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An injection every two weeks, and stomach trouble for five in six

A fortnightly drug beat weekly semaglutide on blood sugar. It also raised gastrointestinal side effects from half of patients to most of them.

Neil Sanders6 min read
Biweekly bofanglutide vs weekly semaglutide 1 mgHbA1c fall2.28 vs 1.60the tablet-free arm winsstomach side effects87% vs 52%and loses hereHalf as many injections. Most patients felt it.Phase 2b · 24 weeks · open-label · China onlyNot approved or available anywhere.

Injection frequency is one of the few things about these drugs a buyer can actually feel every week, and nobody has tested whether the day you take it matters — that absence is documented in injection day. How often you take it is a different question, and a phase 2b trial put an every-two-weeks injection against a weekly one [1].

On blood sugar the fortnightly drug did well. HbA1c fell 2.28 percentage points on bofanglutide 18 mg every two weeks against 1.60 on weekly semaglutide, a difference of -0.68 points (95% CI -1.04 to -0.33). The 12 and 24 mg fortnightly doses also beat the comparator, and hypoglycemia stayed rare across all arms with no severe episodes.

The comparator choice is by now a familiar pattern on this desk. Semaglutide 1 mg is the diabetes dose, not the 2.4 mg weight-management dose, and a favorable head-to-head against the lower arm keeps appearing in this literature — the same structural point made in cost per patient who actually hits the target and the super-responder brand comparison.

The authors list their own limitations plainly: open-label, short duration, and Chinese participants only. The trial was funded by Gan & Lee Pharmaceuticals, which makes the drug — stated in the paper, and ordinary for a phase 2b, but worth knowing. Twenty-four weeks is also too short to say anything about whether a fortnightly schedule helps people stay on treatment, which is the commercial question a fortnightly drug would need to answer.

Nothing here is buyable. Bofanglutide is not approved anywhere, and a phase 2b result is two expensive steps from a pharmacy. What it establishes is that dosing intervals longer than a week are pharmacologically achievable, which would change the arithmetic of what a year of treatment costs and how much of it people complete — the figures in two thirds stop within a year and what a GLP-1 actually costs are the ones it would have to move.

Frequently asked

Can I get an injection that lasts two weeks?
Not yet. Bofanglutide is not approved or available anywhere, and this was a phase 2b trial in China lasting 24 weeks.
Did it work better than semaglutide?
On blood sugar, yes — HbA1c fell 2.28 points against 1.60. But the comparator was semaglutide 1 mg, a diabetes dose rather than the weight-management dose.
What was the downside?
Stomach side effects. They affected 81.8% to 87.3% of bofanglutide participants against 51.9% on semaglutide, though mostly mild to moderate in severity.

Sources

  1. [1] Liu M, Cheng Z, Lu L, Cai H, et al. (2026). Weekly and Biweekly Treatment With Bofanglutide Versus Semaglutide in Chinese Patients With Type 2 Diabetes: A Phase 2b Randomized Clinical Trial Annals of Internal Medicine. PMID 42372276

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