On The Pen GLP-1 News

Retatrutide’s New Phase 3 Data, CagriSema in Menopause, and the Growing GLP‑1 Access CrisisHost Dave Knapp recaps major obesity-drug updates, focusing on Eli Lilly’s triple agonist retatrutide and Novo Nordisk’s CagriSema. He reviews Triumph 1 obesity results (up to 25% average weight loss at 80 weeks) and highlights New England Journal of Medicine Phase 3 data showing large reductions in obstructive sleep apnea events in people with and without type 2 diabetes, while noting uncertainty about weight-loss versus nervous-system mechanisms. He also covers TRANSCEND CKD Phase 2B kidney findings: no significant improvement in measured GFR, but favorable secondary markers including reduced urine albumin in a subset. Novo’s post hoc Redefine 1 analyses show strong CagriSema weight loss across pre-, peri-, and post-menopausal women. He discusses Zealand/Roche’s petrelintide Phase 2 results emphasizing low GI discontinuation and argues tolerability matters as much as potency. The episode closes on worsening affordability and coverage, including employers dropping benefits and Pennsylvania Medicaid GLP-1 spending rising to an estimated $1.3B, warning restricted access fuels the gray market.00:00 Big Week in Obesity Drugs00:53 Show Intro and Disclaimers02:03 Sponsor Spotlight VoaFit03:06 Retatrutide Weight Loss Context05:27 Sleep Apnea Phase 3 Results10:23 Beyond Weight Loss Benefits12:14 Kidney Study Nuance16:53 CagriSema Menopause Data19:20 Petrelintide Amylin Update23:33 Top Host Voting Pitch ( otplinks.com )25:29 Access and Coverage Crisis27:42 Medicaid Costs and Gray Market31:21 Wrap Up and Schedule

Specific lots of compounded tirzepatide have been recalled over sterility concerns, another pharmacy recently recalled compounded semaglutide after particulate matter was identified, patients have reported visible strands and fibers in other compounded GLP-1 vials, and now FDA inspectors have documented black mold, insects, hidden paperwork, and questionable testing practices at facilities manufacturing GLP-1 active ingredients.So, should people taking compounded GLP-1s panic? No.Millions of people have used compounded semaglutide and tirzepatide, and these incidents still appear relatively uncommon compared with the enormous scale of use. But patients deserve transparency about who made their medication, where the active ingredient came from, what testing was performed, and what happens when something goes wrong.In this episode of On The Pen, we break down:- The Apothecary Pharma compounded tirzepatide recall- The affected lots and sterility concerns- Apollo Care and the compounded semaglutide “floaters”- The Hyalo/NewLife vials with reported visible strands or particulate- FDA findings involving black mold, insects, records, and GLP-1 API suppliers in China- Why these stories should not become Pharma vs. compounding- Why pharmaceutical manufacturers deserve scrutiny too- CagriSema, amylin, and why I’m watching January 2027- Lilly’s $1.1 billion METiS TechBio deal- Why the future of obesity and diabetes treatment needs to move beyond GLP-1s and weekly shots foreverAffected lot numbers and supporting links:👉 https://otplinks.comThe goal here is not fear. It is giving patients enough information to understand what they are actually injecting and enough context to put these stories into perspective.Subscribe to On The Pen for breaking GLP-1, obesity, diabetes, and metabolic health news.🔗 All my links: https://linktr.ee/manonthemounjaro#GLP1 #Tirzepatide #Semaglutide #Mounjaro #Zepbound #Ozempic #Wegovy #CompoundedGLP1 #CagriSema #WeightLossNews

