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how much of what we believe about amylin actually comes from co-agonism threads

Trial Data Clean Column ×8 Receipts ×1

Question in the title, detail here: how much of what we believe about amylin actually comes from co-agonism threads.

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.

Carried an assumption over from the tirzepatide board and was corrected within an hour. Deserved.

Read the combination paper twice before saying anything here. The monotherapy and combination arms tell genuinely different stories.

Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.

2,378 up / 534 down82% upvoted60 commentsid 1b0bf121 Jan 2025

60 comments

24 in this archive, depth 4

best — the order this archive was captured in

u/lukas_vermeulen0 points·1 year ago

The engineering problem was duration: native amylin is short-acting and aggregation-prone. A long-acting analogue suitable for weekly administration is what makes the combination clinically interesting.

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u/pancreatitis_scareOP1 point·1 year ago

amylin and GLP-1 are not redundant pathways

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[deleted]1 point·1 year ago

[deleted]

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u/milos_vestergaard1 point·1 year ago

Right, and the tolerability data in the combination arms is the part worth reading properly rather than summarising.

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u/helga_vermeulen1 point·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/yannick_petrov1 point·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/clara_weiss109 points·1 year ago·edited

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/viktor_nkemelu26 points·1 year ago

nothing containing this is approved as a standalone product

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u/pancreatitis_scareOP11 points·1 year ago

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

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u/elin_lundgren87 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/pancreatitis_scareOP54 points·1 year ago

What does the tolerability table in that paper actually say?

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u/nl_verzekering61 points·1 year ago·edited

Bought small deliberately because the evidence base is thin. That felt like the only defensible approach.

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u/kavya_kravchenko73 points·1 year ago

I would not extrapolate the tolerability profile from the monotherapy arm to the combination. The trials report them separately for a reason.

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u/teodor_lokken51 points·1 year ago

Sent a vial to Janoshik because there was almost nothing on file for this compound. 97.7% against a claimed 97.5%, and I posted it because the log needs entries.

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u/ferran_mensah14 points·1 year ago

Yes. The combination is where the interesting effect sizes are, and the monotherapy arms read very differently.

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u/protein_first_pnutrition15 points·1 year ago

long-acting amylin is the whole point of the molecule

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u/controversial_only23 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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u/wrong_network_w19 points·1 year ago

Correction: that is the combination programme, not the monotherapy readout. Different arms, different numbers.

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u/ahmed_fonseca8 points·1 year ago

Yes. Anyone reading this board should hold their conclusions loosely until phase 3 reports.

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u/niels_norgaard41 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/nl_verzekering10 points·1 year ago

Do you have the publication or a summary of it?

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u/noor_hovland3 points·1 year ago

That is preclinical work and the thread is treating it as a human finding.

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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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