The Peptide CommonsEst. May 2024
Independent. We sell nothing and are affiliated with no manufacturer or pharmacy. Every moderation action is logged in public
Compounds · Retatrutide · continued

Retatrutide dose escalation in the published trials posts 61–90

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

VK
v.kjaerTL2 Moderator28 Mar 2025#61

Picking up post #58: that is the part I would want checked first.

The phase 2 obesity paper reported dose-dependent weight reduction of a magnitude that attracted attention. It also reported dose-dependent heart-rate increases. The heart-rate signal is the reason phase 3 exists rather than something assumed negligible based on phase 2.

1 like 16mo
G
GEldridgeTL3Regular29 Mar 2025#62
p.mwangi, post #10: Dose escalation in the published trials: the protocols started at lower doses and escalated by defined steps. The step sizes are documented and they may or may not match what someone self-prescribing would choose. Go to post

TRIUMPH is phase 3 and it is ongoing. No phase 3 results exist. Nothing should be attributed to TRIUMPH because the trial has not finished. When it does, this page will update.

7 likes in reply to #10 16mo
AN
a.nascimentoTL2 Moderator29 Mar 2025#63
f.fontaine, post #31: TRIUMPH is phase 3 and it is ongoing. No phase 3 results exist. Nothing should be attributed to TRIUMPH because the trial has not finished. When it does, this page will update. Go to post

Hepatic effects: glucagon receptor agonism promotes hepatic fat oxidation, which is mechanistically plausible for benefit in metabolic liver disease. Whether that translates to improved clinical outcomes is being tested in phase 2 work.

23 likes in reply to #31 16mo
DB
d.bramleyTL329 Mar 2025#64
MA
m.almeidaTL2 Moderator29 Mar 2025#65

This follows post #62 rather than contradicting it.

Why this subcategory is more cautious than elsewhere: retatrutide is investigational, phase 3 is ongoing, and the heart-rate signal in phase 2 is not negligible. Caution is proportionate to the evidence status.

0 likes 16mo
KB
k.brandl_deTL3Translator · DE30 Mar 2025#66
r.mensah, post #4: How to read phase 2 without treating it as phase 3: phase 2 establishes that a dose range produces an effect and is tolerable enough to justify large trials. It does not establish safety, durability, or whether real humans differ from the selected population. Go to post

I read post #64 twice before replying, because I had assumed the opposite.

Mass and identity: a report on retatrutide should state the mass detected by LC-MS, not assume a theoretical mass. The theoretical mass is not published in peer-reviewed literature for retatrutide at present.

3 likes in reply to #4 16mo
YI
y.ibarraTL2 Moderator30 Mar 2025#67

Triple agonism: is the effect additive, synergistic, or neither? A phase 2 comparison of tirzepatide (dual) to retatrutide (triple) would answer that question. The published data does not include such a direct comparison.

17 likes 16mo
AK
a.kowalczykTL2Regular30 Mar 2025#68

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

33 likes 16mo
NV
n.vukovicTL2 Moderator30 Mar 2025#69

Phase 2 sample sizes are not adequate for safety characterisation of a novel triple agonist. Phase 3 is where that question gets answered. Using phase 2 results to make claims about safety profile is using the trial for a purpose it was not designed for.

6 likes 16mo
PN
plateau_notesTL2Regular31 Mar 2025 · edited#70

Coming back to post #68, because the follow-up matters more than the original answer.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

16 likes 16mo
JF
j.fonsecaTL2 Moderator31 Mar 2025#71

Dose escalation in the published trials: the protocols started at lower doses and escalated by defined steps. The step sizes are documented and they may or may not match what someone self-prescribing would choose.

0 likes 16mo
DO
dr_okonkwoTL4 Moderator31 Mar 2025 · edited#72
Staff post. Actions described here are recorded in the public moderation log and may be challenged in Meta.

post #71 answers the question as asked. The question underneath it is different.

Retatrutide is investigational. Anything obtained outside a trial is by definition research-use-only material with no human-use authorisation. This site will state that plainly rather than winking at it.

31 likes 16mo
NB
n.brobergTL2 Moderator1 Apr 2025#73
c.grimaldi, post #42: Hepatic effects: glucagon receptor agonism promotes hepatic fat oxidation, which is mechanistically plausible for benefit in metabolic liver disease. Whether that translates to improved clinical outcomes is being tested in phase 2 work. Go to post

Coming back to post #71, because the follow-up matters more than the original answer.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

10 likes in reply to #42 16mo
PW
PharmNotes_WhitfieldTL4Pharmacist1 Apr 2025#74
two_year_line, post #26: Coming back to post #24, because the follow-up matters more than the original answer. TRIUMPH is phase 3 and it is ongoing. No phase 3 results exist. Nothing should be attributed to TRIUMPH because the trial has not finished. When it does, this page will update. Go to post

Why this subcategory is more cautious than elsewhere: retatrutide is investigational, phase 3 is ongoing, and the heart-rate signal in phase 2 is not negligible. Caution is proportionate to the evidence status.

3 likes in reply to #26 16mo
IA
i.almeidaTL2 Moderator1 Apr 2025#75

Worth separating two things that post #71 runs together.

How to read phase 2 without treating it as phase 3: phase 2 establishes that a dose range produces an effect and is tolerable enough to justify large trials. It does not establish safety, durability, or whether real humans differ from the selected population.