Eli Lilly’s fight over retatrutide may be about much more than one obesity drug.I’ve been covering retatrutide since early 2023, and since late 2024 I’ve been closely following the legal fight over whether reta should be treated as a biologic. From the beginning, I’ve argued that this case could have consequences far beyond retatrutide itself.In this episode, I break down the growing unauthorized retatrutide market, the serious adverse events and death reports now entering the conversation, Lilly’s repeated legal actions against sellers, the restricted Seventh Circuit filings, and new context I’ve heard from someone connected to senior HHS policy discussions.The biggest question is no longer simply what happens to retatrutide. It’s whether this case could help shape how future peptide medicines are classified, regulated, and protected.I’m continuing to track the Seventh Circuit docket and work on the restricted filings. If those documents become available or I can independently confirm what is in them, subscribers at obesity.news and OnThePen.com will hear about it first.This episode is brought to you by VoaFit and Trilogiii Daily Essentials. Check the links in the show notes, and use code OTP10 for Trilogiii.Visit Trilogiii: https://triii.life/tiers/daily-essentials?utm_source=onthepen&utm_medium=influencer&utm_campaign=dave_knappVisit Voafit: https://www.voafit.com/otp

Zepbound isn’t just changing people’s weight. GLP-1 medications are beginning to change America itself.

Restaurants are rethinking what they serve. Grocery baskets are changing. Food companies are paying attention to protein and portion size. Employers and insurers are wrestling with the enormous cost of covering obesity treatment. And pharmaceutical companies are spending billions trying to build the drugs that come after Zepbound.

This week on On The Pen, The Weekly Dose, we’re connecting those dots.

We get into the next generation of obesity medicines, including retatrutide, eloralintide, amylin combinations and oral GLP-1s, plus the growing race to preserve muscle while producing even greater weight loss.

But there is another side to this story.

As the science gets better, access may actually be getting worse. Coverage restrictions are forcing patients off medications that work, employers are reconsidering GLP-1 benefits, and we’re approaching a strange moment where medicine may finally have extraordinarily effective treatments for obesity while millions of people still can’t afford them.

And then there’s McDonald’s.

When one of the largest restaurant companies in the world starts thinking differently about what consumers want in the GLP-1 era, this isn’t just a pharmaceutical story anymore.

It’s a cultural one.

🎙️ On The Pen, The Weekly Dose
Recorded from the Bask Health Studios
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This Episode is Brought to you by:
Voafit and the MyLevel App
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Follow On The Pen and find everything I’m working on here:
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In this episode: Retatrutide • Zepbound • Mounjaro • Ozempic • Wegovy • Eloralintide • Oral GLP-1s • Amylin • Muscle preservation • GLP-1 insurance coverage • The changing American food industry

This content is for informational purposes and is not medical advice.

This week on On The Pen, The Weekly Dose, we break down one of the biggest weeks in obesity medicine coming out of EASD 2026.Eli Lilly says Zepbound may still outperform Wegovy 7.2 mg, even after Novo Nordisk tripled the familiar maintenance dose, but the details are more complicated than the headline. We dig into the difference between the treatment-regimen and efficacy estimands, and why this was not a true head-to-head trial.We also cover Novo Nordisk’s $2.6 billion bet on a potential once-weekly oral GLP-1/GIP, new Foundayo data against high-dose oral semaglutide, Viatris and Mylan’s renewed patent fight over the future of generic Wegovy, and the full Phase 3 retatrutide publication in the New England Journal of Medicine.Plus, after weeks of concern over GLP-1 medications and NAION-related vision loss, we look at one practical thing patients may be able to do right now to better understand their own baseline risk.This episode is about more than who “wins” between Lilly and Novo. It is about what the data actually says, where the next generation of obesity treatment is headed, and what all of this means for patients trying to make informed decisions with their doctors.Covered in this episode: Zepbound vs. Wegovy 7.2 mg, retatrutide TRIUMPH-1 Phase 3 data, Foundayo/orforglipron, oral semaglutide, once-weekly oral GLP-1s, generic Wegovy patent litigation, NAION, GLP-1 vision risk, EASD 2026, Eli Lilly, Novo Nordisk, Viatris and Mylan.Subscribe for breaking GLP-1, obesity, diabetes and metabolic-health news, explained from the patient perspective.Get Exclusive OTP Savings and Resrouces:Https://www.otplinks.comGet Breaking Obesity Medicine News:HTTPS://www.onthepen.com