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While anorectics like GLP-1s help people lose weight, the weight loss is typically a mix of fat and lean mass. Lilly hoped that by anabolic agent, they can preserve lean mass while maintaining and enhancing fat mass
Earlier this month, Regeneron and Scholar Rock demonstrated that the composition of weight loss (fat mass %, lean mass %) could be altered by adding a weak anabolic agent, anti-myostatin, to GLP-1s
In Regeneron’s COURAGE Phase 2, neutralization of an additional ligand, Activin A, further improved weight loss composition. Just 6% of weight lost was lean mass. But, multiple patient deaths ignited safety concerns.
Lilly’s Bimagrumab blocks the receptor for myostatin and activin A. In a prior Phase 2, Bimagrumab helped T2D patients lose fat mass while increasing lean mass. Lilly hopes that a strong anabolic agent like bimagrumab can help achieve pure fat mass loss, but avoid the safety
Today, Lilly revealed the weight loss & composition at 48 weeks
Sema: -13.5% (72% Fat)
Bima: -8.6% (100% Fat)
Bima + Sema: -16.4% (>90% Fat)
Patients on bima+sema saw >40% decrease in body fat with **no change** in lean mass at 24W. Overall, bima and bima+sema were well tolerated
No striking SAE imbalances
This is important for a few reasons:
1. Preserving lean mass *might* enhance durability of weight loss
2. Lean mass preservation is a major concern for key groups (elderly, limited mobility, etc.)
3. Lilly leads in a lane competitors had hoped to use to break into to
GLP-1 agents, and their multi-agonist derivatives, are great for wight loss. But, as patients discontinue, weight rebounds. The composition of the weight rebound has not been assessed in an RCT, but it is likely mostly fat
Can retaining metabolically active skeletal muscle help
Repeated weight-loss, weight-regain cycles are associated with an increased risk of development of sarcopenia, a key concern for older adults
Earlier this year, Veru assessed this in a study of older adults. They found deficits in power for adults >65 y/o on GLP-1s for 4 months
Lilly has set the bar for weight loss yet again
While Bima won't be a solution for everyone, many patients will benefit
Emerging competitors hoping to carve out the lean mass sparing weight loss niche to differentiate from Lilly and Tirzepatide might need to reevaluate
In the end, Lilly acheived more weight loss and more fat loss
Lilly's Bima is in multiple Ph2b studies with Tirzepatide, (BELIEVE was initiated prior to Lilly's acquisition of Bima vs. Versanis)
With today's results, we're another step closer to solving the obesity epidemic
How long until it's released the public after trials and all that?
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What were the deaths in the regeneron study attributed too?
what is your take on these studies? Can this solve obesity problems?
Ho letto che gli anabolizzanti alzanonol livello di testosterone (il chè può andare abbastanza bene per un maschio ma non lo è per niente per una femmina).
Cosa si consiglierebbe ad una donna?
In più: molta massa spesso è costituita da un tessuto limpedematoso e linfedematoso
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