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c/orforglipron·posted 1 year ago by u/ice_pack_audit

reading oral GLP-1 threads from 2024 and half of it aged badly

Discussion Long Haul ×6

Posting this as a discussion rather than a claim: reading oral GLP-1 threads from 2024 and half of it aged badly.

What is actually known, and what is being assumed.

Known: it is a small-molecule GLP-1 receptor agonist, dosed daily, with clinical programmes reporting in both obesity and type 2 diabetes. Its tolerability profile broadly resembles the class in the data published so far.

Assumed, frequently and confidently: that milligram comparisons with injectables mean something, that adherence is straightforwardly better because it is a tablet, that peptide purity discussions transfer to it. None of those hold. And nothing containing this compound is approved anywhere, which makes research-use-only material exactly that — not approved for human use.

Why "oral" is doing two completely different jobs in the sentences people write here.

Oral semaglutide is a peptide co-formulated with an absorption enhancer, which is why it comes with food and water timing requirements. This compound is a non-peptide small molecule that activates the same receptor, formulated as an ordinary tablet.

The practical consequences differ enormously: no timing constraints, a conventional manufacturing route, different stability behaviour, and a different analytical problem for anybody trying to verify identity or purity. Whenever a thread here compares the two, check which sense of "oral" each half is using.

Holding off on any opinion until phase 3 reports. That is not a satisfying position and it is the honest one.

Would rather be corrected in public than confident in private.

400 up / 114 down78% upvoted30 commentsid 1w2h8v25 Aug 2024

30 comments

21 in this archive, depth 5

best — the order this archive was captured in

u/dilara_weiss53 points·1 year ago

Nothing containing this compound is approved by any regulator, and research-use-only material is not approved for human use.

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u/mateusz_mensah39 points·1 year ago

I would not assume the tolerability profile transfers exactly. Similar class effects, different exposure profile.

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u/ice_pack_auditOPcold chain45 points·1 year ago

Correcting myself: that was a phase 2 readout and I described it as phase 3.

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u/chidi_yilmaz34 points·1 year ago

ATTAIN and ACHIEVE are the programmes to keep straight

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u/purity_pedantanalytical8 points·1 year ago·edited

the manufacturing story is genuinely different from the injectables

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u/piotr_bruun10 points·1 year ago

oral semaglutide is a peptide with an absorption enhancer, this is not that

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u/meera_sandvik17 points·1 year ago

small molecule, not a peptide, and that changes everything about it

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u/discount_math_dm11 points·1 year ago

Compared milligram figures across two completely different molecule classes in a comment. Deserved the correction.

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u/farid_kuipers35 points·1 year ago

no food and water restrictions is the practical difference people care about

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u/salma_almeida31 points·1 year ago

Analytically this is a small-molecule identity and purity problem, not a peptide one. The methods, the impurity classes and the reference standards are all different.

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u/the_poster_in_question_202630 points·1 year ago·edited

Careful — purity methods for peptides do not read across to a small molecule and the numbers are not equivalent.

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u/preservative_free_p9 points·1 year ago·edited

the tolerability profile reads broadly similar to the class

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[deleted]6 points·1 year ago

[deleted]

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u/scam_taxonomyc/scamalerts5 points·1 year ago

Are you comparing doses across a small molecule and a peptide?

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u/throwaway_wl20261 point·1 year ago·edited

Are you comparing doses across a small molecule and a peptide?

Adding the standing caveat — unapproved, and research material is not for human use.

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u/brigade_detector14 points·1 year ago

The analytical point, which this board keeps getting wrong by importing habits from the peptide side.

For a peptide, purity is typically reported as area percent by HPLC with identity by mass spectrometry, and the impurity classes are things like deletion and oxidation products. For a small molecule the relevant impurities are synthetic intermediates, degradants and residual solvents, and identity is established differently.

So the certificate you would want looks different, the questions to ask are different, and a "purity" figure quoted here is not comparable to one quoted on the peptide boards. Anybody posting a result should say what method produced it, which is good practice everywhere and essential here.

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u/deleted_my_history4 points·1 year ago

That is a phase 2 result being quoted as though the programme had reported.

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u/flair_enthusiast3 points·1 year ago

It is a non-peptide small-molecule agonist at the GLP-1 receptor. That is a substantial medicinal chemistry achievement: getting a small molecule to activate a receptor evolved for a peptide ligand.

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u/ice_pack_auditOPcold chain3 points·1 year ago

What did the tolerability table look like at that dose?

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u/preservative_free_p15 points·1 year ago

Daily dosing, so what does the exposure profile look like across the day?

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u/phase_two_peteMOD10 points·1 year ago·edited

Standing reminder: unapproved compound, research material is not for human use, and no schedules for other members.

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The small-molecule oral: why a non-peptide agonist escapes the absorption problems of oral semaglutide, what the ATTAIN and ACHIEVE readouts showed, and what a pill with no refrigeration requirement would do to the entire supply conversation this site is built around.

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