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ForumsMASH / Liver DiseaseSurvodutide SYNCHRONIZE Phase 3 — anyone have experience?

Survodutide SYNCHRONIZE Phase 3 — anyone have experience?

Dr.LeslieOBGYN Sun, Apr 5, 2026 at 5:01 PM 7 replies 652 viewsPage 1 of 2
Dr.LeslieOBGYN
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Apr 5, 2026 at 5:01 PM#1

Watching the glucagon co-agonists for the liver endpoints and finding almost nothing written about them that is not a press release.

What would genuinely help is knowing whether the liver signal is independent of weight loss or downstream of it, because that determines whether any of this is interesting for someone whose weight is already where they want it.

Numbers rather than impressions, if you have them.

49 19Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 46 others
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pete_manc_UK
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Apr 5, 2026 at 6:12 PM#2

Short answer first, then the reasoning. Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.

Last edited: Apr 6, 2026 at 12:12 AM
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Dr.GastroMayo
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Apr 5, 2026 at 7:23 PM#3
pete_manc_UK said:
Relative and absolute effects need reading together.

Agreed, and subgroup analyses deserve particular suspicion. With enough subgroups something is significant by chance, and pre-registered subgroups are a different animal from ones found afterwards.

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mel_PDX
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Apr 5, 2026 at 8:34 PM#4
Dr.LeslieOBGYN said:
Watching the glucagon co-agonists for the liver endpoints and finding almost nothing written about them that is not a press release.

Same pattern here, and in the same order.

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lisa_labSD
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Apr 6, 2026 at 3:22 AM#5

Adding the clinical framing, because it changes how the question reads.

Glucagon receptor pharmacology in triple agonists (retatrutide), relevant to the glucagon co-agonists: the glucagon component is the most controversial because glucagon traditionally raises blood glucose. So why include it in an anti-obesity drug?

Key insight: glucagon increases energy expenditure (thermogenesis), promotes hepatic lipid oxidation, and reduces appetite through distinct CNS mechanisms. The hyperglycemic effect is counterbalanced by the GLP-1 component's insulin secretagogue action.

Net result: more weight loss through increased expenditure (glucagon) + decreased intake (GLP-1/GIP), with neutral or improved glycemia. An elegant pharmacological balancing act[1].

References:
[1] Day JW, et al. Nat Rev Drug Discov. 2022;21:37-54.
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