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cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here concern the amylin contribution, why a co-formulation is not the same as two injections, and how to read a combination trial.

14 questions · sorted by votes

39 votes 4 answers28k views
Five weeks with no scale movement at month five: how do I tell adaptive thermogenesis from adherence drift?

Month five, semaglutide 1.7 mg, and the scale has not moved in five weeks. Before that I was averaging about 0.5 kg a week fairly reliably. I am now at 88.1 kg from a…

plateau
plateau

A stall in progress: distinguishing adaptive thermogenesis from measurement error from adherence drift, how long to observe before changing…

35 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
nutrition
nutrition

Eating on a suppressed appetite: hitting nutritional targets inside a small energy budget, micronutrient risk, meal structure, and what the trial…

92 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
asked by nynke_dekker 18k · 15 months ago
38 votes 2 answers28k views
What does the mechanism of tirzepatide predict that SURPASS-2 did not test?

The particulars: tirzepatide · SURPASS-2. I understand the observation; what I do not understand is the mechanism behind it. I have read the two review articles that…

glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gip-receptor
gip-receptor

GIP receptor pharmacology, and the still-unsettled question of whether agonism or antagonism at GIPR is the metabolically useful direction.…

83 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
asked by sample_id 17k · 19 months ago
28 votes 5 answers28k views
Does the REDEFINE-1 population resemble anyone asking about liraglutide here?

Conditions: REDEFINE-1 · liraglutide. I would like to know the limits of what can be inferred from this. What I am trying to avoid is over-reading a single result,…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
survodutide
survodutide

A GLP-1 and glucagon receptor dual agonist with a substantial published MASH dataset. Use this tag for its hepatic endpoints, its dose ladder, and…

14 questions
asked by seven_day_half 16k · 15 months ago
25 votes5 answers17k views
Is SELECT a fair comparison of liraglutide against its comparator arm?

Concretely: SELECT · liraglutide. The claim is plausible, which is exactly why I want to check it. I am able to read a paper if someone points me at one. Can anyone…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
tirzepatide
tirzepatide

A dual GIP and GLP-1 receptor agonist. Questions here cover the SURPASS and SURMOUNT programmes, the practical differences from a pure GLP-1…

162 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
asked by bridget_nyathi 16k · 23 months ago
24 votes 3 answers11k views
CagriSema in REDEFINE - why did 22.7% get treated as a disappointment?

REDEFINE 1 reported mean weight loss of about 22.7% for CagriSema at 68 weeks, which as far as I can tell is the largest figure any phase 3 obesity trial has…

cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
amylin
amylin

Amylin and its analogues, most prominently cagrilintide, as a satiety mechanism orthogonal to incretin signalling. Includes the pharmacology of…

14 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
glucagon-receptor
glucagon-receptor

Glucagon receptor agonism as a deliberate component of dual and tri-agonists: what it adds in energy expenditure and hepatic fat mobilisation, and…

14 questions
asked by cake_collapsed 13k · 13 months ago
23 votes0 answers4.8k views
Is STEP 4 a fair comparison of orforglipron against its comparator arm?

Numbers first: STEP 4 · orforglipron. I am asking for verification rather than opinion, ideally with something I can read myself. It is possible the evidence exists…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
tirzepatide
tirzepatide

A dual GIP and GLP-1 receptor agonist. Questions here cover the SURPASS and SURMOUNT programmes, the practical differences from a pure GLP-1…

162 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
asked by tare_weight 47k · 5 months ago
22 votes1 answer9.3k views
Why does amylin co-agonism add to a GLP-1 effect rather than duplicate it?

I am asking mechanistically rather than practically — I want the model, not the protocol. I can predict the outcome but I cannot explain it, which means I will get…

amylin
amylin

Amylin and its analogues, most prominently cagrilintide, as a satiety mechanism orthogonal to incretin signalling. Includes the pharmacology of…

14 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
asked by cake_intact 18k · 11 months ago
19 votes 5 answers28k views
What does the mechanism of mazdutide predict that FLOW did not test?

