Do you anticipate added benefit of triple agonist therapy for patients with early type 2 diabetes mellitus and MASLD given evidence of glucagon resistance?

I anticipate triple agonist therapy will offer added benefits over dual agonist therapy in patients with diabetes and obesity. There are studies showing greater weight loss with triple agonist therapy with retatrutide (24 to 30%; Jastreboff et al., PMID 37366315, Triumph-4 trial data released by Lilly) than is generally seen with dual agonist therapy (20% tirzepatide; Jastreboff et al., PMID 35658024). In a study specifically looking at metabolic dysfunction-associated steatotic liver disease (MASLD), 86% of patients on retatrutide had normalization of liver fat content (Sanyal et al., PMID 38858523). This was felt to be due to weight loss, abdominal fat decrease, and improved insulin sensitivity. In news released at the June American Diabe...