Visepegenatide dosage and evidence
Written by Aaron CuhaReviewed Sep 2026
The short answer
In a large final-stage study of 273 Chinese adults on no diabetes drug yet, it lowered average blood sugar (HbA1c) by 1.36 points, against 0.63 on a dummy shot, over 24 weeks. People start on the full dose, with no slow build-up. In its first safety study, 28 percent of healthy volunteers made antibodies against it.
Evidence grade for Visepegenatide: 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, 572 people given it. A grade counts how much has been done to people, not whether it works.
- People given it
- 572
- Human studies
- 4
- Found nothing
- 1
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, 572 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
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.
Visepegenatide is a weekly diabetes shot from China. It is the older drug exenatide with a chain added so it lasts longer. People start on the full dose, with no slow build-up. It was reported approved in China in November 2025.
What people take it for
- Lower blood sugar in type 2 diabetes.
- A weekly shot with no dose build-up.
- Some weight loss.
What studies in people showed
The biggest study had 273 Chinese adults new to diabetes drugs. Over 24 weeks, average blood sugar fell 1.36 points on the drug and 0.63 points on a dummy shot. About half of people on the drug got their blood sugar under 7 percent. Weight loss was small and very uneven from person to person. In an early study of 36 healthy people, 10 made antibodies against the drug after six weeks. Those antibodies changed how the drug acted in their blood. Nobody has checked this over years.
What people report
Reports, not study results
The good
- Blood sugar dropped, and fewer people needed rescue drugs. 3 on the drug needed them, against 17 on the dummy shot.
- No slow dose build-up is needed.
The bad
- Stomach side effects, mostly at the top dose in the early study.
- More than a quarter of healthy volunteers made antibodies against it.
- Weight loss was small and varied a lot between people.
Where these come from: The study results on this page. We have not collected user reports on this one yet.
My bottom line
It lowers blood sugar like the rest of this family. The antibody question is the one I would want answered before taking it for years. It is not a weight-loss drug.
An opinion, not a finding. I am a coach, not a doctor.
What it has been measured to do
Measured in people
Goals Visepegenatide 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 insulin560 people · 3 studies · 1 found nothing
- Losing weight273 people · 1 study
34 of the 36 indexed goals have no study of any kind behind Visepegenatide
No study in people, animals or cells on this page reports a result for these. That does not prove Visepegenatide does nothing for them. It does mean anything you have heard about Visepegenatide and one of these did not come from a study cited here.
Show full evidence
What is Visepegenatide?
In a large final-stage study of 273 Chinese adults on no diabetes drug yet, it lowered average blood sugar (HbA1c) by 1.36 points, against 0.63 on a dummy shot, over 24 weeks. People start on the full dose, with no slow build-up. In its first safety study, 28 percent of healthy volunteers made antibodies against it.
Visepegenatide is exenatide with a PEG chain attached. PEG is a long chemical chain that slows how fast the kidneys clear a drug. It turns a shot you need twice a day into a shot once a week. It comes from PegBio in Hangzhou and was called PB-119 in most of its papers.
The selling point is not how much it lowers blood sugar. That is normal for this drug family. The selling point is that people start on the full dose. Every other weekly GLP-1 shot needs a slow dose build-up over weeks to keep nausea bearable. The researchers say stomach problems were less common than with other weekly shots. But no study compared them directly.
The main study ran 24 weeks with a dummy-shot group where nobody knew who got what. Then everyone took the real drug for 28 more weeks. So the 52-week numbers have no comparison group after week 24.
The fact most coverage leaves out is antibodies. In the first safety study, 10 of 36 healthy volunteers made antibodies against the drug after six weekly shots. Their blood levels of the drug were measurably different. Long-acting drugs like this have a history here. Weekly exenatide and albiglutide, which was later dropped, both had antibody findings. The main study report does not tell us what this means over years of use.
How does Visepegenatide work?
The core is exenatide, a copy of a hormone found in Gila monster venom. It works on the same switch as the gut hormone GLP-1. A PEG chain is attached, which makes the molecule bigger so the kidneys clear it more slowly. Plain exenatide lasts a few hours. This version takes about 55 hours for the body to clear half of it. That is long enough for one fixed shot a week. Once 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. One small study used meal tests to model how the body handles insulin. It found better function in the cells that make insulin, and better modelled insulin sensitivity. But the simpler standard test of insulin resistance did not change.
What have studies in people found about Visepegenatide?
One published large final-stage study with a dummy-shot group, in 273 Chinese adults on no diabetes drug yet. There is also a mid-stage study of 251 patients, an early safety study in healthy volunteers, and a small study of how it works. A mid-stage study was also run in the United States, which the main study report mentions.
