r/AppliedBioscience

Same conference as the retatrutide data I posted the other day in this post, (EASD in Milan), but this one got way less attention. Lilly presented phase 2 results for EloraTZP, a combination of tirzepatide and a new drug called eloralintide. Some of the numbers here are pretty wild.

What is it?

Tirzepatide is Mounjaro/Zepbound, and it hits the GLP-1 and GIP receptors. Eloralintide is a once-weekly shot that mimics amylin, a hormone your pancreas releases after you eat. Amylin slows down how fast your stomach empties and tells your brain you're full. It works on a different pathway than GLP-1, so the theory is that stacking the two adds up.

If you've heard people talk about stacking cagrilintide with sema or tirz, this is the same idea. Cagri is Novo's amylin drug, and eloralintide is Lilly's.

The trial

• 367 adults with obesity and type 2 diabetes
• 48 weeks, double blind, placebo controlled
• Compared four combo doses against tirz 15 mg alone, eloralintide alone, and placebo

Weight loss at 48 weeks

Average % of body weight lost.

• Elora 3 mg + tirz 5 mg: 13.2%
• Elora 6 mg + tirz 5 mg: 19.4%
• Elora 6 mg + tirz 10 mg: 19.9%
• Elora 9 mg + tirz 15 mg: 23.3% (~54 lbs)
• Tirz 15 mg alone: 14.8%
• Eloralintide alone: 8.2% to 12.3%
• Placebo: 3.0%

The line that jumped out at me: 6 mg elora + 5 mg tirz lost 19.4%, vs 14.8% on tirz 15 mg alone. That's more weight loss on a third of the tirz dose.

A1C (blood sugar)

A1C is your average blood sugar over ~3 months. A 1 point drop is considered a big deal.

• EloraTZP: dropped 2.2 to 2.9 points
• Tirz 15 mg alone: dropped 2.4
• Eloralintide alone: dropped 1.1 to 1.4
• Placebo: dropped 0.3

The top combo dose took people from an average A1C of 8.1 down to around 5.2, which is in the normal, non-diabetic range.

The catch: dropouts

The % of people who stopped treatment because of side effects.

• EloraTZP: 10.8% to 27.0%, depending on dose
• Tirz 15 mg alone: 2.9%
• Eloralintide alone: 0% to 10.8%
• Placebo: 16.7%

This is where it gets messy. At the high end, roughly 1 in 4 people on the combo quit, vs about 1 in 35 on tirz alone. Side effects were mostly GI (nausea, vomiting and so on), mostly mild to moderate, and mostly during the dose ramp-up. They also happened more often on the combo than on either drug alone.

And then there's the 16.7% placebo dropout, which makes no sense for a dummy shot. I haven't seen an explanation yet. It could be a reporting quirk, or something about how the trial was run. If anyone has the full paper, I'd love to know.

How does it compare to reta?

Not a perfect comparison, since these are different trials with different lengths, but both were in people with diabetes and obesity:

• Reta 12 mg (TRIUMPH-2): 20.8% at 80 weeks
• EloraTZP top dose: 23.3% at 48 weeks

So in a shorter trial, the combo came out ahead. Reta's dropout rate topped out at 11.6%, though, a lot lower than EloraTZP's 27%.

What's next

Lilly says phase 3 for EloraTZP should start by the end of 2026. Eloralintide on its own is already in phase 3 (called ENLIGHTEN). So nothing is close to approval, and realistically it's years away.

Questions for you guys

• Anyone here who stacked cagri with tirz: does the "more weight loss but more nausea" pattern match what you saw?
• Does the low tirz + mid elora combo (19.4% with way less tirz) seem like the real story to anyone else?
• Any theories on the placebo dropout number?

Sources: Lilly / EASD 2026 presentation (Sept 30), via HCPLive, Pharmacy Times and EurekAlert. Research and discussion only, not dosing advice.

Lilly presented TRIUMPH-2 at EASD (a big European diabetes conference) on Tuesday, and the full paper went up in The Lancet the same day. This trial looked at people who have both type 2 diabetes and obesity, so it's the first big look at how reta does in diabetics. I read through it, and the headline number (20.8%) is honestly the least interesting part.

Quick background

Retatrutide is a weekly injection from Lilly. Sema (Ozempic) targets one gut hormone receptor (GLP-1), and tirz (Mounjaro) targets two (GLP-1 and GIP). Reta targets three, adding glucagon. The idea is that the extra one helps you burn more energy, not just eat less.

The setup

• 1,152 people
• 80 weeks (about 18 months)
• Four groups: 4 mg, 9 mg, 12 mg, or placebo (a dummy shot)
• Everyone on the real drug started at 2 mg and moved up every 4 weeks until they hit their dose, which helps with side effects

Weight loss

Average % of body weight lost over the 80 weeks.

• 4 mg: 12.7% (~30 lbs)
• 9 mg: 19.1% (~45 lbs)
• 12 mg: 20.8% (~50 lbs)
• placebo: 4.0% (~9 lbs)
• 12 mg, people with a BMI of 35+ only: 23.4% (~61 lbs)

Going from 4 to 9 mg adds about 6 points of weight loss. Going from 9 to 12 adds less than 2. In other words, most of the benefit is already there at 9 mg.

