how much feeding by drip people with short bowel syndrome needed. Once weekly did not. 106 adults were split by chance into three groups for about six months. Nobody involved knew which. On twice-weekly dosing, weekly drip feeding fell by more than five litres against under three litres on the dummy. Two thirds responded against under four in ten. Five people came off drip feeding entirely, against none on the dummy. Zealand Pharma sponsored it.
EASE SBS-1: 106 adults with short bowel syndrome and intestinal failure randomised 1:1:1 to 10 mg twice weekly, 10 mg once weekly or placebo for 24 weeks. Weekly parenteral support fell 5.13 litres on twice-weekly dosing against 2.85 on placebo (P equals 0.0039). Clinical response 65.7 against 38.9 percent; at least one fewer day on support 51.4 against 19.4 percent; enteral autonomy in 5 (14 percent) against 0. The once-weekly arm did not differ significantly from placebo on any primary or key secondary endpoint. Sponsor Zealand Pharma.
- Study in people2024Efficacy And Safety Evaluation of Glepaglutide in Treatment of Short Bowel Syndrome (EASE SBS-1)
This is the registry entry for the main glepaglutide trial. 106 people took part, it finished in July 2022, and results were posted in October 2024. Zealand Pharma sponsored it. The outcome is in the paper above: twice-weekly dosing worked, once-weekly dosing did not.
Phase 3, 106 participants, completed July 2022, results posted 21 October 2024. Sponsor Zealand Pharma.
- Study in people2019Glepaglutide, a novel long-acting glucagon-like peptide-2 analogue, for patients with short bowel syndrome: a randomised phase 2 trial
An early trial showed glepaglutide cuts fluid loss from the bowel, at the higher doses. 18 adults with very heavy output each took two different doses in turn, and nobody involved knew which was which. 16 finished. At the middle dose, output fell by nearly 600 grams a day, and at the top dose by over 800. The lowest dose did nothing. Side effects were heavy: stoma problems in seven in ten, injection site reactions in six in ten, swelling in over half. Zealand Pharma funded it.
Single-centre, double-blind crossover in 18 adults with faecal output of 1,500 g a day or more, two 3 week periods of daily injections at 0.1, 1 or 10 mg; 16 completed. Faecal wet weight fell 592 g per day at 1 mg (95 percent CI 272 to 913) and 833 g per day at 10 mg (515 to 1,152); no change at 0.1 mg. Treatment-related adverse events: stoma complications 72 percent, injection site reactions 61 percent, peripheral oedema 56 percent, nausea and abdominal pain 44 percent each. Funded by Zealand Pharma.
- Study in people2025Outcomes of glepaglutide on intestinal absorption and parenteral support in patients with short bowel syndrome
A tiny open study found once-weekly glepaglutide improved absorption and cut drip feeding. 10 patients took it, everybody knew what they were getting, and there was no comparison group. Fluid absorption rose, though not by enough to call. Energy absorption rose more clearly. After a year, drip feeding had dropped by about 800 millilitres a day. Ten people with nothing to compare against cannot tell you what would have happened anyway. Four of the authors work for Zealand. The registry lists twelve enrolled and the paper reports ten.
Single-centre open-label phase 3b in 10 patients (8 with intestinal failure) on 10 mg once weekly. Wet weight absorption rose 398 g per day at 24 weeks (P equals 0.0585, not significant); energy absorption rose 1,038 kJ per day (P equals 0.0215); parenteral support fell 800 mL per day at week 52 (P equals 0.0106). No control group. Four authors are Zealand employees. The registry record (NCT04991311) lists 12 enrolled against 10 reported.
- Study in people2026Evaluation of Long Term Safety and Efficacy of Glepaglutide in Treatment of SBS
The long-term glepaglutide studies have published nothing. The main extension enrolled 150 people and reached its measurement point in April 2026. A second extension of 84 people finished the same day. Neither has posted results as of September 2026. These are the studies that would show what happens to people taking this drug for years, and that is exactly what is missing.
Phase 3 long-term extension, 150 participants, completed with primary completion 30 April 2026; no results posted as of 11 September 2026. A second extension (NCT04881825, 84 participants) completed the same day, also without posted results.
- Study in people2026Efficacy And Safety Evaluation of Glepaglutide in Treatment of SBS (new phase 3)
A fresh large study is recruiting and will not answer anything for years. It plans to enrol about 90 people to confirm that twice-weekly glepaglutide works and to gather longer safety data. It started recruiting in February 2026, and the main measurement point is set for October 2028. A 28 person follow-on study for people from earlier studies is also running. Nothing has been published from either.
