u/cato_batista

oral and non-peptide is the whole engineering story

Bacteriostatic water contains a preservative, which is what makes repeated entry into a vial reasonable. Sterile water does not, and the two are not interchangeable for that purpose.

Correction: that is the authorisation position, and the question was about reimbursement.

Disagreeing with this bit: that criterion belongs to one member state and is being quoted as general.

This. The absence of food and water timing restrictions is the practical difference people will actually notice.

Kept a vial at room temperature for eleven days by accident. Tested it out of guilt. It was fine.

the reimbursement criteria are published in most member states

Disagree. You are comparing doses across a small molecule and a peptide, which is not a comparison of anything.

This. Albumin binding and modification are why the half-life is what it is, and it is a design decision rather than an accident.

the weight numbers are secondary to what this is being developed for

What pack size is that price for?

Yes. Clothes fitting differently arrives well before the scale acknowledges anything.

That is area percent from a certificate, not the amount of peptide in the vial. Two different numbers and a very common mix-up.

It is a dual agonist at the GLP-1 and glucagon receptors. The glucagon arm is associated with increased energy expenditure and with effects on hepatic fat, which is why the development programme is oriented towards liver disease.

Which member state?

MASH endpoints are histological, which is a much harder bar

phase 3 is where the comparison becomes fair

bruno_dumitru is right that milligram comparisons across classes tell you nothing.

Correcting myself: the readout I quoted was the 46-week interim rather than the endpoint.

Correction: that is the imaging endpoint, not the histological one. The paper reports both and they differ substantially.

That figure is from the obesity programme, and this thread is about the hepatic one.

Assumed a prescription would be honoured across the border. It was not, and the rules are clear once you actually read them.

Which programme and which readout are you quoting?

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

Assumed the peptide purity conversations transferred and they do not. Different analytical problem entirely.

Titration is a tolerance ladder. Each step exists so the gastrointestinal effects settle before the next increase, which is why the intervals are what they are.

Stalled for 20 weeks and measured my waist out of stubbornness. It had moved. The scale had not.

dual GLP-1 and glucagon agonist, and the glucagon arm is the story

Was completely wrong about the gastric emptying story in a thread here two years ago. Someone corrected me with a citation and I have not made that mistake since.

Careful — you have a plausible mechanism and no evidence that it is the operative one in the case you are describing.

Asked here what the difference was between the imaging and biopsy endpoints and got a genuinely excellent answer.

the manufacturing story is genuinely different from the injectables

powder at room temperature for a few days is usually a non-event

This. The published reimbursement criteria are the document to read, and most member states do publish them.

GLP-1 receptor agonism acts both peripherally — insulin secretion in a glucose-dependent way, slowed gastric emptying — and centrally, on appetite regulation. The central component is the better explanation for sustained intake reduction.

MASH endpoints are histological, which is a much harder bar

Moved everything off the fridge door after reading a thread here and my temperature log immediately got boring.

Small fix — the two programme names got swapped upthread and it changes which population the figure came from.

fridge, not freezer, once it is in solution

nils_ferreira is right that the pack failing is not the material failing. Two separate claims.

Because it is not a peptide, it is not subject to the same degradation pathways, does not require the absorption enhancers used for oral peptides, and can be formulated as a conventional tablet.