Details up front: mazdutide · FLOW. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how confident…

glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gip-receptor
gip-receptor

GIP receptor pharmacology, and the still-unsettled question of whether agonism or antagonism at GIPR is the metabolically useful direction.…

83 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
amylin
amylin

Amylin and its analogues, most prominently cagrilintide, as a satiety mechanism orthogonal to incretin signalling. Includes the pharmacology of…

14 questions
asked by gel_pack_warm 13k · 2.4 years ago
18 votes 5 answers9.9k views
What does STEP 4 actually establish about ecnoglutide?

The particulars: STEP 4 · ecnoglutide. I have the document in front of me and I can read the numbers. What I cannot do is interpret them. I am reasonably comfortable…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
cardiovascular
cardiovascular

Cardiovascular outcomes: the SELECT major-adverse-event result, SOUL, SUSTAIN 6 and REWIND, how to convert a hazard ratio into an absolute risk…

111 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
asked by micron22 36k · 3 months ago
14 votes 5 answers7.1k views
Does splitting a 50 mg weekly dose of semaglutide across two administrations change anything?

The specifics, since they change the answer: 50 mg · semaglutide. I would like the mechanism, because I want to be able to reason about the cases nobody has written…

split-dosing
split-dosing

Dividing a weekly dose across more than one administration. Questions here concern the pharmacokinetic rationale, whether the peak-to-trough ratio…

39 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
asked by tadhg_o_riordan 14k · 3 months ago
13 votes 5 answers9.3k views
Is STEP 1 a fair comparison of oral semaglutide against its comparator arm?

The case in front of me: STEP 1 · oral semaglutide. I want to know whether there is evidence behind this or only repetition. I have checked the obvious registries and…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
tirzepatide
tirzepatide

A dual GIP and GLP-1 receptor agonist. Questions here cover the SURPASS and SURMOUNT programmes, the practical differences from a pure GLP-1…

162 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
hormones
hormones

Endocrine changes accompanying substantial weight loss: sex hormone binding globulin, testosterone, oestradiol, cortisol and the reproductive…

14 questions
asked by deamidation_watch 43k · 3 months ago
9 votes 5 answers27k views
CagriSema versus a tri-agonist — different mechanisms, same result?

I am asking mechanistically rather than practically — I want the model, not the protocol. The comparison I want does not seem to exist anywhere in a form I can…

cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
retatrutide
retatrutide

An investigational GLP-1, GIP and glucagon receptor tri-agonist, studied in the TRIUMPH programme. Not approved anywhere. Use this tag for…

14 questions
amylin
amylin

Amylin and its analogues, most prominently cagrilintide, as a satiety mechanism orthogonal to incretin signalling. Includes the pharmacology of…

14 questions
asked by bufferline42 49k · 20 months ago
6 votes0 answers2.7k views
Does splitting a 50 mg weekly dose of ecnoglutide across two administrations change anything?

For reference: 50 mg · ecnoglutide. I understand the observation; what I do not understand is the mechanism behind it. I have read the two review articles that come…

split-dosing
split-dosing

Dividing a weekly dose across more than one administration. Questions here concern the pharmacokinetic rationale, whether the peak-to-trough ratio…

39 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
asked by threadlock7 14k · 4 months ago
5 votes5 answers12k views
How many weeks to steady state for semaglutide on a weekly schedule?

My background is chemistry rather than physiology, which may explain where I am stuck. I want the working, not the result — I need to be able to redo it with…

glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
cagrisema
cagrisema

A fixed-ratio combination of cagrilintide, a long-acting amylin analogue, with semaglutide, studied in the REDEFINE programme. Questions here…

14 questions
liraglutide
liraglutide

A once-daily GLP-1 receptor agonist and the compound that established the class. Still relevant for its shorter half-life, its paediatric and…

14 questions
asked by mz_4113 99k · 2.0 years ago
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