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(Eli Lillys pill Foundayo led to the same rate of weight loss in a Phase 3 study that lasted twice as long, but its hard to compare across trials in different phases.) In a separate Phase 2 trial in people with diabetes, called SOLSTICE, patients on the highest dose saw up to a 1.74 percentage-point decrease in a measure of blood sugar called A1C after 26 weeks

It may therefore interfere with methylation- dependent metabolism and indicate poor flow through the methionine cycle

and for those tesamorelin-treated patients completing the 26-week treatment period that were re-randomized to tesamorelin (T-T group) or re-randomized to placebo, 48.9% and 50.6%, respectively, had impaired glucose tolerance, while 4.3% re-randomized to tesamorelin and 12.9% re-randomized to placebo had diet-controlled diabetes mellitus

Practical takeaway Until stronger evidence exists, the review argues the path forward is collaborative pregnancy registries + better real-world data, so inadvertent exposures can be counselled with confidenceand so we can finally test whether pharmacotherapy could ever play a role in carefully selected high-risk cases