Published today, the first-ever clinical practice guideline on cardiovascular-kidney-metabolic (CKM) syndrome from the American Heart Association and @ACCinTouch. The focus of this clinical practice guideline is to create a living, working document that provides current knowledge in the field of CKM syndrome aimed at all practicing cardiologists, endocrinologists, nephrologists, and primary care and specialty clinicians who manage these patients. ✍🏼 @ChiadiNdumele @HeartDocSadiya @kardiologykazi @noshreza @virani_md @biykemb @NutritionHF @mandeepbajaj65 @KatherineTuttl8 @RangaswJ @lisaVWMD @KBreathettMD @EmoryFamMed @ShoaClarke @mad_sters @jmortonmd @sripalbangalore @AnumSaeedMD

Canada STUNS USA to win GOLD at the U18 AmeriCup 🔥 @americup USA’s U18 team won Gold at the previous seven tournaments.

The main challenge 8 yrs ago was convincing patients and health care providers that obesity was a chronic disease that deserved effective treatment. Now the challenge is keeping up with the quickly evolving landscape of treatment options and research that proves how correct that assertion was.

Comparison of hemoglobin A1c reduction among semaglutide, tirzepatide, and retatrutide. Comparable A1c reduction of retatrutide and tirzepatide in this indirect comparison. This disproves the hypothesis that adding glucagon agonism would increase glucose.

A summary slide of the TRIUMPH-1 retatrutide data presented today by Dr. Ania Jastreboff at #ADA2026 🚨 TRIUMPH-1: Phase 3 Obesity Trial with Retatrutide 🚨 Retatrutide 💉, a once-weekly triple hormone receptor agonist. 📅 80 weeks (20 months) | 12 mg ⬇️ 28.3% average body weight reduction ⚖️ 70.3 lbs (31.9 kg) lost 📈 Participants in Extension lost up to 30% (85 lbs) on average at 104 weeks 🎯 Weight Reduction Thresholds ✅ Nearly all lost ≥5% ✅ Over 85% lost ≥15% ✅ More than 1 in 4 lost ≥35% 📏 Anthropometric Treat-to-Target 🔵 BMI <30 → 2/3 🔵 BMI <25 → 1/3 📅 At 80 weeks | 4 mg (just 1 titration step) → 19% body weight reduction 🩺 Health Outcomes 🦵 Knee OA: >70% reduction in WOMAC pain subscale 😴 OSA: >60% reduction in AHI 🩸 Prediabetes reverted to normoglycemia in >95% of participants ⬇️ TG 41.0% | LDL 19.6% | SBP 12.3 mmHg ⚠️ Safety 🤢 Most common side effects were gastrointestinal, more frequent with RETA 9 & 12 mg 📉 Reported hypotension more common with RETA in participants on antihypertensive meds 🚽 UTIs more common with RETA, occurring mostly in female participants #ADASciSessions #Obesity #Retatrutide

Now you see it now you don’t 👀✨ Before and after survodutide 48 weeks treatment. 35% liver fat content ➡️ 2% fat content in this patient. Poof 🪄💨 Results from survodutide’s SYNCHRONIZE-MASLD trial.

And today @JAMA_current Mazdutide, also a GLP-1 and glucagon dual receptor agonist with similar body weight loss as Survodutide jamanetwork.com/journals/jam…

The tide is coming in. High tide of the X-tides, that is in the new GLP-1 family of peptide drugs. Today @NEJM survodutide, a GLP-1 and glucagon dual receptor agonist (no GIP, like tirzepatide) drug that achieved ~16% body weight loss at 2 different doses cf placebo nejm.org/doi/full/10.1056/NE…

Retatrutide publication to me feels similar to the transformative moment that Chat GPT dropped - an awareness that we are entering into a new world.

Retatrutide in adults with obesity over 104 weeks in the highest dose group had 30.3% weight loss. Nearly 2/3 reached BMI < 30 1 in 3 reached BMI < 25

I'll have A LOT of retatrutide thoughts. But these cardiometabolic improvements are stunning. 40% drop in triglycerides, 20% drop in LDL. 63% drop in hsCRP, 12 point reduction in BP. It's not a stretch to imagine this drug massively reducing death from CVD and CKD all on its own.

If you haven't connected Claude to an Obisidian Vault, you are missing out on a superpower! For someone like me who has numerous tangential ideas, interests, projects that exceed my deficient organizational skills, its a "game changer." I used @dSebastien obsidian starter kit to get me started obsidianstarterkit.com/. I still have a lot to learn about this process but even with just a simple connection btw. Claude and Obsidian you can start creating your personal knowledge base. Its a malleable, adaptable, steal trap. Each day you can watch the map of your knowledge grow. For me there are areas that are related to my personal life and biographic memory (which I have significant deficiencies in without support!), family schedule (kids activities, meal planning, grocery lists, multiple to do lists), medical knowledge, writing, projects, talks, notes from podcasts or conferences, creative ideas, etc etc. All of these things can become atomic notes with an interconnected web.

Systematic review and meta-analysis of weight loss with GLP-1 agonists. onlinelibrary.wiley.com/doi/…

Based on this adjuvant anti obesity medicine should be considered standard of care for most patients 2 to 3 yrs out from sleeve. Let’s not wait 10 yrs.

Can GLP-1 drugs improve psoriasis beyond standard therapy alone? In this RCT of 274 psoriasis patients, those randomized to Tirzepatide Ixekizumab had a higher rate of full skin clearance (PASI 100) compared to Ixekizumab alone (40.6% vs 29.0%).

Mindblown that when I was diagnosed with Stage 3 MASH in 2021 there was literally no cure, and certainly nothing that would help the fibrosis. And here I am now, completely cured for 2 years thanks to Semaglutide.

Obesity pharmacotherapy is exploding 🤯. Remember when the choices were contrave or saxenda? And the studies were based on a couple thousand patients showing a 5 to 7% weight loss? Hard to believe wegovy’s step trial was published only 5 yrs ago. Every week now there is an announcement of another therapy pushing 15 to 20 % weight loss.

Criminal! On a Blue Cross form for Mounjaro there is a field for “# of doses per vial”. I wrote 4. Of note, there is no field for “number of doses per pen.” The patient takes my Rx to the pharmacy and is informed I sent in a request to blue cross for Mounjaro vials which was approved by Blue Cross; however blue cross did not approve pens. The pharmacy only has pens. Five weeks now of trying to figure out what is going on