Market Announcement | Frost & Sullivan Supports Shaanxi Makuo Auto Pharmaceutical Technology Co., Ltd. in Successfully Listing in Hong Kong (2335.HK)

Shaanxi Makuo Medical Technology Co., Ltd. (hereinafter referred to as “Makuo”) offered approximately 58.0544 million H shares in its global offering, with the highest issue price at 21 Hong Kong dollars.

During the Hong Kong listing process, Frost & Sullivan performed the following tasks: helping the issuer accurately and objectively understand its position in the target market, using objective market data to identify, support, and highlight the issuer’s competitive advantages, assisting the issuer, investment banks, and other intermediaries in writing important sections of the prospectus (such as overview, competitive advantages and strategy, industry overview, business, etc.), helping the issuer communicate with the Stock Exchange and investors, enabling investors to quickly understand the market ecosystem and competitive landscape, and assisting the issuer in responding to various questions regarding the industry from the Stock Exchange.

Frost & Sullivan has always been a leader in helping companies list on the Hong Kong market. According to LiveReport Big Data (data as of March 31, 2026), over the past 36 months and 12 months, and from January to March 2026, Frost & Sullivan provided listing industry consulting services for 195, 101, and 30 Hong Kong IPO listings respectively, ranking first in terms of number of engagements. It possesses rich industry experience and communication skills with regulatory authorities, exchanges, investment and financing institutions, and related organizations.

●The company’s core product MT1013 is the world’s first CaSR and OGP receptor dual-target receptor agonist peptide

It is primarily used to treat CKD-SHPT in dialysis patients, and also has potential for expansion to CKD-MBD with osteoporosis and non-dialysis CKD-SHPT indications. Phase II clinical data for MT1013 show that it can significantly improve the overall compliance rate of iPTH, blood calcium, and blood phosphorus levels, with rapid onset and long-lasting effects. The product also reduces cardiovascular risk markers, offers clear cardiovascular benefits, promotes bone formation, increases bone density, and improves overall bone metabolism.

●The company’s key product XTL6001 is the world’s first and only GLP-1R/GCGR/MasR triple target agonist that has received clinical approvals in both China and the United States and is in the clinical trial stage

The product innovates by integrating the MasR target into the GLP-1R/GCGR combination, providing a differentiated advantage among existing GLP-1 drugs. Its potential indications include long-term weight management for obese/overweight individuals, chronic kidney disease with proteinuria, and MASH. Pre-clinical studies have shown that XTL6001 can maintain muscle mass during weight loss, achieve weight reduction through improved energy metabolism, and provide protective effects on multiple organs such as the kidneys.

●The company’s key product MT1002 is the world’s first dual-target peptide antagonist for coagulation factor II and GPIIb/IIIa

MT1002 is mainly targeted at clinical needs in ACS-PCI surgery, stroke, anticoagulation and anti-thrombosis during renal dialysis, and HD-PF4. Clinical studies show that MT1002 can address the challenge of balancing bleeding and ischemia in ACS-PCI, featuring rapid onset, quick recovery after stopping, stable pharmacokinetic properties, and good population adaptability.

●Differentiated pipelines targeting high-potential areas with significant unmet clinical needs

The company focuses on addressing significant unmet clinical needs in metabolic diseases, especially those related to kidney diseases, and cardiovascular diseases, aiming to provide effective treatment solutions worldwide. In addition to the core product MT1013, the company has advanced several key products with differentiated mechanisms to expand treatment options.

●The company has established four core technology platforms covering the entire R&D cycle of multifunctional peptide drugs

Including (i) dual/multifunctional peptides and peptide-based macromolecular technology platforms, which employ multi-target synergistic design to precisely identify targets and optimize drug structures; by integrating protein engineering and related technologies, they extend half-life, enhance metabolic stability, increase specificity, and reduce adverse reactions; (ii) computer-assisted peptide design platforms that utilize artificial intelligence algorithms to accelerate molecular design and optimization, thus achieving intelligent R&D processes from molecular generation to drug evaluation; (iii) oral peptide administration platforms, which are under development, aimed at overcoming the limitations of injectable peptide therapies to improve patient convenience and treatment adherence; and (iv) drug evaluation platforms that use approximately 100 animal models and conduct numerous in vivo and in vitro evaluations annually, supporting the screening of clinical candidates from target verification onward.

Peptide drugs consist of amino acids arranged in specific sequences, with molecular weights typically ranging from 500 to 5,000 daltons. Peptide drugs exert therapeutic effects by acting as agonists or antagonists of endogenous peptides or proteins, due to their high affinity and specific binding to biological targets.

