PEG-loxenatide dosage and evidence
Written by Aaron CuhaReviewed Sep 2026
The short answer
Approved in China in 2019, based on two large studies with a dummy-shot group, one of 361 patients and one of about 360.
Evidence grade for PEG-loxenatide: Moderate. The rule: at least one finished study in people, and at least 100 people who took it. The sum on this page: 4 completed trials, 590 people given it. A grade counts how much has been done to people, not whether it works.
- People given it
- 590
- Human studies
- 4
- 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.
4 completed trials, 590 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, Heart and circulation
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.
PEG-loxenatide is a weekly diabetes shot approved in China in 2019. It is a changed version of exenatide, an older diabetes drug. A chain is added so it lasts a week. It is not approved in the West.
What people take it for
- Lower blood sugar in type 2 diabetes.
- Weight loss, based on high-dose studies.
- Protecting the kidneys in diabetes.
What studies in people showed
Two big studies got it approved. In one, 361 patients took it alone. Average blood sugar fell 1.02 and 1.34 points at the two doses, against 0.17 on a dummy shot. In the other, people at 44 hospitals added it to metformin. Both doses cut blood sugar by the same amount. Weight barely changed. One study at one hospital used much higher doses than approved. Weight fell 16.34 and 21.14 kg, but the dummy group also lost 6.75 kg. In a small kidney study, it cut protein in the urine about as much as dapagliflozin.
What people report
Reports, not study results
The good
- Blood sugar dropped reliably in the big studies.
- Stomach upset was mostly mild at approved doses.
- Few people made antibodies against it.
The bad
- Nausea and vomiting went up at the higher approved dose. Vomiting hit 8.3 percent at 200 micrograms.
- At the very high doses, side effects hit 36.11 percent, against 11.43 percent on the dummy shot.
- Stomach side effects were more common than on dapagliflozin in the kidney study.
Where these come from: The study results on this page. We have not collected user reports on this one yet.
My bottom line
A solid, ordinary blood sugar drug. The big weight-loss numbers come from doses nobody approved. Judge it on the big studies, not the headlines.
An opinion, not a finding. I am a coach, not a doctor.
What it has been measured to do
Measured in people
Goals PEG-loxenatide 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.
- Blood sugar and insulin590 people · 4 studies · 2 found nothing
- Losing weight123 people · 1 study
- Kidney function106 people · 1 study · 1 found nothing
33 of the 36 indexed goals have no study of any kind behind PEG-loxenatide
No study in people, animals or cells on this page reports a result for these. That does not prove PEG-loxenatide does nothing for them. It does mean anything you have heard about PEG-loxenatide and one of these did not come from a study cited here.
Show full evidence
What is PEG-loxenatide?
Approved in China in 2019, based on two large studies with a dummy-shot group, one of 361 patients and one of about 360. It lowered average blood sugar (HbA1c) by about 1.0 to 1.3 points. Its effect on weight in those studies was small. The big weight numbers come from later single-hospital studies using doses well above the approved ones.
PEG-loxenatide, usually called PEX168 in study papers, is a changed version of exenatide with a PEG chain attached. PEG is a long chemical chain that slows how fast the body clears a drug. It comes from Hansoh Pharmaceutical. It was approved in China in 2019. That makes it one of the first weekly GLP-1 shots developed in China to reach the market anywhere.
It has one of the deeper records on this page. Beyond the two studies that got it approved, there are studies comparing it with insulin glargine and with metformin. There is a study in diabetic kidney disease against dapagliflozin, a study of how people with weak kidneys handle it, and several reviews that pooled the studies. That is a real body of evidence. But almost all of it is from China, and much of it comes from single hospitals.
The approved doses were 100 and 200 micrograms a week. Keep that in mind when you see the weight-loss numbers people pass around. A 2026 study at one hospital, in people with type 2 diabetes and severe obesity, used 300 and 400 micrograms a week. That is one and a half to four times the approved doses. Weight fell 16.34 and 21.14 kg over 24 weeks, against 6.75 kg on a dummy shot. Those are dramatic numbers. But they come from 105 people who finished, at one hospital, on doses that are not approved. And the dummy group losing 6.75 kg tells you everyone was also on a strong diet or lifestyle program.
