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Shanmeining + metformin is a combination therapy consisting of efmedaglutide alfa (Shanmeining), a long-acting recombinant human glucagon-like peptide-1 (hGLP-1) Fc fusion protein, and metformin, a first-line oral biguanide antihyperglycemic agent. Efmedaglutide alfa selectively binds to and activates the GLP-1 receptor, promoting glucose-dependent insulin secretion and inhibiting glucagon release, while also suppressing appetite and delaying gastric emptying. Metformin complements this by reducing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity. Developed by CSPC Pharmaceutical Group (in collaboration with TJ Biopharma and Genexine), this combination is primarily indicated for glycemic control in adults with type 2 diabetes mellitus who have inadequate glycemic control on metformin monotherapy. In Phase III clinical trials, the once-weekly subcutaneous injection of efmedaglutide alfa in combination with daily oral metformin demonstrated rapid, robust, and sustained reductions in HbA1c and body weight, showing superior glycemic control compared to dulaglutide.
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