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ForumsPharmacology & MechanismsTachyphylaxis vs tolerance — looking for input Page 2

Tachyphylaxis vs tolerance — looking for input

TrialTracker_MD Sun, Oct 6, 2024 at 12:48 PM 9 replies 1,875 viewsPage 2 of 2
HPLC_Greg
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Oct 7, 2024 at 4:14 AM#6
TrialTracker_MD said:
The pharmacokinetics explain nearly every practical question asked here.

Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%), creating a depot effect with a ~168-hour half-life enabling weekly dosing[1].

Tirzepatide is a dual GIP/GLP-1R agonist with higher GIP affinity (5:1 GIP:GLP-1 potency ratio). The GIP component may enhance beta-cell function and adipocyte lipid metabolism beyond what GLP-1 alone achieves.

For the pharmacology, the pharmacology explains the clinical differences between these agents.

References:
[1] Lau J, et al. J Med Chem. 2015;58(18):7370-7380.
Last edited: Oct 7, 2024 at 10:14 AM
2 22SallyK_inj, CryptoCarl
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robert_kc
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Oct 7, 2024 at 10:21 AM#7

Following on from KevinCompounds — and this may be the naive question:

Was that from a primary source or from a summary of one?

1 21SleepFixSam
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Dr.MetabolicMD
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Oct 7, 2024 at 4:29 PM#8
HPLC_Greg said:
Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%),…

PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing. Semaglutide:

  • Tmax: 24-72 hours post-injection
  • T½: ~168 hours (7 days) — enables weekly dosing
  • Steady state: reached at 4-5 weeks
  • Bioavailability (SubQ): ~89%
  • Volume of distribution: ~12.5L (primarily plasma)

The albumin binding (>99%) is the key pharmacological innovation — creating a sustained-release effect from a single injection. Previous GLP-1 agonists (exenatide) required BID dosing due to rapid clearance.

Last edited: Oct 7, 2024 at 6:29 PM
50 20HealthEcon_DC, PedsEndoPhilly, SleepDoc_PDX and 47 others
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TrialTracker_MD
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Oct 7, 2024 at 10:37 PM#9

OP back with an update, since a thread like this is useless without one.

Update — tachyphylaxis to the gastric effect, persistence of the appetite effect. Two curves, and I had been watching the wrong one.

49 19Dr.PulmRoch, maya_sedona, stefan_berlin and 46 others
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rick_sfbay
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Oct 9, 2024 at 4:03 AM#10
Dr.MetabolicMD said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

Amycretin (AMY/GLP-1 dual agonist) emerging data relevant to the pharmacology: Phase 1 showed -13.1% body weight at only 12 weeks, the fastest trajectory ever seen for an anti-obesity agent[1].

Amylin receptor agonism enhances satiety signaling through the area postrema and reduces glucagon secretion. Combined with GLP-1R agonism, this dual mechanism may produce even greater efficacy than current agents.

Early-stage data — interpret with caution. But the trajectory is extraordinary.

References:
[1] Novo Nordisk investor presentation, September 2023.
Last edited: Oct 9, 2024 at 10:03 AM
5 3Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 2 others
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