The global peptide drug market increased from $62.8 billion in 2020 to $139.3 billion in 2025, and is expected to reach $267.6 billion by 2030, with a compound annual growth rate of 13.9%. Given the advantages of peptide drugs, their clinical applications will expand into various fields such as cardiovascular diseases, tumors, and immune regulation. Thanks to favorable policies, growing treatment needs, and technological innovation, China’s peptide drug market is showing accelerated growth. The Chinese peptide drug market increased from 58.9 billion RMB in 2020 to 70 billion RMB in 2025, and is expected to reach 172.4 billion RMB by 2030, with a compound annual growth rate of 20.0%. Driven by population aging, rising incidence of chronic diseases, and advancements in expensive innovative therapies, cost control has become a major trend in the global healthcare sector. Under financial pressures, governments and third-party payers (commercial insurance companies) are controlling rising medical expenses by limiting coverage for certain drugs and adjusting reimbursement rates. Although medical cost control has become a global norm, this trend also promotes structural optimization of the medical payment system, prioritizing limited public healthcare funds and commercial insurance resources for innovative drugs with differentiated clinical value, especially those with new target combinations, new mechanisms of action, and capable of addressing unmet clinical needs.

●Significant and Unmet Treatment Needs Due to Chronic Disease Pandemics

According to the World Health Organization, the global obese population exceeds 1 billion, and is closely associated with increased risks of multiple diseases, including type 2 diabetes and certain cancers. Peptide drugs, represented by GLP-1 agonists, have achieved safe and effective weight loss effects comparable to bariatric surgery for the first time through pharmacological means, meeting this large market demand. Meanwhile, global population aging continues to expand the patient population affected by CKD and osteoporosis. According to a study published in The Lancet, as the global population ages, the prevalence and burden of CKD continue to rise. Osteoporosis disrupts calcium-phosphorus metabolism and may induce or exacerbate CKD-SHPT, further driving treatment needs and providing a stable market for peptide drugs.

●The Emergence and Development of Multi-Target Peptides

Compared to single-target peptides, multi-target peptides can act on multiple interconnected targets within a disease, producing synergistic effects and potentially improving efficacy and safety. For example, Eli Lilly’s Tirzepatide has shown significant clinical and commercial value in glucose control and weight loss. Compared to single-target drugs, dual- or triple-target GLP-1 agonists have increased weight loss effectiveness by 30–50%.

●Innovation in Oral Formulation Development

The emergence and commercialization of oral formulations represent a major breakthrough in peptide therapy, significantly enhancing patient convenience and treatment adherence. Unlike conventional peptide administration methods such as intravenous or intramuscular injection, which often require professional medical supervision and frequent visits, oral peptide formulations allow patients to administer medication independently at home.

Metabolic diseases are a series of diseases caused by imbalances in body substance metabolism, such as carbohydrates, lipids, proteins, and purines. Imbalances in body substance metabolism can damage organs such as the kidneys; if this persists over time, it may lead to organ failure and trigger or worsen diseases like CKD. Common metabolic diseases include CKD, obesity and overweight, MASH, and other conditions.

CKD is a group of chronic diseases centered on renal structure or function abnormalities. The diagnostic criteria involve renal damage or a decrease in glomerular filtration rate (GFR) lasting for 3 months or more. The core feature of chronic kidney disease is progressive decline in renal function, resulting in the kidneys being unable to perform essential tasks such as excreting metabolic waste, regulating water and electrolyte balance, and maintaining endocrine functions. Common causes include diabetic nephropathy, hypertensive nephropathy, primary glomerulonephritis, and polycystic kidney disease. Diabetes and hypertension are the main drivers of the incidence of chronic kidney disease worldwide. Chronic kidney disease affects not only the kidneys themselves but also causes multi-system complications, such as renal anemia, chronic kidney disease secondary hyperparathyroidism (CKD-SHPT), and cardiovascular diseases (e.g., heart failure, arteriosclerosis). CKD-SHPT is particularly common in patients with mid-to-late stage CKD, severely affecting the quality of life and lifespan of patients.

●The Synergy of Rising Prevalence and Population Aging

Due to the high incidence of metabolic diseases such as diabetes and hypertension, as well as unhealthy lifestyles, the prevalence of CKD continues to rise. The acceleration of population aging leads to an increasing proportion of elderly people, and elderly patients are more likely to have multiple chronic diseases. The complexity of their conditions also increases the difficulty of diagnosis and treatment, as well as the consumption of medical resources.