- Final-stage study, 24 weeks: average blood sugar (HbA1c) fell 1.36 points, against 0.63 on the dummy shot. 50.4 percent got below 7.0 percent, against 14.2 percent.
- The 52-week numbers come from a follow-on period where the dummy group switched to the real drug. So there is no fair comparison after week 24.
- Weight loss was small and depended on starting size. It reached 4.77 kg at week 52 in people with a BMI above 32. But results were spread so wide, about 13.94 kg either side, that the average does not describe a typical person.
- Mid-stage study, 12 weeks: the 150 microgram dose lowered blood sugar more than the 200 microgram dose. That is why the middle dose went forward.
- First safety study: 27.78 percent of healthy volunteers made antibodies against the drug after six weekly shots. Those people handled the drug differently.
What this does not tell you: The period with a dummy-shot group lasted only 24 weeks. The claim that it causes less stomach upset than other weekly shots comes from comparing separate studies, not from testing them side by side. The antibody finding comes from 36 healthy volunteers over six weeks. Nobody has followed it out to the years people actually take a diabetes drug. There is no heart attack and stroke study. And the weight-loss number quoted most often swings by about three times its own size from person to person. That means a few people are pulling the average.
The state of the research
Two things on this page deserve more attention than they get.
The first is the dose result in the mid-stage study. The 150 microgram dose lowered blood sugar more than the 200 microgram dose. You would expect more drug to do more. The study was too small to tell the two doses apart for sure. But that result is why the middle dose became the one sold. Picking a dose off an odd result like this is common. It is worth knowing when it has happened.
The second is antibodies. This is built into the drug, not a factory problem. Exenatide comes from a lizard, not a human. Adding the PEG chain gives the immune system one more thing to react to. Antibodies to exenatide-based drugs are well known. The maker's own first safety study found them in more than a quarter of healthy volunteers after six weeks, and they changed how much drug was in the blood. The summary of the main study does not report antibodies. Anyone comparing this drug with one based on the human hormone should want that number over a year, not six weeks.
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
572people, across 4 studies in people cited here
| Study | People | Share |
|---|---|---|
| The Lancet Regional Health Western Pacific 2024 | 273 | 48% |
| Diabetologia 2021 | 251 | 44% |
| Frontiers in Pharmacology 2023 | 36 | 6% |
| European Journal of Drug Metabolism and Pharmacokinetics 2021 | 12 | 2% |
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. 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 3 different years, 2021 to 2024, 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
- PEGylated exenatide. The peptide core is exendin-4; total mass depends on the PEG chain and is not asserted here.
- Half-life
- About 2.3 daysLong, 1 to 7 days
- Chain length
- None on file
No amino acid sequence is on file for Visepegenatide, so none is drawn rather than guessed from a name.
The studies we cite
- Study in people2024Efficacy and safety of visepegenatide, a long-acting weekly GLP-1 receptor agonist as monotherapy in type 2 diabetes mellitus: a randomised, double-blind, parallel, placebo-controlled phase 3 trial
It lowered blood sugar in people newly treated for diabetes, and the weight number needs care. 273 adults who had never been treated were split evenly by chance to 150 micrograms weekly or a dummy for 24 weeks. Average blood sugar fell 1.36 points against 0.63. 50.4 percent got below 7.0 percent against 14.2 percent. 3 people on the drug needed rescue treatment against 17 on the dummy. The 4.77 kg weight loss at week 52 varied so widely that it should not be read as typical. PegBio funded it.
273 treatment-naive adults at 30 Chinese centres, randomised 1:1 to 150 micrograms weekly or placebo for 24 weeks, then all on active drug to week 52. At week 24 glycated haemoglobin fell 1.36 percentage points against 0.63 on placebo, a difference of 0.73 points. 50.4 percent reached below 7.0 percent against 14.2 percent. Rescue therapy was needed by 3 participants on drug against 17 on placebo. Weight loss was reported as BMI-dependent and reached 4.77 kg at week 52 in those with BMI above 32, with a standard deviation of 13.94 kg, which is wide enough to warrant caution. Funded by PegBio.
- Study in people2021Efficacy and safety of PEGylated exenatide injection (PB-119) in treatment-naive type 2 diabetes mellitus patients: a Phase II randomised, double-blind, parallel, placebo-controlled study
The middle dose beat the highest one, which is why the middle dose went forward. 251 Chinese patients who had never been treated got a dummy or 75, 150 or 200 micrograms weekly for 12 weeks. Average blood sugar over three months fell further than the dummy group by 0.72, 1.18 and 1.02 points. Nobody had a serious drug-related event, severe low blood sugar, or died. One thing to know before quoting it: this paper has a published correction.
