The quantity and quality of emerging data on amylin, a pancreatic beta cell hormone, have provided valuable updates to help healthcare professionals understand its use and how well it is tolerated in both animals and humans, according to panelists during the symposium, Amylin as a Novel Diabetes and Obesity Therapy, held Friday, June 5.

“Not only are these weight loss drugs, these are also health-gain drugs, gains that we can materialize when we are treating our patients,” said Carel le Roux, MBChB, FRCP, FRCPath, PhD, Professor and Director of the Metabolic Medicine Group at University College Dublin, Ireland. He summarized findings from six monotherapy trials and two combination trials, including the REDFINE series.

“We use this clinical trial data to try and predict where we will be in one, two, or three years from now, given this incredible new class of medications,” Dr. le Roux said. “Ultimately, we want to predict how these assets will behave in clinical practice.”

On-demand access to recorded presentations from this and other sessions will be available to registered participants following the conclusion of the 2026 Scientific Sessions, from June 10–August 10.

Dr. le Roux shared findings from a study of the long-acting human amylin analog cagrilintide that resulted in double-digit weight loss. He added that the drug works in the subcortical areas of the brain, a part of the brain researchers now think is causing the disease of obesity.

In sharing data on the efficacy and tolerability of eloralintide, a long-acting, selective amylin receptor agonist, he noted the top dose of 9 mg resulted in vomiting in 11% of participants, yet a smaller dose titration, from 3–9 mg, resulted in a vomiting rate of 2%. Such results reinforce how well-tolerated amylin-based medications are, he noted.

Key data from the REDEFINE 1 trial, in which patients were treated with 2.4 mg of CagriSema, showed a high proportion of participants in all active treatment arms achieved a weight loss of 5% or 10%, and most participants achieved weight reduction at 68 weeks. The most common adverse events were gastrointestinal (GI), and the onset was mainly during dose escalation.

In REDEFINE 2, patients achieved up to a 15.7% reduction in body weight. Further, the proportion of participants reaching 5%–20% weight loss thresholds in REDEFINE 2 was significant, at 89.7%.

Regarding the quantity and speed of amylin studies, Dr. le Roux emphasized the importance of good clinical observation in the process of uncovering benefits, noting that researchers and healthcare professionals working together will be invaluable moving forward in clinical practice.

“Amylin-based medications will have a role both as monotherapy and as combination therapies, because of this added efficacy on top of other treatments,” Dr. le Roux said.

And while he acknowledged that many questions still need to be addressed, he remained encouraged.

“Ultimately, I’m confident that this class is going to make a very big impact on your patients and my patients to allow us to have sustained health gains,” Dr. le Roux concluded.

Thomas Alexander Lutz, DVM, PhD, Professor in Veterinary Physiology at the University of Zurich, Switzerland, discussed neuropharmacology and biological actions of amylin, focusing on the current understanding in rodents. He detailed studies showing that amylin decreases eating and lowers body weight in rats. He also noted that the decrease in energy expenditure is attenuated. Dr. Lutz also shared insights from trials showing that amylin prevented the decrease in energy expenditure that would typically result from reduced eating and ensuing body weight loss.

In sharing reasons why amylin-based pharmacology may provide advantages over currently available therapies, he identified better tolerability, positive effects on bone health, better preservation of skeletal muscle, and an increase in leptin sensitivity.

Dr. Lutz discussed the effects of amylin agonists on different organs, specifically addressing muscle mass and bone loss. He noted a large body of literature on in vitro animal models showing amylin and salmon calcitonin (sCT) reduce bone resorption, and amylin increases bone formation. He added that while preclinical data are not conclusive, calcitonin receptor expression in adult stem cells (satellite cells) in skeletal muscle is important for function and recovery.

“We really have to learn a lot more about the biology and pharmacology of the animal receptors,” Dr. Lutz stated. “There’s a lot more to learn than just focusing on the specificity for the one or the other receptor. Several studies published in recent years show the need to look into each one of the amylin analogs, and then receptor agonists, to understand how they interact with the receptor systems, and what they actually do to the interaction of the core receptor.”

Serving as symposium moderator and a panelist, W. Timothy Garvey, MD, Professor of Nutrition Science at the University of Alabama at Birmingham (UAB) and Director of the UAB Diabetes Research Center, focused on long-acting amylins and the pharmacotherapeutic landscape of obesity and diabetes. He explained that amylins reduce caloric intake and induce weight loss by binding receptors in the hypothalamus and area postrema. Early clinical trials find they achieve weight loss of 10–20%. Further, long-acting amylins have been found to add to weight loss in combination with glucagon-like peptide-1 (GLP-1) receptor agonists, while showing low rates of GI side effects and improvements in cardiometabolic disease risk factors.

Dr. Garvey added that, despite the availability of second-generation medications, the greatest challenge now being faced is maintaining patients on long-term therapy.

“I think there’s a bright future here,” said Dr. Garvey. In acknowledging the divergent demands of doctors, patients, pharmaceutical companies, and investors, he added, “I hope they will continue to think outside the GLP-1 box to develop new mechanisms of action, new drugs that help us better individualize care.”

As he sees it, practitioners are seeking obesity medication that provides about 15% weight loss in a majority of patients, is well tolerated, affordable, accessible, and promotes long-term medication persistence.

Potential mechanisms of action and targets that Dr. Garvey shared included controlled metabolic accelerators, cannabinoid-1 receptor blockers, brain-penetrant NLRP3 inflammasome inhibitors, long-acting corticotropin-releasing factor receptor 2 (CRF2) agonists, and long-acting therapies with less frequent administration.

Register On-site for the 2026 Scientific Sessions

You can register on-site at the Ernest N. Morial Convention Center in New Orleans to join the 2026 Scientific Sessions, taking place June 5–8. Don’t miss your chance to learn about the latest advances in diabetes research, prevention, and care. After the meeting, registered participants will have on-demand access to recorded presentations.