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c/survodutide·posted 6 months ago by u/fibre_forward

MASH — my 24-week log, condensed into one table

Caution Sourced ×8

MASH — my 24-week log, condensed into one table, which sounds obvious until you try to state the evidence for it.

It is a dual agonist at the GLP-1 and glucagon receptors. The glucagon arm is associated with increased energy expenditure and with effects on hepatic fat, which is why the development programme is oriented towards liver disease.

Phase 2 in a biopsy-confirmed population is a demanding design: recruitment is slow, the population is specific, and the results do not generalise to people who have not been characterised that way.

Imaging-derived liver fat fraction is a surrogate. It correlates with histology imperfectly, and a trial reporting one is not reporting the other.

If somebody has the same thing measured a different way, post it next to mine and we will see whether they agree.

635 up / 105 down86% upvoted28 commentsid 1wdvuu30 Jan 2026

28 comments

23 in this archive, depth 4

best — the order this archive was captured in

u/clara_restrepo62 points·5 months ago

Independent purity results for this compound are very sparse across the whole site, which means any impression about consistency is built on almost nothing.

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u/liver_enzyme_lizMOD34 points·5 months ago

Removed the escalation schedule. Unapproved compound, no protocols for other members, no exceptions.

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u/lyophile_lou50 points·5 months ago

Went slowly because everything published describes a deliberate escalation. That is the extent of what I will say about it.

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u/dario_boateng-35 points·5 months ago

do not import intuitions from the obesity programmes

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u/fibre_forwardOP1 point·5 months ago

What does the tolerability table say at that dose?

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u/patient_labslip_log1 point·5 months ago

Are you reading the publication or a summary?

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u/fibre_forwardOP1 point·5 months ago

How fast was the escalation in that protocol?

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u/employer_carveout32 points·5 months ago

The endpoint vocabulary, because you cannot read this literature without it.

Resolution of steatohepatitis without worsening of fibrosis and improvement in fibrosis without worsening of steatohepatitis are the two standard composite endpoints, both scored on biopsy by pathologists against a defined system. Liver fat fraction is an imaging surrogate that correlates imperfectly with histology.

A trial can move the surrogate substantially and the histological endpoint modestly. Both results are real; they answer different questions. Anybody quoting a response rate here should say which endpoint it refers to, and most summaries do not.

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u/kaia_kuusela10 points·5 months ago

research material is not approved for human use, which is why the clinical record here is thin

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u/nadia_kjaer3 points·5 months ago

phase 2 in liver disease is a different evidence question from weight

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u/milan_mensah27 points·6 months ago

Assumed the weight numbers were the point and was corrected. They are secondary to what this is being developed for.

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u/valeria_karlsen15 points·5 months ago

Looked for independent results across this whole site and found almost none. Worth knowing before forming an opinion.

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u/kaia_kuusela4 points·5 months ago

dual GLP-1 and glucagon agonist, and the glucagon arm is the story

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u/kian_ferreira12 points·5 months ago·edited

Asked here what the difference was between the imaging and biopsy endpoints and got a genuinely excellent answer.

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u/vitamin_d_void8 points·6 months ago

Cosigning on the glucagon arm. It is the mechanistic thread that connects the hepatic and the metabolic effects.

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u/slow_logbook_notes307 points·5 months ago

Same. Very thin independent data on this one, which should make everybody here more tentative than they are.

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u/santiago_villalobos3 points·5 months ago·edited

Same.

slow_logbook_notes30 is right that biopsy and imaging endpoints are not interchangeable.

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u/nadia_kjaer3 points·5 months ago

That is an escalation schedule for an unapproved compound and this board does not host those.

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u/fibre_forward5 points·5 months ago

That figure is from the obesity programme, and this thread is about the hepatic one.

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u/britt_abubakar2 points·5 months ago·edited

MASH endpoints are histological, which is a much harder bar

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u/camila_marchand2 points·5 months ago

the weight numbers are secondary to what this is being developed for

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u/kasper_cabrera0 points·5 months ago

The escalation schedules in the published protocols are slow and deliberate, and the tolerability tables show why. That is a description of the trials rather than a suggestion for anybody.

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u/camila_marchand0 points·5 months ago

Nothing containing this compound is approved anywhere. Research-use-only material is not approved for human use.

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Survodutide-specific discussion: glucagon-receptor co-agonism, the hepatic fat and MASH resolution data, and how the side-effect profile compares with GIP-based dual agonism. Small community, high signal.

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