What the approval studies actually showed was ordinary and solid. Average blood sugar fell about 1.0 to 1.3 points. Stomach upset was mild. Low blood sugar and weight gain did not go up. Under 2 to 2.5 percent of patients made antibodies against the drug.
How does PEG-loxenatide work?
It is a changed version of exenatide, a lizard hormone that works on the same switch as the gut hormone GLP-1. A PEG chain is attached at one set spot. That makes the molecule bigger, so the kidneys clear it more slowly. A drug that would need two shots a day becomes a once-a-week shot. In the body it acts like any GLP-1 drug. It helps release insulin when blood sugar is high, holds back glucagon (a hormone that raises blood sugar), slows the stomach and cuts appetite. The kidneys do much of the clearing, so separate studies looked at people with weak kidneys. Later Chinese studies report changes in protein in the urine, gut bacteria and the lining of blood vessels. Those were side measures, not proven health benefits.
What have studies in people found about PEG-loxenatide?
Two large studies at many hospitals, with a dummy-shot group and nobody knowing who got what. These got it approved. There are also studies against insulin glargine, metformin and dapagliflozin, a study in people with weak kidneys, and several reviews that pooled studies. Almost all of it is from China.
- Drug alone, 361 patients: average blood sugar (HbA1c) fell 1.02 and 1.34 points at 100 and 200 micrograms, against 0.17 on a dummy shot.
- Added to metformin, at 44 hospitals: blood sugar fell 1.16 and 1.14 points, while it rose 0.35 points on the dummy shot. The two doses did the same.
- Antibodies against the drug showed up in 1.2 percent and under 2 percent of patients in the two approval studies. That is far lower than in the first safety study of the other PEG-exenatide drug on this site.
- The big weight numbers, 16 to 21 kg over 24 weeks, come from one study at one hospital using 300 and 400 micrograms a week. That is above the approved doses, and only the patients were kept in the dark.
- In diabetic kidney disease, it cut protein leaking into the urine as much as dapagliflozin over 24 weeks. That was in 80 people who finished, at one hospital, and it is a lab marker, not a kidney outcome.
What this does not tell you: The approval studies had 24 weeks with a dummy-shot group, then a follow-on where everyone knew what they took. There is no heart attack and stroke study. There is no study of real kidney outcomes, only protein in the urine. The striking weight results come from one hospital, on doses above the approved ones, where the dummy group itself lost nearly 7 kg. And every study was in Chinese patients, who start at a much lower BMI than people in Western weight-loss studies.
The state of the research
The most useful thing about this drug is what happens to its numbers as you move away from the approval studies.
The approval studies were big, at many hospitals, with a dummy-shot group and nobody knowing who got what. They showed a solid, ordinary blood sugar drug. Average blood sugar fell about a point. Nausea was mild. Low blood sugar was not a problem. Few people made antibodies. The weight effect was so small that the metformin study describes it as no weight gain, not as weight loss.
Later papers have far more dramatic numbers. Almost all come from single-hospital studies, studies where people knew what they took, doses above the approved ones, or look-backs at patient records. The 21 kg weight loss is the clearest example. One hospital, only the patients kept in the dark, 400 micrograms a week, and a dummy group that lost 6.75 kg on its own.
None of that means the later studies are wrong. It means the number you quote depends on which study you quote. The big approval studies leave the least room for the study design, rather than the drug, to produce the result.
The kidney study deserves the same reading. Cutting protein in the urine as much as dapagliflozin, over 24 weeks in 80 people, is a lab marker result. Dapagliflozin has hard kidney outcome data behind it. This drug does not.
A note on what Chinese approval does and does not tell you. China's drug regulator requires studies in Chinese patients. The key studies behind these approvals are real, carefully run studies with a dummy-shot group. They are published in mainstream medical journals, including Diabetologia, Nature Communications, Diabetes Obesity and Metabolism and the Lancet regional journal. What is usually missing, compared with the Western drugs, is a big study of heart attacks and strokes. Semaglutide and liraglutide have heart data in tens of thousands of patients followed for years. None of the drugs on this page does. So the fair statement is this. These drugs lower blood sugar and body weight in Chinese adults over months. They have not been shown to prevent heart attacks. That gap is real. It is a separate question from whether a Western reader has heard of the drug.
