Preserving Muscle During Weight Loss
Regeneron Trial Finds Experimental Drug Halves Muscle Loss During Weight Loss
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Key Points
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In the MRI-based fat-free muscle-volume analysis, the 75-mg trevogrumab group showed 72.7% preservation at 26 weeks and 68.9% at 52 weeks; the 25-mg group showed 63.6% and 71.8% preservation at those time points, respectively.
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At the lower doses, at least one adverse event was reported by 77% of trevogrumab participants, compared with 82% in the placebo group. The most common events, each occurring in at least 10% of patients, were nausea, constipation, diarrhea and vomiting.
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The COURAGE study enrolled 975 participants; its lower-dose arm included 376 people treated for 52 weeks, and an exploratory MRI substudy assessed muscle volume in 76 participants.
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In a separate part of the study, participants who stopped semaglutide but continued trevogrumab reportedly regained muscle mass to their pre-study level, according to Regeneron.
Regeneron's experimental drug trevogrumab showed it can preserve muscle during weight loss, a breakthrough for people using GLP-1 medicines like semaglutide. In a Phase II trial called COURAGE, the higher dose of trevogrumab cut muscle loss in half compared to semaglutide alone, according to Yahoo Finance. The 75-mg dose preserved 42.5% more lean mass over 52 weeks and showed 50.7% preservation at 26 weeks.
GLP-1 drugs have become wildly popular for weight loss but often cause people to lose muscle alongside fat. Clinical Trials Arena reported that the COURAGE trial tested whether adding trevogrumab—an antibody that targets myostatin, a protein that limits muscle growth—could solve this problem. The findings suggest Regeneron may have found a way to help people keep their strength while shedding pounds.
The Muscle-Sparing Effect of Trevogrumab
The trial tested three different doses of trevogrumab alongside semaglutide in 975 people with obesity. The Pharma Letter reported that the 75-mg dose preserved the most muscle, showing 72.7% fat-free muscle volume preservation at 26 weeks and 68.9% at 52 weeks. The lower 25-mg dose also performed well, preserving 63.6% of muscle volume at 26 weeks and 71.8% at 52 weeks.
MRI scans specifically looked at thigh muscle, a key marker of physical strength and mobility. MarketWatch confirmed the drug prevented lean mass loss in GLP-1 users during the trial. These results matter because maintaining muscle helps older adults stay independent and reduces fall risk as they age.
Lower Doses Were Well Tolerated by Patients
At the lower doses of trevogrumab, 77% of participants reported at least one adverse event—slightly better than the 82% who experienced side effects in the placebo group. News Medical noted that the most common complaints were nausea, constipation, diarrhea, and vomiting, each affecting at least 10% of patients. The 376 participants in the lower-dose arm received treatment for the full 52 weeks.
No serious safety issues emerged that would stop the trial. The side effect profile suggests the drug could be used in older adults with obesity and muscle weakness, Regeneron's next planned population. This is crucial because elderly patients often have less tolerance for new medicines.
Muscle Regrowth After Stopping Semaglutide
In a striking finding, some trial participants stopped taking semaglutide but kept taking trevogrumab. Clinical Trials Arena reported they regained muscle mass back to their pre-study levels. This suggests trevogrumab doesn't just slow muscle loss—it may help muscle rebuild on its own.
Regeneron now plans to test trevogrumab with GLP-1 therapies in older adults who have obesity and reduced muscle mass or strength. The company aims to start further trials this year. If successful, the combination could become standard for weight loss treatment in people at risk of becoming frail.
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