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c/survodutide·posted 1 year ago by u/trialwatch_theo

glucagon is the most under-discussed thing on this board

Caution Receipts ×4 Cold Box ×2

Something I keep coming back to: glucagon is the most under-discussed thing on this board.

Imaging-derived liver fat fraction is a surrogate. It correlates with histology imperfectly, and a trial reporting one is not reporting the other.

Nothing containing this compound is approved anywhere. Research-use-only material is not approved for human use.

The escalation schedules in the published protocols are slow and deliberate, and the tolerability tables show why. That is a description of the trials rather than a suggestion for anybody.

Would rather be corrected in public than confident in private.

1,927 up / 169 down92% upvoted56 commentsid 1uz9k910 Sep 2024

56 comments

26 in this archive, depth 5

best — the order this archive was captured in

u/nadia_kjaer174 points·1 year ago

It is a dual agonist at the GLP-1 and glucagon receptors. The glucagon arm is associated with increased energy expenditure and with effects on hepatic fat, which is why the development programme is oriented towards liver disease.

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u/incretin_ivyMOD95 points·1 year ago

Left up. It reads the paper carefully and is explicit about the population.

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u/santiago_villalobos115 points·1 year ago

Phase 2 in a biopsy-confirmed population is a demanding design: recruitment is slow, the population is specific, and the results do not generalise to people who have not been characterised that way.

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u/heart_rate_bump160 points·1 year ago

Which endpoint — histological response, fibrosis improvement, or fat fraction?

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u/joaquin_ivaturi78 points·1 year ago

phase 2 in liver disease is a different evidence question from weight

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u/vitamin_d_void-12 points·1 year ago

Yes — nothing containing this is approved anywhere, which is the first fact and usually the last one mentioned.

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u/trialwatch_theoOPtrial nerd1 point·1 year ago

Biopsy-confirmed population or imaging-selected?

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u/trialwatch_theoOPtrial nerd1 point·1 year ago

Which phase and which arm are you quoting?

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u/britt_okwuosa1 point·1 year ago

fibrosis improvement without worsening steatohepatitis is the phrase to learn

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u/whois_wanda1 point·1 year ago

Histological endpoints in this field are scored on biopsy: resolution of steatohepatitis without worsening of fibrosis, or improvement in fibrosis without worsening of steatohepatitis. Both are harder to achieve and to interpret than an imaging surrogate.

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u/meera_sandvik1 point·1 year ago·edited

Small fix — dual agonist, GLP-1 and glucagon. No GIP arm in this molecule.

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u/laila_yilmaz1 point·1 year ago

biopsy-confirmed is not the same as imaging-suggested

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u/jarno_adeyemi56 points·1 year ago

Assumed the weight numbers were the point and was corrected. They are secondary to what this is being developed for.

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[removed]42 points·1 year ago

[removed by moderator]

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u/refund_ledger0 points·1 year ago

Not convinced. Imaging-based fat fraction is not the same as a histological response and the paper is explicit about that.

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u/yannick_petrov1 point·1 year ago

do not import intuitions from the obesity programmes

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u/rania_marchand25 points·1 year ago

How fast was the escalation in that protocol?

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u/tired_ledger_ftw35 points·1 year ago

glucagon agonism and energy expenditure is the mechanistic thread

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u/customs_seizure_sid21 points·1 year ago

Has anyone posted an independent purity result for this compound?

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u/joaquin_ivaturi11 points·1 year ago·edited

Asked here what the difference was between the imaging and biopsy endpoints and got a genuinely excellent answer.

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u/elin_ferrari20 points·1 year ago

the titration in the trials was slow and deliberate

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About c/survodutide

Survodutide-specific discussion: glucagon-receptor co-agonism, the hepatic fat and MASH resolution data, and how the side-effect profile compares with GIP-based dual agonism. Small community, high signal.

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