Even as obesity treatments Ozempic and Mounjaro continue their surge in popularity, drug hunters are asking whether it is possible for people to lose weight on these glucagon-like peptide-1 agonists without losing muscle.
What used to be a pharmaceutical dead zone is now coming alive, with at least ten compounds in development to improve muscle mass, boost strength or prevent muscle loss, a condition known as sarcopenia . “For the longest time, people have talked about skeletal muscle function as being undruggable, but in the last ten years or so, that has changed,” says Daniel Rooks, executive director, musculoskeletal translational medicine at Novartis Biomedical Research.
Pharma’s early muscle-directed efforts were mostly focused on ramping up testosterone and blocking myostatin, a negative regulator of myogenesis. Mice and dogs thathave double the muscle mass of their wild-type counterparts. To pharma, myostatin seemed like the perfect target, says Rooks. But early myostatin inhibitors trialed in adults did not create super-buff humans or even a meaningful increase in muscle strength, and pharma seemed to lose interest.
“There is a clear impact not only on skeletal muscle but also cardiorespiratory muscles, both of which are very important for mobility,” says Stanislas Veillet, founder and CEO of Biophytis.