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c/cagrilintide·posted 7 months ago by u/nz_unfunded

reading REDEFINE threads from 2024 and half of it aged badly

Lab Slow Clap ×2 Long Haul ×1

reading REDEFINE threads from 2024 and half of it aged badly. Making the case below, and I expect to lose some of it in the comments.

Complementary mechanisms are the rationale for pairing: satiety signalling alongside incretin signalling, rather than more agonism at the same receptor.

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.

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.

Would rather be corrected in public than confident in private.

2,588 up / 82 down97% upvoted42 commentsid 1buyi84 Dec 2025

42 comments

30 in this archive, depth 4

best — the order this archive was captured in

u/milos_vestergaard309 points·7 months ago·edited

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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u/yara_mensah199 points·7 months ago

Same view — long-acting is the engineering achievement here, and it is why the molecule exists at all.

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u/emil_agyeman124 points·7 months ago

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

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u/noor_ivaturi-19 points·7 months ago

Combination and monotherapy arms must be read separately. Efficacy and tolerability both differ substantially between them and summaries routinely blur the two.

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u/rina_sobczak91 points·7 months ago

Same view — long-acting is the engineering achievement here, and it is why the molecule exists at all.

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

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u/clara_weiss56 points·7 months ago

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

This is the distinction that keeps this board honest — different axis, not a stronger version of the same one.

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u/rania_marchand71 points·7 months 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/nz_unfunded165 points·7 months ago

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

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u/rina_sobczak133 points·7 months ago

Cosigning on the thin independent data. Fewer members test this, so the bands are wider and should be treated that way.

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[removed]96 points·7 months ago

[removed by moderator]

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u/zaid_balogun65 points·7 months ago·edited

Monotherapy arm or combination arm?

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u/amara_halonen54 points·7 months 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/lucia_bruun113 points·7 months ago

Sent a vial to Medutest because there was almost nothing on file for this compound. 97.6% against a claimed 97.0%, and I posted it because the log needs entries.

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u/rina_sobczak41 points·7 months ago

independent purity data on this compound is thin

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u/emeka_beaulieu0 points·7 months ago

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

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u/marta_ilunga1 point·7 months ago

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

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u/hugo_pires41 points·7 months ago

This. Complementary mechanisms rather than more of the same is the actual argument for the pairing.

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u/controversial_only23 points·7 months ago

Small fix — amylin analogue, not a GLP-1 analogue. The whole mechanism argument changes on that word.

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u/ines_ekstrom115 points·7 months ago

Kept a log purely because so few people are logging this one. It is one person and it is not data.

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u/elin_lundgren0 points·7 months ago

Kept a log purely because so few people are logging this one.

ines_ekstrom is right that the evidence base here is thin. Conclusions should be held loosely.

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u/throwaway_44b154 points·7 months ago·edited

Kept a log purely because so few people are logging this one.

Adding the standing caveat — nothing here is approved standalone and research material is not for human use.

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u/ravi_sandvik77 points·7 months ago

Nothing containing this compound is approved as a standalone product, and research-use-only material is not approved for human use.

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u/hugo_pires62 points·7 months 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/throwaway_44b116 points·7 months ago

amylin analogue, different receptor family, different story

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u/lukas_vermeulen46 points·7 months ago

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

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u/incretin_ivyMOD35 points·7 months ago

Independent result added to the log. Thank you for paying for it — there are very few on this compound.

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u/nz_unfundedOP26 points·7 months ago

Independent result added to the log.

Agreed, and the combination arms are where the interesting numbers actually live.

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u/emeka_beaulieu19 points·7 months 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/micro_bump_mick15 points·7 months ago

That result is preclinical. Worth flagging, since the thread has been reading it as human data.

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u/emil_agyeman14 points·7 months ago

the co-agonism argument is about complementary mechanisms

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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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