●Innovations and Breakthroughs in Diagnosis and Monitoring Technologies

Innovations in diagnosis and monitoring technologies improve the diagnosis and treatment processes for CKD. Artificial intelligence algorithms can accurately identify early signs of renal damage, enhancing diagnostic accuracy; the integration of smart wearable devices and telemedicine enables real-time monitoring of renal function parameters, providing data support for early screening and personalized diagnosis and treatment.

●Transformation of Chronic Disease Management Models

The management model for CKD has shifted from end-stage treatment to comprehensive management throughout the entire cycle. A hierarchical healthcare system optimizes the allocation of medical resources, digital tools improve patient compliance with treatment, and multidisciplinary collaboration provides comprehensive diagnosis and treatment services, effectively slowing down the progression of CKD.

CKD-SHPT is a common and serious complication among patients with chronic kidney disease, especially those on dialysis. It is one of the core manifestations of mineral and bone abnormalities in CKD. The pathogenesis mainly results from progressive renal function decline leading to phosphorus excretion disorders, which cause hyperphosphatemia, insufficient synthesis of active vitamin D, and hypocalcemia. Abnormalities in regulatory pathways involving calcium sensors and vitamin D receptors continuously stimulate the parathyroid gland to overproduceparathyroid hormone, further causing diffuse or nodular hyperplasia of the parathyroid glands, creating an irreversible vicious cycle of autonomous parathyroid hormone secretion. CKD-SHPT may cause renal osteopathy, vascular and soft tissue calcification, and other diseases. Clinical symptoms include bone pain, pathological fractures, vascular stiffness, and increased cardiovascular burden, significantly increasing the risk of cardiovascular adverse events and death in affected patients.

●Multiple peptide CaSR agonists will be launched and included in the national medical insurance drug list, improving drug accessibility

Etekacet was approved by the National Medical Products Administration in May 2023, but has not yet been included in the national medical insurance drug list. Additionally, two other peptide CaSR agonists (MT1013 and SHR6508) are in phase III clinical trials and are nearing approval. Since most other drugs in the CKD-SHPT treatment area have been included in the national medical insurance drug list, it is expected that all three drugs will be added to the national medical insurance list through negotiations within the next 2 to 3 years, thereby increasing their accessibility and enabling commercial growth

●Small molecule CaSR agonist Cilazapril is limited by high rates of gastrointestinal adverse reactions and poor patient adherence, which hinders its market penetration and expansion

Cilazapril has a high incidence of gastrointestinal adverse reactions, causing many patients to stop treatment due to intolerance. As an oral medication, it requires strict administration and has significant side effects, leading to frequent missed doses, arbitrary dose adjustments, and even early termination of treatment, resulting in poor overall adherence. These gastrointestinal adverse reactions and adherence issues not only limit Cilazapril’s market penetration but also reduce the overall treatment rate of CKD-SHPT patients, creating a bottleneck that restricts further market growth

●Peptide CaSR agonists can avoid the common adverse reactions of small molecule CaSR agonists and expand the eligible patient population

Peptide CaSR agonists are administered intravenously, directly entering the bloodstream, thus avoiding the severe gastrointestinal adverse reactions commonly associated with oral Cilazapril. This enables many patients who previously could not tolerate oral treatment to receive standardized treatment. The risk of hypercalcemia and hyperphosphatemia is also lower, and their indications can be extended to all stages of CKD-SHPT patients

Driven by improved accessibility, safety advantages, and better treatment adherence of peptide CKD-SHPT drugs when included in the national medical insurance list, along with higher treatment costs compared to small molecule CKD-SHPT drugs, sales volume and average treatment cost per patient will increase simultaneously, promoting rapid expansion of the domestic CKD-SHPT product market. It is estimated that by 2030, the market size will reach 5 billion RMB, and by 2035, it will reach 13.1 billion RMB, with compound annual growth rates of 18.7% and 21.4%, respectively

CKD-MBD is a common complication in patients with chronic kidney disease, characterized by mineral metabolism disorders, bone metabolism and structural abnormalities, and calcification of blood vessels and other soft tissues. This represents a systemic manifestation of multi-system involvement during the progression of chronic kidney disease. Patients with CKD-MBD may experience increased risks of bone pain, deformities, and fractures in the skeletal system, and children may also experience growth delays

In 2025, the market size of CKD-MBD drugs in China reached 5.7 billion RMB. It is expected that by 2030, the market size will reach 9.9 billion RMB, and by 2035, it will reach 19.8 billion RMB

