Pemvidutide’s Weight Loss and CVD Evidence

The weight loss drug arena might have another contender on the way, as interim Phase 2 results from the MOMENTUM trial show that Altimmune’s pemvidutide drove significant weight loss and improved key cardiovascular metrics.

  • Pemvidutide is an investigational peptide-based GLP-1/glucagon dual receptor agonist  for the treatment of obesity and and non-alcoholic steatohepatitis (NASH)
  • Pemvidutide’s unique dual activation approach is believed to mimic the complementary effects of diet (via GLP-1) and exercise (via glucagon) on weight loss

Twenty four-week data from 160 patients detailed by Medscape showed that different doses of pemvidutide (1.2 mg, 1.8 mg, or 2.4 mg) led to promising weight and cardiovascular improvements. 

That’s especially (and logically) true for patients taking the maximum 2.4 mg pemvidutide dose: 

  • Weight loss = -10.7% vs. -1% w/ placebo
  • Patients who lost ≥5% of their body weight = -66.7% vs. -25% w/ placebo
  • Patients who lost ≥10% of their body weight = ~50%
  • Waist circumference = -10.2 cm
  • Total cholesterol = -16.5%
  • Triglyceride levels = -25%
  • Systolic blood pressure =  -5.5 mm Hg
  • Diastolic blood pressure = -1.8 mm Hg

Similar to other weight loss drugs, pemvidutide led to increased adverse GI events, including four patients reporting severe vomiting in the 2.4 mg group and one patient in the 1.8 mg group. 

  • The researchers and pemvidutide-watchers are likely paying special attention to drug tolerance, noting previous challenges with study participants dropping out due in part to adverse events.

The MOMENTUM trial (48-weeks, 320 participants, 30 sites) is one of the few obesity drug studies not focused on patients who also have diabetes, noting that because pemvidutide has a neutral impact on glucose, it’s specifically intended for treating obesity and nonalcoholic steatohepatitis (not T2D).

This might be precursor to a future trend toward weight loss drug specialization, as GLP-1s like semaglutide and tirzepatide potentially become positioned as ideal for the 20%-25% of obese patients with diabetes, while GLP-1/glucagon agonists like pemvidutide could be targeted at obese patients with fatty liver disease or hyperlipidemia. 

  • The good news for Cardiac Wire readers is all of these drugs appear to have a positive impact on key cardiovascular metrics, and potentially on CV events.

The Takeaway

Although we’re still a few months away from seeing final results from the MOMENTUM trial, these are solid weight loss and cardiometabolic improvements for just 24 weeks, and pemvidutide’s “twincretin” approach seems promising – especially for non-diabetic patients.

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