251 treatment-naive Chinese patients randomised to placebo or 75, 150 or 200 micrograms weekly for 12 weeks. Glycated haemoglobin differences against placebo were 0.72, 1.18 and 1.02 percentage points, with the middle dose performing best rather than the highest, which is why 150 micrograms went forward. No treatment-emergent serious adverse event, severe hypoglycaemia or death. Note that this paper has a published correction.
- Study in people2021Safety, Pharmacokinetics and Pharmacodynamics of Multiple Escalating Doses of PEGylated Exenatide (PB-119) in Healthy Volunteers
The body's own immune response changed how the drug behaved. Twelve healthy volunteers per group had weekly shots under the skin at 165, 330 or 660 micrograms for six weeks. The body took about 55 to 57 hours to clear half of it. 10 of the 36 people made antibodies against the drug. Those people carried more of it in the blood but cleared it faster and built up less. Side effects clustered in the top dose group, where 8 of 12 reported 16 events, mostly stomach ones.
Twelve healthy volunteers per group received weekly subcutaneous injections at 165, 330 or 660 micrograms for six weeks. Half-life was approximately 55 to 57 hours across all three doses. 10 of 36 subjects, 27.78 percent, developed specific antibodies, and antibody-positive subjects had higher average and maximum concentrations but lower clearance, half-life and accumulation index. Adverse events clustered in the top dose group, 8 of 12 subjects reporting 16 events, mostly gastrointestinal. The authors conclude that pharmacokinetics may be affected by immunogenicity.
- Study in people2023PEGylated exenatide injection (PB-119) improves beta-cell function and insulin resistance in treatment-naive type 2 diabetes mellitus patients
A mechanism study in 36 people, and the plainest measure of insulin resistance did not budge. The patients got 25 or 50 micrograms weekly, or twice-daily exenatide, for 12 weeks. Meal tests were used to model how the pancreas and body handled insulin. Both treatments improved pancreas function against each group's own starting point. The high dose improved a modelled insulin sensitivity measure. The standard measure of insulin resistance showed no change, within groups or between them. This was built to look at biology, not benefit.
36 Chinese patients randomised to 25 or 50 micrograms weekly or to twice-daily exenatide for 12 weeks, with oral mixed meal tolerance tests modelled to estimate beta cell function and insulin sensitivity. Both treatments raised beta cell function parameters, disposition index and insulin secretion rates against their own baseline. The high dose improved a modelled insulin sensitivity parameter, but the simpler homeostatic model assessment of insulin resistance showed no significant change within or between treatments. A 36 person mechanistic study, not an efficacy trial.
Where to buy Visepegenatide
No seller we track lists Visepegenatide 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 Visepegenatide been tested in people?
Yes. 572 people given it across 4 completed trials cited here, 1 of which found nothing. In a large final-stage study of 273 Chinese adults on no diabetes drug yet, it lowered average blood sugar (HbA1c) by 1.36 points, against 0.63 on a dummy shot, over 24 weeks. People start on the full dose, with no slow build-up. In its first safety study, 28 percent of healthy volunteers made antibodies against it.
What is the Visepegenatide 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, 572 people given it
Is Visepegenatide FDA-approved?
Not approved in the United States. Reported as approved in China in November 2025, after its final-stage study was published. We have not found the Chinese approval document, so treat that date as reported, not checked by us.
What is the difference between visepegenatide and exenatide?
It is the same molecule, exenatide, with a PEG chain attached. The chain slows how fast the body clears it. That turns a shot twice a day into a shot once a week. The body takes about 55 hours to clear half of it. It works on the body the same way.
Why does it not need titration?
Its makers give it at one fixed weekly dose. They report fewer stomach problems than with other weekly shots, and that is their reason. No study has tested it side by side with a drug where the dose is slowly raised. So the claim rests on comparing separate studies.
Should I worry about antibodies?
It is the open question for this drug. In the first safety study, 10 of 36 healthy volunteers made antibodies against it after six weekly shots. The amount of drug in their blood was measurably different from people without antibodies. Nobody has published what this looks like after a year. For a diabetes drug, a year or more is what matters.
Can I get it outside China?
No. It is not approved in the United States, United Kingdom, Australia or Canada. A mid-stage study was run in the United States, but no filing with a Western regulator has been found.
How much weight will it cause me to lose?
Not much. In the large final-stage study, people with a BMI above 32 lost 4.77 kg on average at 52 weeks. Results varied hugely from person to person, by about 13.94 kg either side. People with a lower BMI lost less. It is a blood sugar drug with some effect on weight, not a weight-loss drug.