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ForumsPharmacology & MechanismscAMP signaling cascade from GLP-1R activation — need advice

cAMP signaling cascade from GLP-1R activation — need advice

LondonLisa Tue, Sep 24, 2024 at 3:28 AM 13 replies 1,952 viewsPage 1 of 3
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LondonLisa
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Sep 24, 2024 at 3:28 AM#1

I went looking for why the dosing schedule is what it is and found that almost every practical question on this board has a pharmacokinetic answer nobody states.

What I actually want to know is which effects tachyphylax and which persist, because the answer explains why tolerability improves while the appetite effect keeps working.

Numbers rather than impressions, if you have them.

4 24SaraMom3, Dr.MetabolicMD, RetaRick_CA and 1 other
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PurityPaulOR
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Sep 24, 2024 at 3:45 AM#2
LondonLisa said:
I went looking for why the dosing schedule is what it is and found that almost every practical question on this board has a pharmacokinetic answer…

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.

3 23MikeNYC_runner
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carlos_SATX
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Sep 24, 2024 at 4:02 AM#3
PurityPaulOR said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

PurityPaulOR has the substance of this right. The condition it depends on is worth stating. 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.

2 22Dr.BariatricHTX, LindaRN_retired
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nick_SD_fit
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Sep 24, 2024 at 4:19 AM#4
LondonLisa said:
I went looking for why the dosing schedule is what it is and found that almost every practical question on this board has a pharmacokinetic answer…

Can confirm. Same sequence, different timescale.

1 21PharmacoVig_BOS
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VendorMark
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Sep 24, 2024 at 5:49 AM#5

Adding the clinical framing, because it changes how the question reads.

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.
50 20claudia_zurich, nancy_portland, rick_sfbay and 47 others
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