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ForumsCardiovascular OutcomesHas anyone dealt with anti-thrombotic properties of glp-1 receptor activation? Page 2

Has anyone dealt with anti-thrombotic properties of glp-1 receptor activation?

rachel_ABQ Tue, Nov 18, 2025 at 5:17 PM 30 replies 1,490 viewsPage 2 of 6
Dr.AddMedPHL
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Nov 18, 2025 at 10:06 PM#6
PurityPaulOR said:
Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%),…

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.

Last edited: Nov 19, 2025 at 12:06 AM
50 3FitDadDave, RunnerRach, TrialNerd_Beth and 47 others
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PeptideSynthNJ
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Nov 18, 2025 at 11:59 PM#7
rachel_ABQ 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…

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.
Last edited: Nov 19, 2025 at 3:59 AM
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Dr.NateNeph
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Nov 19, 2025 at 1:52 AM#8
Dr.AddMedPHL said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

Pharmacist here. I want to add the drug interaction perspective on the pharmacology.

Key points from a pharmacokinetic standpoint:

  • GLP-1 agonists delay gastric emptying, which can affect Tmax of co-administered oral medications
  • Monitor patients on warfarin (INR), levothyroxine (TSH), and oral contraceptives during dose titration
  • The albumin-binding mechanism of semaglutide (C-18 fatty acid linker) gives it the ~168-hour half-life that enables weekly dosing
  • Steady state is reached at approximately 4-5 weeks after dose initiation or adjustment

Re: the pharmacology specifically — the pharmacology here is well-characterized and the clinical implications are straightforward.

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dave_SLC
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Nov 19, 2025 at 3:45 AM#9

A narrower follow-up, since the general answer is now clear:

Was that from a primary source or from a summary of one?

Last edited: Nov 19, 2025 at 7:45 AM
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rachel_ABQ
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Nov 19, 2025 at 12:47 PM#10

Closing the loop on my own question.

Update — tachyphylaxis to the gastric effect, persistence of the appetite effect. Two curves, and I had been watching the wrong one.

Last edited: Nov 19, 2025 at 5:47 PM
19 19Dr.CardioMD, EndoResFellow, PharmacoVig_BOS and 16 others
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