The evidence, in charts
Fig. 1a · how many people
590people, across 3 studies in people cited here
| Study | People | Share |
|---|---|---|
| Diabetes, Obesity and Metabolism 2021 | 361 | 61% |
| Frontiers in Endocrinology 2026 | 123 | 21% |
| Frontiers in Endocrinology 2024 | 106 | 18% |
One study holds 61% of these people, so the total rests more on one study than its size suggests. 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. 1 more study in people gives no headcount and is not counted here. Studies still signing people up are left out, and only studies cited on this page are counted.
Fig. 1b · evidence mix
All 4 sources here are studies in people.
- Study in people · done in people4100%
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, 2020 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
- A PEGylated exendin-4 analogue. Total mass depends on the polyethylene glycol chain and is not asserted here.
- Half-life
- Stated in words, not a numbersee the exact wording below
- Chain length
- None on file
Half-life as stated on file: Long enough for once-weekly subcutaneous dosing. No specific human figure is asserted here; no source loaded states one in the records resolved for this entry.
No amino acid sequence is on file for PEG-loxenatide, so none is drawn rather than guessed from a name.
The studies we cite
- Study in people2021Efficacy and safety of polyethylene glycol loxenatide monotherapy in type 2 diabetes patients: A multicentre, randomized, double-blind, placebo-controlled phase 3a clinical trial
On its own it lowered blood sugar clearly, and the higher dose brought more sickness. 361 Chinese patients whose blood sugar was not under control were split by chance to a dummy, 100 or 200 micrograms weekly for 24 weeks. Average blood sugar fell 1.02 and 1.34 points against 0.17 on the dummy. 34.7 and 46.6 percent got below 7 percent against 15.7 percent. Nausea hit 5.6 and 10.0 percent against nobody on the dummy, and vomiting 2.4 and 8.3 percent against nobody. 4 patients made antibodies.
361 Chinese patients with inadequate glycaemic control randomised to placebo, 100 or 200 micrograms weekly for 24 weeks, then a 28 week extension. Glycated haemoglobin fell 1.02 percentage points on 100 micrograms and 1.34 on 200 against 0.17 on placebo. 34.7 percent and 46.6 percent reached below 7 percent against 15.7 percent. Nausea occurred in 5.6 and 10.0 percent against none on placebo, vomiting in 2.4 and 8.3 percent against none. Antidrug antibodies developed in 4 patients, 1.2 percent.
- Study in people2020Efficacy and safety of polyethylene glycol loxenatide as add-on to metformin in patients with type 2 diabetes: A multicentre, randomized, double-blind, placebo-controlled, phase 3b trial
Added to metformin it worked, and doubling the dose added nothing. Across 44 Chinese sites patients took metformin plus a dummy, plus 100 micrograms, or plus 200 micrograms, for 24 weeks. Average blood sugar fell 1.16 and 1.14 points on the two doses, while the dummy group's rose 0.35. 37.4 and 40.6 percent got below 7.0 percent against 16.8 percent. The two doses came out the same, so there is no case for the bigger one. Stomach reactions were mild, and under 2 percent made antibodies.
The add-on registration trial across 44 Chinese sites, randomised to metformin plus placebo, plus 100 micrograms or plus 200 micrograms, 24 weeks core plus 28 week extension. Glycated haemoglobin fell 1.16 and 1.14 percentage points against a rise of 0.35 on placebo. 37.4 and 40.6 percent reached below 7.0 percent against 16.8 percent. Notably the two doses performed the same, gastrointestinal reactions were mild, hypoglycaemia and weight gain did not increase, anti-drug antibodies appeared in under 2 percent, and no treatment-emergent serious adverse events occurred.