Parathyroid Calcium Sensor (CaSR) is a G-protein coupled receptor found in parathyroid glands, kidneys, and other tissues. Its core function is to detect changes in extracellular calcium concentration and regulate the secretion of parathyroid hormone (PTH) through negative feedback, thereby maintaining calcium metabolism homeostasis. CaSR agonists bind to CaSR, enhancing its sensitivity to extracellular calcium. Even when blood calcium levels are low, they can activate the CaSR signaling pathway and directly inhibit PTH secretion by principal cells of the parathyroid gland. Long-term use of these drugs can reduce parathyroid cell proliferation and slow down gland hyperplasia. This mechanism not only lowers PTH levels but also indirectly improves calcium-phosphorus metabolism disorders, thus alleviating complications such as bone pain, fractures, and vascular calcification caused by CKD-SHPT.

Osteogenic Growth Peptide (OGP) is an active peptide involved in bone metabolism regulation. It promotes osteoblast proliferation, enhances osteogenic activity, stimulates collagen synthesis and bone matrix formation, and regulates bone formation processes. OGP has the potential to counteract the excessive bone resorption and impaired bone formation symptoms associated with CKD-SHPT. By promoting bone formation, it reduces excessive calcium release from bones, facilitates calcium and phosphorus deposition in bone tissue, and indirectly stabilizes blood phosphorus and calcium levels—thus reducing stimulation of the parathyroid gland due to bone calcium loss. Although no drugs targeting OGP have been approved yet, the mechanism of OGP’s bone metabolism regulation offers therapeutic prospects for CKD-MBD-related conditions.

As of the latest practical date, two CaSR agonist drugs have been approved by the FDA.

As of the latest practical date, three CaSR agonist drugs have been approved by the National Medical Products Administration.

As of the latest practical date, five global CaSR agonist candidate drugs for CKD-SHPT are in clinical stages.

Historically, treatment options for overweight and obesity in China were relatively limited. The mismatch between existing treatments and clinical needs has created significant market opportunities for GLP-1 receptor agonists. Development of long-acting GLP-1 drugs can reduce dosing frequency and improve patient compliance, potentially increasing the penetration of GLP-1 therapies. This will expand the patient base and further increase the market penetration of GLP-1 drugs. In 2025, the Chinese overweight and obesity drug market was worth 5.7 billion RMB. It is expected that the market will grow to 23.5 billion RMB by 2030 and to 107.3 billion RMB by 2035.

●Significant Unmet Clinical Needs

Due to modern lifestyle factors such as excessive calorie intake and lack of physical activity, the prevalence of obesity and overweight among children/young adults and elderly people in China and globally has risen rapidly. Several GLP-1R drugs have already been approved; however, many unmet clinical needs remain, including muscle loss after weight loss, severe weight rebound after stopping medication, deterioration of body composition, and failure to fully address various comorbidities common in clinically obese patients.

●Increasing Awareness of Obesity and Overweight Management

Public awareness of health risks related to obesity and overweight is rising, leading to a surge in demand for effective management solutions. According to the "China Public Weight Management and Nutrition Perception Survey Report (2026)", 91.7% of the public recognizes the importance of weight management. Especially the younger generation, who are increasingly affected by obesity and overweight, show a stronger willingness to participate in weight management treatments.

●Multitarget GLP-1 Peptide Drugs Become the Mainstream

Multitarget drugs that activate multiple metabolic-related receptors such as GLP-1R, GIPR, and GCOGR simultaneously to achieve synergistic efficacy and optimized side effects have become a key area of competition for global pharmaceutical companies. Many companies’ multitarget GLP-1-related peptide drugs have proven to be more effective than single-target drugs, and multitarget GLP-1-related peptide drugs are expected to dominate the market.

●Expansion of Indications

Initially, GLP-1 drugs were used only for blood sugar reduction treatment in diabetic patients. With clinical research and the unmet needs of many obese patients, the indications for GLP-1 peptide drugs have gradually expanded to include obesity, CKD with albuminuria, and other metabolic diseases. According to the “Prevalence of Chronic Kidney Disease in China,” over 80% of CKD patients exhibit albuminuria. According to the “Basic Guidelines for the Diagnosis and Treatment of Metabolic-Related Fatty Liver Disease (NMAFLD) (2025 Edition),” there are more than 40 million MASH patients in China, but current drugs can only provide symptom relief with limited effectiveness. GLP-1 peptide drugs have the potential to address these unmet clinical needs and have become one of the most important treatment options in the field of metabolic diseases.