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Evidence-based GLP-1 & peptide discussion since 2023
ForumsPharmacology & MechanismsMy pharmacist tried to explain the mechanism and my eyes glazed over — looking for input Page 2

My pharmacist tried to explain the mechanism and my eyes glazed over — looking for input

hannah_MT Thu, Jan 9, 2025 at 3:59 AM 13 replies 1,633 viewsPage 2 of 3
bri_stats
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Jan 9, 2025 at 5:13 AM#6
hannah_MT said:
The mechanism is more central than most summaries suggest.

Amycretin (AMY/GLP-1 dual agonist) emerging data relevant to the pharmacology: Phase 1 showed -13.1% body weight at only 12 weeks, the fastest trajectory ever seen for an anti-obesity agent[1].

Amylin receptor agonism enhances satiety signaling through the area postrema and reduces glucagon secretion. Combined with GLP-1R agonism, this dual mechanism may produce even greater efficacy than current agents.

Early-stage data — interpret with caution. But the trajectory is extraordinary.

References:
[1] Novo Nordisk investor presentation, September 2023.
16 11sarah_nash92, FitDadDave, RunnerRach and 13 others
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Dr.EndoEP
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El Paso, TX
Jan 9, 2025 at 5:41 AM#7

A narrower follow-up, since the general answer is now clear:

What did you change at the same time, and can you separate the two now?

15 10james_edin, FranDenver, Dr.BariatricHTX and 12 others
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Dr.CardioMD
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Jan 9, 2025 at 6:09 AM#8
bri_stats said:
Amycretin (AMY/GLP-1 dual agonist) emerging data relevant to the pharmacology: Phase 1 showed -13.1% body weight at only 12 weeks, the fastest…

PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing. Semaglutide:

  • Tmax: 24-72 hours post-injection
  • T½: ~168 hours (7 days) — enables weekly dosing
  • Steady state: reached at 4-5 weeks
  • Bioavailability (SubQ): ~89%
  • Volume of distribution: ~12.5L (primarily plasma)

The albumin binding (>99%) is the key pharmacological innovation — creating a sustained-release effect from a single injection. Previous GLP-1 agonists (exenatide) required BID dosing due to rapid clearance.

14 9tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 11 others
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hannah_MT
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Jan 9, 2025 at 6:37 AM#9

OP back with an update, since a thread like this is useless without one.

Update — tachyphylaxis to the gastric effect, persistence of the appetite effect. Two curves, and I had been watching the wrong one.

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traveltech_sara
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Jan 9, 2025 at 8:51 AM#10
Dr.CardioMD said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

Semaglutide structural biology relevant to the pharmacology: semaglutide is a 31-amino acid peptide with 94% homology to native GLP-1(7-36). Three key modifications enable its pharmacokinetic profile:

  1. Aib8 substitution: DPP-4 resistance (prevents enzymatic degradation)
  2. Arg34 substitution: improved chemical stability
  3. C18 fatty diacid at Lys26: albumin binding → long half-life

These three modifications transform a peptide with a 2-minute half-life (native GLP-1) into one with a 168-hour half-life (semaglutide). A masterclass in peptide engineering.

21 19BenResearch_OR, MikeKY_noInsulin, Dr.RaviCardio and 18 others
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