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Insulin efsitora alfa is a once-weekly basal insulin designed as a recombinant fusion protein that combines a novel single-chain variant of insulin with a human IgG2 Fc domain. This structure extends its half-life, enabling weekly subcutaneous dosing. It acts as an agonist at the insulin receptor, mimicking endogenous human insulin to regulate blood glucose levels. Developed by Eli Lilly, it is intended for the treatment of both type 1 and type 2 diabetes mellitus. Phase 3 clinical trials (QWINT program) have demonstrated non-inferior efficacy and safety compared to daily basal insulins such as degludec and glargine in reducing HbA1c in adults with diabetes[1][4][5][6][7].
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