1 like 16mo
OO
orbitrap_olaTL3Mass spectrometrist1 Apr 2025#76

post #75 is right about the mechanism and I think understates the practical bit.

Hepatic effects: glucagon receptor agonism promotes hepatic fat oxidation, which is mechanistically plausible for benefit in metabolic liver disease. Whether that translates to improved clinical outcomes is being tested in phase 2 work.

0 likes 16mo
RF
ro.friskTL2 Moderator2 Apr 2025#77

Glucagon receptor agonism seems paradoxical in a weight-loss compound because glucagon raises blood glucose. The paradox resolves because glucagon agonism also increases energy expenditure and promotes hepatic fat oxidation, and the incretin components offset the glycaemic effect. In diabetes trials, HbA1c improved rather than worsened.

15 likes 16mo
DS
dr_seongTL3Physician2 Apr 2025#78
b.oyler, post #36: For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use. Go to post

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.

6 likes in reply to #36 16mo
FW
f.weissTL2 Moderator2 Apr 2025 · edited#79

On post #75 — agreed on the reasoning, with one qualification.

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

3 likes 16mo
CL
customs_ledgerTL3Regular2 Apr 2025#80
aliquot_line, post #55: How to read phase 2 without treating it as phase 3: phase 2 establishes that a dose range produces an effect and is tolerable enough to justify large trials. It does not establish safety, durability, or whether real humans differ from the selected population. Go to post

What we do not know about retatrutide, listed explicitly: long-term safety, real-world response rates, the dose response in diverse populations, whether the heart-rate signal persists or attenuates, durability of effect on withdrawal, efficacy in comorbidities beyond obesity.

0 likes in reply to #55 16mo
RM
r.mcalisterTL3Regular2 Apr 2025#81
v.kjaer, post #61: Picking up post #58: that is the part I would want checked first. The phase 2 obesity paper reported dose-dependent weight reduction of a magnitude that attracted attention. It also reported dose-dependent heart-rate increases. The heart-rate signal is the reason phase 3 exists rather than something assumed negligible based on phase 2. Go to post

The phase 2 obesity paper reported dose-dependent weight reduction of a magnitude that attracted attention. It also reported dose-dependent heart-rate increases. The heart-rate signal is the reason phase 3 exists rather than something assumed negligible based on phase 2.

0 likes in reply to #61 16mo
IB
i.balogunTL2 Moderator3 Apr 2025#82

TRIUMPH is phase 3 and it is ongoing. No phase 3 results exist. Nothing should be attributed to TRIUMPH because the trial has not finished. When it does, this page will update.

4 likes 16mo
DT
dexa_twice_yearlyTL3Regular3 Apr 2025#83

Picking up post #80: that is the part I would want checked first.

Phase 2 sample sizes are not adequate for safety characterisation of a novel triple agonist. Phase 3 is where that question gets answered. Using phase 2 results to make claims about safety profile is using the trial for a purpose it was not designed for.

13 likes 16mo
HF
h.friskTL2 Moderator3 Apr 2025#84

Coming back to post #82, because the follow-up matters more than the original answer.

Retatrutide is investigational. Anything obtained outside a trial is by definition research-use-only material with no human-use authorisation. This site will state that plainly rather than winking at it.

27 likes 16mo
BV
bias_varianceTL4Biostatistician3 Apr 2025#85
n.broberg, post #73: Coming back to post #71, because the follow-up matters more than the original answer. Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had been repeating something I had not checked carefully enough. Go to post

Triple agonism: is the effect additive, synergistic, or neither? A phase 2 comparison of tirzepatide (dual) to retatrutide (triple) would answer that question. The published data does not include such a direct comparison.

2 likes in reply to #73 16mo
MS
m.steinerTL2 Moderator4 Apr 2025#86

Dose escalation in the published trials: the protocols started at lower doses and escalated by defined steps. The step sizes are documented and they may or may not match what someone self-prescribing would choose.

8 likes 16mo
FD
f.demirTL2Regular4 Apr 2025#87

This follows post #84 rather than contradicting it.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

19 likes 16mo
AI
a.iyerTL2 Moderator4 Apr 2025 · edited#88
n.abernathy, post #47: What we do not know about retatrutide, listed explicitly: long-term safety, real-world response rates, the dose response in diverse populations, whether the heart-rate signal persists or attenuates, durability of effect on withdrawal, efficacy in comorbidities beyond obesity. Go to post

Mass and identity: a report on retatrutide should state the mass detected by LC-MS, not assume a theoretical mass. The theoretical mass is not published in peer-reviewed literature for retatrutide at present.

0 likes in reply to #47 16mo
CR
compounding_ruthTL4Pharmacist4 Apr 2025#89

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.

0 likes 16mo
HD
h.delgadoTL2 Moderator5 Apr 2025#90
ambient_draft, post #17: Dose escalation in the published trials: the protocols started at lower doses and escalated by defined steps. The step sizes are documented and they may or may not match what someone self-prescribing would choose. Go to post

On post #86 — agreed on the reasoning, with one qualification.

Dose escalation in the published trials: the protocols started at lower doses and escalated by defined steps. The step sizes are documented and they may or may not match what someone self-prescribing would choose.

0 likes in reply to #17 16mo