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Conflict, stated first. I am a consultant to Viking Therapeutics, which develops VK2735, and I provide research consulting to Novo Nordisk, which makes a competing drug class. Weigh how I frame everything below with that in mind.
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| Clinical Takeaway |
| Domain | Key Finding | Evidence Level |
| The step-down |
After 21 weeks of weekly injections, people switched to dosing every 4 weeks kept 85% of the weight they had lost, pooled across arms, over 12 more weeks. Every-other-week dosing kept 90%. Switching to placebo kept 61%. |
Phase 1 RCT, ~180; sponsor topline; exploratory endpoint; 10 to 16 per drug arm |
| Treatment discontinuation |
Few stopped treatment because of adverse events: 1 participant (1%) during the 21-week induction, then 1 of 37 (every other week) and 1 of 66 (every 4 weeks) during maintenance. Low discontinuation is not the same as low symptom burden. |
Same study; sponsor topline |
| The context |
The peer-reviewed 13-week injection trial reached 14.7% weight loss at 15 mg, where 20% stopped treatment because of adverse events. The pill reached 12.2% at 120 mg, where 30% stopped treatment because of adverse events vs 13% on placebo. |
Phase 2 RCTs: peer-reviewed paper (injection); topline and conference poster (pill) |
| The caveat |
All 3 studies were sponsor-funded, ran 13 to 33 weeks, and excluded diabetes. 12 weeks cannot establish long-term maintenance. |
Early |
| Where it fits |
Nothing to prescribe for VK2735. For an approved drug, SURMOUNT-MAINTAIN offers 1 year of randomized data on lowering tirzepatide to 5 mg. VANQUISH tests weekly VK2735 only. |
Extrapolation |
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Last week in this newsletter was all new hormones. Glucagon recast from villain to fat-burner. Amylin promoted from footnote to drug class. Then an amylin drug stacked on tirzepatide pushed weight loss to 23.3% in type 2 diabetes. More receptors, bigger numbers.
This week, a different question. What if the next advance isn't another hormone, but the same two, given less often?
VK2735 is Viking Therapeutics' dual GLP-1/GIP agonist. It has 3 sponsor-funded readouts: a 13-week injection trial published in a peer-reviewed journal, a 13-week pill trial reported in a topline release and a conference poster, and a 33-week study of stepping down the dose, so far available only as a topline release. That last study asks what patients on weekly injections eventually ask me: do I have to do this every week, forever?
