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ForumsPharmacology & MechanismsGLP-1/GIP receptor co-agonism — September 2026 Page 2

GLP-1/GIP receptor co-agonism — September 2026

AussieAnna Thu, Aug 29, 2024 at 11:51 PM 11 replies 1,876 viewsPage 2 of 3
Dr.PainCLE
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Aug 30, 2024 at 10:01 AM#6
BenResearch_OR said:
The GIP arm is doing real work rather than padding the label.

Pushing back on BenResearch_OR here. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

9 4Dr.PathRoch, mona_PHX, andrew_nyc and 6 others
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Dr.AddMedPHL
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Aug 30, 2024 at 2:02 PM#7

One concrete data point for the thread. Numbers worth memorising for this class: Tmax one to three days for the weekly peptides, terminal half-life about a week for semaglutide and about five days for tirzepatide, steady state at four to five half-lives, subcutaneous bioavailability high enough that site choice is irrelevant.

8 3sarah_nash92, FitDadDave, RunnerRach and 5 others
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Dr.GutHealth
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Aug 30, 2024 at 6:03 PM#8
Dr.PainCLE said:
The "tirzepatide is simply better" summary irritates me.

Coming at Dr.PainCLE’s question from a different direction. The mechanism is more central than most summaries suggest. Receptor agonism in the arcuate nucleus activates POMC neurons and inhibits AgRP/NPY signalling, and the downstream MC4R pathway is the same one disrupted in monogenic obesity — convergent genetic evidence that the target is the right one. Peripherally there is glucose-dependent insulin secretion, glucagon suppression and delayed gastric emptying, but the gastric component largely adapts over months while the central effect persists, which is why the durable effect is appetite rather than fullness.

Last edited: Aug 30, 2024 at 11:03 PM
7 2jennifer_SEA, tyler_CSCS, VanRx_Mike and 4 others
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wendy_avl
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Aug 30, 2024 at 10:04 PM#9

A narrower follow-up, since the general answer is now clear:

How much of the tirzepatide advantage is the GIP component and how much is simply that the dose ladder goes higher in receptor-occupancy terms?

6 1PharmHunterJen, TomTeleRx, DoseLogDan and 3 others
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AussieAnna
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Aug 31, 2024 at 5:20 PM#10

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

Reporting back after another eight months at the same dose. Still losing slowly, no new side effects, and no reason I can find to climb further.

Last edited: Aug 31, 2024 at 6:20 PM
38 11pete_manc_UK, anna.melb_AU, mark_tokyo and 35 others
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