Phase 3, estimated 90 participants, recruiting since 11 February 2026, primary completion 23 October 2028. Registered purpose: to confirm the efficacy and safety of glepaglutide 10 mg twice weekly and to generate additional long-term safety data. A 28 person extension for prior trial participants (NCT07228403, EASE SBS 6) is active.
- Review of studies2025Personalized Dosing Strategies: The Missing Link in Glepaglutide Therapy for Short Bowel Syndrome
One of three letters written in response to the big glepaglutide study. It questions the dosing plan, since the once-a-week dose failed, and whether the result applies to most patients.
One of three letters published in response to EASE SBS-1 (with PMIDs 40517965 and 40516831), questioning the dosing strategy given the failure of the once-weekly arm and the generalisability of the result.
- Review of studies2026Interpreting pooled GLP-2 analogue effects in chronic intestinal failure: transparency, attrition, and real-world generalisability
A letter raising concerns about pooled results for GLP-2 drugs in intestinal failure, including glepaglutide. It points to how many people dropped out and whether the results hold in everyday care.
Letter raising attrition and generalisability concerns about pooled estimates of GLP-2 analogue effect in intestinal failure, including the glepaglutide data.
Where to buy Glepaglutide
1 seller lists Glepaglutide in our latest read. They are ranked by trust score, then by archive rating, then by certificate tier, then by the lowest price per milligram. Archive evidence is counted before source-backed. Each path is out of 4, and the two are not added. A higher price does not raise the score. The letter is the certificate chip. 0 of them have a published certificate that names Glepaglutide.
Some seller links may pay this site when you buy through them. A payment never changes a seller's tier or rank, and no seller has a say in any page.
| Seller | Trust score | Vial sizes | From, per mg | Certificate for Glepaglutide | Seller link |
|---|---|---|---|---|---|
| Boston Molecules | 28 InsufficientSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $81.0 | None found for Glepaglutide | View |
- LC Lab-confirmed: the issuing laboratory echoed this certificate back
- A Current certificate, independent laboratory named, laboratory not yet checked
- B Certificate published, but no laboratory link, older than a year, or the laboratory did not recognise the published lookup
- C No certificate could be read
Every listing and vial size for Glepaglutide · How the trust score is counted
Sellers named on the price pages are ranked by certificate tier, then price, and any affiliate income is disclosed there. Naming a seller is not a recommendation to buy or use anything.
Common questions
Has Glepaglutide been tested in people?
Yes. 230 people given it across 3 completed trials cited here, 2 of which found nothing. Glepaglutide is a long-lasting copy of GLP-2, a gut hormone, for people whose short bowel means they need feeding by drip.
What is the Glepaglutide dosage?
No human dose established. Amounts that were given in studies sit in Human evidence on this page. None of them is a personal dose. 3 completed trials, 230 people given it
Is Glepaglutide FDA-approved?
Not FDA approved. No application in the FDA drug database (Drugs@FDA) and no European (EMA) medicine page as of 11 September 2026. The final-stage study EASE SBS-1 is finished. A second final-stage study to confirm the results (NCT07197944) has been signing people up since February 2026.
Is glepaglutide approved?
No. As of September 2026 there is no application in the FDA's drug database and no medicine page at the European Medicines Agency. The main large study is published, and another large study is recruiting, due to finish in 2028.
How does it compare with teduglutide?
No head-to-head study exists. Teduglutide is a daily shot. Glepaglutide was tested once and twice a week, and only twice a week beat the dummy injection. Comparing across separate studies is not reliable, because the people and the ways results were measured differ.
What did the phase 3 show?
In 106 people with short bowel syndrome who needed drip feeding at least 3 days a week, 24 weeks of 10 mg twice a week cut weekly drip volume by 5.13 litres. On the dummy injection it fell 2.85 litres. About two thirds on the drug, against two fifths on the dummy, cut their drip volume by 20 percent. 5 people on the drug came off drip feeding entirely, against none on the dummy. The once-a-week dose did not beat the dummy.
What are the side effects?
In the 18 person study with daily shots, 72 percent had problems with their stoma, 61 percent had injection site reactions, 56 percent had swollen legs, and 44 percent each had nausea and belly pain. Fluid build-up and stoma changes are expected from a drug that makes the gut absorb more and grow. The big study's paper called the drug well tolerated, but its summary did not give matching rates.