- Study in people2026Effect of polyethylene glycol loxenatide on weight loss in super-obese patients with type 2 diabetes: a randomized controlled trial
Very high doses took off a lot of weight, and this trial cannot carry that. 123 enrolled at one centre and 105 finished, split by chance to 300 or 400 micrograms weekly or a dummy. Weight fell 16.34 kg and 21.14 kg against 6.75 kg. Side effects hit 36.11 percent on the high dose against 11.43 percent. Here is the problem. The doses run up to four times the registered ones, only patients were kept in the dark, and the dummy group lost 6.75 kg, so everyone was dieting hard.
Single-centre, single-blind trial, 123 enrolled and 105 completed, randomised to 300 or 400 micrograms weekly or placebo for 24 weeks. Weight fell 16.34 kg on 300 micrograms and 21.14 kg on 400 against 6.75 kg on placebo. Glycated haemoglobin fell 1.02 and 1.34 percentage points against 0.50. Adverse drug reactions reached 36.11 percent on the high dose against 11.43 percent on placebo. These doses are one and a half to four times the registration doses, the trial is single-centre and single-blind, and the placebo arm losing 6.75 kg indicates a substantial background intervention in all groups.
- Study in people2024Efficacy and safety of polyethylene glycol loxenatide in treating mild-to-moderate diabetic kidney disease in type 2 diabetes patients: a randomized, open-label, clinical trial
It matched the comparison drug on a urine marker, and no actual kidney outcome was measured. 106 people at one centre were assigned by chance and everybody knew what they were taking. 80 finished. Over 24 weeks, protein leaking into the urine fell 29.3 percent on PEG-loxenatide and 31.8 percent on dapagliflozin, a gap too small to call. Average blood sugar fell almost identically. Stomach side effects were more common on PEG-loxenatide. Protein in the urine is a marker. Nobody counted dialysis, transplants or failing kidneys.
Single-centre open-label trial against dapagliflozin. 106 randomised, 80 completed. Urine albumin to creatinine ratio fell 29.3 percent on PEG-loxenatide against 31.8 percent on dapagliflozin over 24 weeks, a difference that was not significant. Glycated haemoglobin fell almost identically in both arms. Triglycerides fell more on PEG-loxenatide. Gastrointestinal adverse events were more common on PEG-loxenatide. Albuminuria is a surrogate marker; no kidney outcome such as dialysis, transplantation or doubling of creatinine was measured.
Where to buy PEG-loxenatide
No seller we track lists PEG-loxenatide yet. We read sellers’ public product lists every week, and this section fills in as soon as one does. Every seller, graded
Common questions
Has PEG-loxenatide been tested in people?
Yes. 590 people given it across 4 completed trials cited here, 2 of which found nothing. Approved in China in 2019, based on two large studies with a dummy-shot group, one of 361 patients and one of about 360.
What is the PEG-loxenatide 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. 4 completed trials, 590 people given it
Is PEG-loxenatide FDA-approved?
Not approved in the United States. Approved in China in 2019 for type 2 diabetes, and widely used there. We found no application to any Western regulator.
Is PEG-loxenatide approved?
Yes, in China, since 2019, for type 2 diabetes. It is not approved in the United States, United Kingdom, Australia or Canada. No filing with a Western regulator has been found.
How much weight does it cause people to lose?
In the big approval studies, very little. The metformin study describes it as no extra weight gain rather than weight loss. Numbers of 16 to 21 kg come from one study at one hospital using 300 and 400 micrograms a week, above the approved doses. In that study the dummy-shot group also lost 6.75 kg.
How does it compare to semaglutide?
No study has put them side by side with people assigned by chance. Chinese papers include look-backs at patient records from two hospitals. Going by the approval studies alone, the blood sugar drop is in the same range as other weekly shots, and the weight effect is smaller than semaglutide's.
Does it protect the kidneys?
One study at one hospital, with 80 people who finished, found it cut protein leaking into the urine as much as dapagliflozin over 24 weeks. That is a lab marker. No study has checked whether it keeps people off dialysis, avoids a transplant, or stops a key kidney blood test from doubling.
Why do the 100 and 200 microgram doses work the same?
That is what the metformin approval study found: 1.16 against 1.14 points of average blood sugar. In the study with the drug alone, the higher dose did better, 1.34 against 1.02. But it came with roughly double the nausea and vomiting. So in one of the two key studies, doubling the dose added nothing. That is a real feature of this drug's record.