My Five Go To GLP-1 Related Videos (plus two Honorable Mentions!) 1️⃣-Dr. Ania Jastreboff interview with Dr Harlan Krumholz on Obesity Medication Usage (16 min) A simple intro on the use of GLP-1s. Great for anyone. Dr Jastreboff is gifted at being utterly winsome in describing these meds and their usage. Very down to earth. She led SURMOUNT-1, the primary trial used for Zepbound’s approval as an obesity medication. She describes how these meds re-regulate the body’s defended fat mass, pushing the defended fat mass downward and allowing patients to lose weight. Establishes “start low and go slow” for titration and recommends that doctor not move patients up in dose automatically, but instead only as needed and only after meaningful side effects have resolved. She also sets appropriate expectations for the weight loss and plateau phases of treatment, particularly related to how appetite and cravings will change through those phases. “Once a patient reaches plateau, their appetite and even their cravings return, but the weight does not as long as they remain on the therapy.” piped.video/j3k3UAEqJio?si=hV4H…

I’m ridiculously, stupidly proud of my joke. Smiling to myself all morning. What a nerd! 🤓🤣

I am shocked Lilly wasted time on the alpha argument and didn’t spend time on the “analogous” to a protein argument AND the 60 day argument. The “analogous” is what got them the remand in the first place. Mind blown that they didn’t continue on that track. 🤯 Definitely still want the best possible pricing for consumers - particularly because I myself need additional therapy and don’t expect my insurance to readily cover Reta.

⚖️ Last week’s warning letter from the FDA to Empower pharmacy may have substantially lowered the stakes for Lilly in their lawsuit against the FDA on retatrutide’s designation. If compounding is reigned in by the FDA to actually just cover scripts for patients truly requiring a compounded product, not merely as a stand-in for a low cost generic, then Lilly has a lot less to lose if Reta is still deemed a drug. They’d obviously love a few more years of exclusivity and the extra hoops for getting a bio similar approved, but, make no mistake, compounding is the big reason Lilly wants the biologic designation.

⚖️ People have really misunderstood this letter by Steven Hazel in relation to Lilly v. Kennedy (FDA). Steven Hazel is one of the lawyers representing the appellees (the FDA). This is *not* the DOJ stepping in to remind the court of something they must adhere to like some referee - it’s the DOJ lawyer who represents the FDA in this very case doing this on behalf of his FDA clients. (The DOJ represents the FDA in court cases.) See the case docket. courtlistener.com/docket/731…

Summary.

🚨Huge 48wk T2D and overweight/obesity results for enicepatide (CT-388) a GLP-1/GIP from Genentech/Roche and Zealand. ▪️2.65% reduction in A1C is 🔥 ▪️15.5% weight loss, which puts it in the current top tier. This is “without a demonstrable plateau.” ▪️ 90% of patients in the 24 mg cohort reached an HbA1c level of ≤6.5% (diagnostic threshold for T2D) and 62% achieved normoglycemia (HbA1c < 5.7%). Begs the question: why has Viking not also pursued a T2D program for VK2375 in parallel? I presume it’s a question of cash. Also smart to release this data before EloraTirz T2D data comes out next week. But more about enicepatide! “Enicepatide was designed to have potent activation of both GLP-1 and GIP receptors, but with minimal to no ß-arrestin recruitment on either receptor. This biased signalling significantly minimizes receptor internalization and consequent desensitization, which is expected to lead to prolonged pharmacological activity.” gene.com/media/press-release…