Amycretin in obesity: Mechanisms, clinical efficacy, and future perspectives

The global escalation of obesity necessitates therapeutic interventions that transcend the efficacy ceilings of current mono-target pharmacotherapies. Amycretin, a novel unimolecular co-agonist targeting glucagon-like peptide-1 (GLP-1) and amylin receptors, has emerged as a promising candidate for weight management. In this review, we examine the developmental rationale of amycretin, elucidating how its dual-agonist mechanism synergistically engages hindbrain-mediated satiety pathways and delays gastric emptying to overcome metabolic plateaus. We summarize pivotal findings from recent clinical trials, highlighting that amycretin elicits profound weight reduction-demonstrating up to 13.1% loss with oral administration (12 weeks) and 24.3% with subcutaneous delivery (36 weeks)-with a safety profile consistent with incretin-based classes. Furthermore, we explore the strategic potential of combining amycretin with insulin-independent agents, such as SGLT2 inhibitors, to optimize cardio-renal outcomes. These insights provide a theoretical framework for positioning amycretin in the future management of adiposity-based chronic diseases.