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c/cagrilintide·posted 1 year ago by u/noor_vermeulen

the satiety question that gets asked weekly, answered properly

Caution Long Haul ×4

the satiety question that gets asked weekly, answered properly, and I am aware this is a minority view on this board.

Why this compound is not simply another agonist, which is how it gets described everywhere else.

Amylin is co-secreted with insulin and signals satiety through its own receptor complexes. It is a different axis from the incretin system, not a parallel version of it. That is why the combination story is interesting: two mechanisms that address appetite differently, rather than more agonism at one receptor.

It is also why the dosing intuitions people bring from the semaglutide and tirzepatide boards do not transfer. Different receptors, different exposure-response, and no published schedule anybody here can reason from.

Reading the trial literature on this without misleading yourself.

Separate the monotherapy arms from the combination arms before you do anything else. They report different effect sizes and different tolerability, and almost every summary that circulates blends them.

Then read the tolerability tables rather than the headline. In combination work the interesting question is whether adding a second mechanism adds effect without adding proportionate side effects, and that question is answered in a table nobody quotes.

Finally, note the durations. Comparing a shorter readout here with a longer one from an established compound is not a comparison at all.

The honest state of the evidence on this board, since somebody should write it down.

Published clinical data exists and is genuinely interesting, particularly in combination. Independent purity data from members is thin — a handful of results across the whole site, against hundreds for the older molecules. Nothing containing this compound is approved as a standalone product, and research-use-only material is not approved for human use.

What follows practically: buy small if you buy at all, test what you get and post the result, and treat confident rankings against established compounds as the extrapolation they are. The board gets better as the log fills, and right now the log is nearly empty.

That is everything I have. The rest is opinion and I have tried to keep it out.

3,418 up / 2,974 down53% upvoted27 commentsid 1agfd521 Oct 2024

27 comments

21 in this archive, depth 5

best — the order this archive was captured in

u/niels_norgaard82 points·1 year ago

Amylin is co-secreted with insulin and acts on satiety and gastric emptying through its own receptor complexes. An amylin analogue is therefore not a variant of an incretin agonist — it is a different signalling axis.

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u/nz_unfunded66 points·1 year ago

Independent purity data on this compound is sparse compared with the older molecules, simply because far fewer members have paid for testing. Sparse data means wide uncertainty, not a verdict.

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u/ines_ekstrom-28 points·1 year ago·edited

read the combination arms separately from the monotherapy arms

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u/zeynep_zielinski1 point·1 year ago

read the combination arms separately from the monotherapy arms

Disagreeing with this line: that figure is from a combination arm and is being quoted as monotherapy.

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u/zeynep_zielinski61 points·1 year ago

Push back: the evidence base here is thin enough that a confident ranking against the established compounds is not supportable.

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[deleted]23 points·1 year ago

[deleted]

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u/titration_marshalmod · c/semaglutide16 points·1 year ago

do not assume the dosing intuitions from the GLP-1 boards transfer

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u/teodor_lokken37 points·1 year ago·edited

Careful — that is a dosing intuition carried over from another board and there is no basis for it here.

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u/liv_dumitru20 points·1 year ago

Asked a question here that turned out to be based on a mechanism confusion. Three people untangled it patiently.

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u/forest_plot_fionastats16 points·1 year ago

long-acting amylin is the whole point of the molecule

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u/ledger_modMOD20 points·1 year ago

Retitled to distinguish the combination arm from the monotherapy arm, which the original ran together.

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u/chidi_yilmaz11 points·1 year ago

Disagree — you are quoting a combination arm as though it were monotherapy. Those are different results.

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u/lane_map_larrylogistics6 points·1 year ago

Agreed that the monotherapy numbers look modest out of context and that the context is the whole story.

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u/tomas_kimani8 points·1 year ago

Not convinced. Amylin signalling is not a GLP-1 pathway and the mechanism you are proposing conflates them.

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u/solene_abubakar5 points·1 year ago

Dosing intuitions from the GLP-1 boards do not transfer. Different receptor family, different exposure-response, and no published schedule for members to reason from.

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Amylin analog pharmacology and the CagriSema combination: why amylin and GLP-1 co-agonism produces a different satiety profile, the REDEFINE readouts, and the very limited pool of people handling cagrilintide as research material.

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