A1C (blood sugar)

A1C is your average blood sugar over the last ~3 months. Under 5.7 is normal, 5.7 to 6.4 is prediabetes, and 6.5+ is diabetes. A drop of 1 point is considered a big deal.

• 4 mg: dropped 1.4 points
• 9 mg: dropped 1.6
• 12 mg: dropped 1.5
• placebo: dropped 0.2
• Up to 40% of people got all the way down to the normal range (under 5.7)
• Up to 79% got out of the diabetes range (6.5 or below)

9 mg and 12 mg are basically identical here. If blood sugar is what you care about, the higher dose isn't buying you anything.

Dropouts

The % of people who quit the trial because of side effects. It's a good real-world gauge of how tolerable a drug is.

• 4 mg: 3.8%
• 9 mg: 11.6%
• 12 mg: 7.7%
• placebo: 4.9%

This is the weird one. You'd expect more people to quit as the dose goes up, but 9 mg had the most dropouts, more than 12 mg. It could just be random chance, or something about when side effects hit during the ramp-up. If anyone has a theory, I'd love to hear it.

Stomach side effects

The % of people who reported each one at least once. Numbers are 4 / 9 / 12 mg vs placebo.

• Nausea: 13.7% / 20.8% / 28.0% vs 8.0%
• Diarrhea: 27.4% / 33.5% / 33.6% vs 13.2%
• Constipation: 14.0% / 16.2% / 16.8% vs 9.4%

Nausea about doubles from 4 to 12 mg, and roughly a third of people on any dose had diarrhea. Paired with the small extra weight loss at 12, that makes 9 look like the sweet spot.

Dysesthesia

A fancy word for strange skin sensations, like tingling, burning, or skin that feels sensitive to touch.

• 4 mg: 4.5%
• 9 mg: 5.6%
• 12 mg: 7.3%
• placebo: 0.7%

This is the one I keep coming back to. It goes up steadily with dose, and it has shown up in other reta trials too, not just this one. You don't really see it with sema or tirz, so my guess is it's linked to the glucagon part, since that's what reta has that the others don't. I haven't seen a solid explanation yet.

Diabetics vs non-diabetics on 12 mg

• Earlier trial, people without diabetes: ~24% weight loss in 48 weeks
• This trial, people with diabetes: 20.8% in 80 weeks

That's not a knock on reta. People with diabetes lose less weight on every drug in this class, and you see the same gap with sema and tirz.

What's next

Lilly plans to file for FDA approval in early 2027, so reta is still not approved. Most of the other big reta trials have already reported, and this was one of the last major ones before filing.

So, for people who follow this closer than I do: based on this, is 12 mg actually worth it over 9? And has anyone seen research on what's causing the dysesthesia?

Source: Lilly press release + The Lancet, Sept 29. Discussion/research only.

I've read a lot about BPC-157 and always assumed there was solid human data behind it somewhere. Turns out there mostly isn't.

A UCLA team reviewed 565 studies on six of the most popular peptides. Their conclusion: "little to no evidence" these work in humans.

What they looked at

• BPC-157: tendon, muscle and gut healing
• TB-500: tissue repair
• CJC-1295: boosts growth hormone
• Ipamorelin: boosts growth hormone
• GHK-Cu: skin and wound healing
• MK-677: boosts growth hormone (technically not even a peptide, it's a pill)

The results

• 565 studies reviewed
• 2/3+ were animal-only, mostly rats and mice
• Very few human studies, and most were small or had no real control group
• "Essentially no studies" showed real benefits for injuries in humans

That last one stings, since injuries and recovery are the main reason people use BPC and TB-500.

Why rat results don't automatically apply to us

• Different injuries: lab animals get clean surgical cuts, not a nagging shoulder from years of lifting
• Rats heal faster: small effects can look bigger than they are
• Dosing doesn't scale simply: a rat dose doesn't just multiply up to a human dose
• Most things fail in humans: across all of medicine, most drugs that work in animals don't pan out in people

So it's not that BPC doesn't work. The data just can't tell us either way yet.

The safety red flags

• MK-677: a trial was stopped due to a higher rate of congestive heart failure, the only real safety signal of the six
• Product quality: the authors flagged possible lead and arsenic contamination in unregulated products

Honestly the quality issue might be the bigger risk. If you don't know what's in the vial, whether it works is a secondary question.

Here's the weird part

A month before this review, an FDA advisory panel voted to let compounding pharmacies make these again.

• BPC-157 and TB-500: passed 8-6
• Also recommended: KPV, MOTS-c, Semax, Epitalon
• Status: just a recommendation, nothing has legally changed yet

It looks like a contradiction, but I don't think it is. The panel wasn't saying "these work." It was about whether people should get them from regulated pharmacies or keep buying them on the grey market.

My take

• No evidence it works ≠ evidence it doesn't work. Nobody has run proper human trials yet
• The animal data is worth following up, but it isn't proof
• Anecdotes are tricky with injuries, because most injuries get better on their own eventually

Curious where you guys land

• If you used BPC or TB-500 for an injury, did you have anything to compare it to?
• If a big human trial came back negative, would you trust it over your own experience?

Sources: Kremen et al., UCLA Health (Aug 31, 2026); FDA Pharmacy Compounding Advisory Committee, July 2026 (via AJMC). Discussion/research only.