Glucagon—a new player in weight management therapeutics?

GLP-1 receptor agonists were first launched as glucose-lowering therapies for people with type 2 diabetes in 2005. GLP-1 receptor agonists are peptides, initially available as twice-daily injections but later formulated for once-weekly subcutaneous administration and more recently once-daily oral dosing. In phase 3 clinical trials, GLP-1 receptor agonists were associated with weight loss independent of glucose-lowering. This led to clinical trial programmes of once-daily liraglutide and once-weekly semaglutide at higher doses than those licenced for diabetes management and their subsequent approvals for weight management. 1 Bain SC Fat – pharmacological therapies. Br J Diabetes. 2022; 22: 559-561 Google Scholar The increase in use of GLP-1 receptor agonists for weight loss, much of it off-licence, is at least partly responsible for the global shortages of these medicines over the past 12 months. 2 Iacobucci G Diabetes: doctors are told not to start new patients on GLP-1 agonists because of shortages. BMJ. 2023; 3822019 Google Scholar Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trialAll tested survodutide doses were tolerated, and dose-dependently reduced bodyweight. Full-Text PDF