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ForumsPublic SquareGLP-1 receptor desensitization and tachyphylaxis — looking for input

GLP-1 receptor desensitization and tachyphylaxis — looking for input

maya_sedona Tue, May 6, 2025 at 2:55 PM 14 replies 1,543 viewsPage 1 of 3
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maya_sedona
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Sep 2024
Sedona, AZ
May 6, 2025 at 2:55 PM#1

Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience both.

Numbers worth memorising for this class: Tmax one to three days for the weekly peptides, terminal half-life about a week for semaglutide and about five days for tirzepatide, steady state at four to five half-lives, subcutaneous bioavailability high enough that site choice is irrelevant.

What I am after is which effects tachyphylax and which persist, because the answer explains why tolerability improves while the appetite effect keeps working.

Tell me what I have not thought of.

47 0wanda_boise, NurseAsh_DET, BenResearch_OR and 44 others
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RetaRick_CA
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May 6, 2025 at 3:03 PM#2
maya_sedona said:
Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…

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.

48 1AmyNC_wife, SkepticalSean, Dr.CardioMD and 45 others
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SkepticalSean
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Maine
May 6, 2025 at 3:11 PM#3
RetaRick_CA said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

Agreeing with RetaRick_CA, and the qualification matters more than the agreement. The mechanism is more central than most summaries suggest. Receptor agonism in the arcuate nucleus activates POMC neurons and inhibits AgRP/NPY signalling, and the downstream MC4R pathway is the same one disrupted in monogenic obesity — convergent genetic evidence that the target is the right one. Peripherally there is glucose-dependent insulin secretion, glucagon suppression and delayed gastric emptying, but the gastric component largely adapts over months while the central effect persists, which is why the durable effect is appetite rather than fullness.

49 2emma_london, tammy_FL, Dr.LipidDallas and 46 others
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ZaraB_AL
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May 6, 2025 at 3:19 PM#4
maya_sedona said:
Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…

Adding a me-too, because a thread of one person's experience is not much use.

Last edited: May 6, 2025 at 4:19 PM
50 3TrialTracker_MD, JennaRN, LabKate and 47 others
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sophie_paris
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May 6, 2025 at 4:02 PM#5

Adding the clinical framing, because it changes how the question reads.

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.
Last edited: May 6, 2025 at 9:02 PM
1 4BethLabQueen
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