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orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes everything about how it is formulated, stored and assayed - a frequent source of confusion here.

14 questions · sorted by votes

34 votes0 answers21k views
What does the mechanism of a GLP-1 receptor agonist predict that SURMOUNT-4 did not test?

Details up front: a GLP-1 receptor agonist · SURMOUNT-4. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by yuki_morishita 19k · 19 months ago
27 votes 4 answers50k views
What does REDEFINE-1 actually establish about tirzepatide?

The case in front of me: REDEFINE-1 · tirzepatide. The figures are clear enough; the question is what they mean and what they do not. I can supply the numbers if the…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by two_two_micron 15k · 2.2 years ago
26 votes 5 answers46k views
Is PIONEER-1 a fair comparison of retatrutide against its comparator arm?

Details up front: PIONEER-1 · retatrutide. I am asking for verification rather than opinion, ideally with something I can read myself. It is possible the evidence…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 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 rania_haddad 17k · 2.4 years ago
26 votes 5 answers22k views
What does TRIUMPH-3 actually establish about mazdutide?

Stated plainly: TRIUMPH-3 · mazdutide. I have read the primary source rather than the summary, which has left me with more questions. I understand the headline. I do…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by kelvin_lam 11k · 19 months ago
25 votes 5 answers29k views
Does the SUSTAIN-6 population resemble anyone asking about dulaglutide here?

What I have: SUSTAIN-6 · dulaglutide. This is presented as though it settles something, and I am not convinced it does. I have two documents that appear to disagree,…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by ellis_thorne 17k · 11 months ago
23 votes3 answers8.9k views
What does orforglipron being a non-peptide small molecule change, practically?

Orforglipron is described as a non-peptide oral GLP-1 receptor agonist, which I take to mean it is a conventional small molecule rather than a peptide with a delivery…

orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
oral-glp1
oral-glp1

Oral routes for GLP-1 receptor agonism: peptide formulations rescued by absorption enhancers such as SNAC, and true small molecules that need no…

14 questions
clinical-trials
clinical-trials

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

913 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
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 ruaidhri_o_shea 51k · 9 months ago
20 votes5 answers17k views
What does the mechanism of mazdutide predict that SURMOUNT-4 did not test?

Numbers first: mazdutide · SURMOUNT-4. I suspect the usual explanation for this is wrong, or at least incomplete. I am aware this may have a boring answer. I would…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by eighty_six_hours 16k · 17 months ago
20 votes 5 answers4.2k views
If food noise returns, is that tolerance or a plateau?

Scale weight, waist circumference and a repetition maximum, all logged weekly. I want to know whether this is a real physical effect or an artefact of how it is…

food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
plateau
plateau

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

35 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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by label_claim 11k · 3 months ago
18 votes 5 answers13k views
Is orforglipron comparable to a peptide agonist on any axis?

I would like to know how much of this is established and how much is a reasonable story. I want to know what the trade-off actually is rather than which option is…

orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
oral-glp1
oral-glp1

Oral routes for GLP-1 receptor agonism: peptide formulations rescued by absorption enhancers such as SNAC, and true small molecules that need no…

14 questions
clinical-trials
clinical-trials

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

913 questions
asked by Dr_Lena_Ostrowska 42k · 10 months ago
16 votes 5 answers9.9k views
What does the mechanism of dulaglutide predict that ESSENCE did not test?

What I am working with: dulaglutide · ESSENCE. The empirical answer seems settled. The explanation does not. If the honest answer is that nobody knows, I would rather…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by micron22 36k · 4 months ago
13 votes 5 answers22k views
What does SELECT actually establish about dulaglutide?

What I have: SELECT · dulaglutide. I can parse the result. I am less sure what it licenses me to conclude. I have deliberately not looked at anyone else’s…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by haze_check 17k · 15 months ago
5 votes 5 answers12k views
What does the mechanism of survodutide predict that ATTAIN-1 did not test?

Conditions: survodutide · ATTAIN-1. I want to know whether this is a real physical effect or an artefact of how it is measured. What prompted the question is an…

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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by oona_kekkonen 16k · 2.1 years ago
3 votes5 answers19k views
What does the mechanism of liraglutide predict that SURMOUNT-5 did not test?

The particulars: liraglutide · SURMOUNT-5. 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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by vial_five 15k · 18 months ago
3 votes5 answers6.5k views
Why does constipation outlast the nausea by months?

It has now persisted for three weeks, which is what moved this from tolerable to worth asking about. I would like the mechanism, because I want to be able to reason…

constipation
constipation

Slowed transit as a consequence of delayed gastric emptying and reduced intake: incidence figures, fibre and hydration evidence, and why it often…

14 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 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
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by swab_and_wait 15k · 9 months ago
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