CAS Number: 910463-68-2
Molecular Formula: C₁₈₇H₂₉₁N₄₅O₅₉
Molecular Weight: 4113.58 g/mol
Sequence: His-Aib-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Val-Ser-Ser-Tyr-Leu-Glu-Gly-Gln-Ala-Ala-Lys-Glu-Phe-Ile-Ala-Trp-Leu-Val-Arg-Gly-Arg (30 amino acids + fatty acid chain)
What is SMA GLP-1?
SMA GLP-1 is a GLP-1 receptor agonist originally developed for managing type 2 diabetes and reducing cardiovascular risk. Taylor & Francis Online It works by mimicking the naturally occurring hormone GLP-1 (glucagon-like peptide-1), which is released after eating. Its effects include appetite suppression, increased satiety, and improvements in cardiovascular, renal, and metabolic parameters. MDPI It is available in both subcutaneous injection (weekly) and oral tablet (daily) forms. Oral and subcutaneous SMA GLP-1 therapies have shown effectiveness in improving glycemic control, weight loss, and reducing cardiovascular risks associated with diabetes mellitus. PubMed Central
Active Areas of Research:
1. Type 2 Diabetes (FDA-Approved) 🩸
In SUSTAIN 1 and PIONEER 1 trials, with patients managing early-stage diabetes with diet and exercise alone, subcutaneous SMA GLP-1 1.0 mg led to a mean weight reduction of 4.5 kg, whereas oral SMA GLP-1 14 mg achieved a 3.7 kg reduction, with effects superior to placebo and other active comparators. PubMed Central 📎 PMC – Arch Intern Med Res, 20252. Obesity & Weight Management (FDA-Approved) ⚖️
2. Obesity & Weight Management (FDA-Approved) ⚖️
In the SELECT cardiovascular outcomes trial, weight loss with SMA GLP-1 continued over 65 weeks and was sustained for up to 4 years, with a mean reduction in weight of −10.2%, waist circumference of −7.7 cm, and waist-to-height ratio of −6.9% versus placebo. Clinically meaningful weight loss occurred in both sexes and all races, body sizes, and regions. Nature More recently, a clinical trial found that tripling the standard dose led to significantly greater weight loss and metabolic benefits without increased risk of serious side effects — with nearly a third of patients losing 25% or more of their starting weight. Utsouthwestern 📎 Nature Medicine, 2024 | UT Southwestern, 2025
3. Cardiovascular Disease (FDA-Approved) ❤️
In the SELECT trial, in patients with obesity and established cardiovascular disease but without diabetes, SMA GLP-1 resulted in a 20% reduction in major adverse cardiovascular events (MACE). The Lancet The SUSTAIN-6 trial demonstrated a 26% MACE reduction in high cardiovascular-risk patients with type 2 diabetes. Taylor & Francis Online 📎 The Lancet, 2025 | Taylor & Francis – CKM Syndrome, 2025
4. Chronic Kidney Disease
The FLOW trial showed a 24% reduction in major kidney disease events with weekly 1.0 mg SMA GLP-1 in individuals with type 2 diabetes and chronic kidney disease (CKD). Taylor & Francis Online 📎 PMC – CKM Syndrome Review, 2025
5. Heart Failure (HFpEF)
In the STEP-HFpEF trial, among patients with obesity and heart failure with preserved ejection fraction (but not diabetes), SMA GLP-1 improved heart failure symptoms and physical function. The Lancet 📎 The Lancet SELECT Analysis, 2025
6. Hospitalization Reduction 🏥
A SELECT trial analysis found that patients given once-weekly SMA GLP-1 2.4 mg had significantly fewer hospital admissions and spent less overall time in hospital compared to placebo, in adults with known heart disease and obesity or overweight. Applied Clinical Trials Online 📎 Applied Clinical Trials, 2024
7. Liver Disease (MASLD/MASH)
SMA GLP-1 has been shown to modulate lipid metabolism and attenuate liver inflammation independently of its weight loss effects. In the ESSENCE phase 3 trial, resolution of steatohepatitis without worsening of liver fibrosis was achieved in significantly more patients receiving SMA GLP-1 (62.9%) versus placebo (34.3%) at week 72. University of Illinois Chicago 📎 UIC Drug Information Group, 2025
8. Addiction & Substance Use Disorders (Active Research) 💊
Real-world studies have explored associations between SMA GLP-1 and reduced incidence of alcohol use disorder, cannabis use disorder, tobacco use disorder, and lower opioid overdose risk in patients with type 2 diabetes. Sage Journals 📎 SAGE Journals – Dementia & Substance Use, 2025
9. Dementia & Alzheimer’s Disease (Ongoing / Mixed Results) 🧠
Emerging evidence suggested that SMA GLP-1 may protect against neurodegeneration and neuroinflammation, with real-world data from over 1 million patients with type 2 diabetes showing associations with reduced first-time Alzheimer’s diagnoses. Wiley Online Library However, in two Phase 3 trials of more than 3,800 adults with Alzheimer’s, SMA GLP-1 was shown to be safe and led to improvements in Alzheimer’s-related biomarkers, but the treatment did not delay disease progression. CNN Research into its preventive potential continues. 📎 Alzheimer’s & Dementia, 2024 | The Lancet – Evoke Trials, 2026
10. Obstructive Sleep Apnea (Active Research) 🌙
SMA GLP-1 has shown benefits in reducing sleep apnea, alongside its broader metabolic and cardiovascular effects, and continues to be investigated in this domain. KESQ 📎 ClinicalTrials.gov
11. PCOS & Hormonal Metabolic Disorders 🔬
SMA GLP-1 showed promise in managing PCOS-related obesity and insulin resistance, as well as demonstrating renoprotective effects in people with diabetes and CKD. Taylor & Francis Online 📎 Taylor & Francis – Multifaceted Effects, 2025
12. Cancer (Exploratory Research) 🧬
As of a 2024 search on ClinicalTrials.gov, 458 registered studies were found for SMA GLP-1, with many still active — including investigations into new indications such as steatohepatitis, acute myocardial infarction, autosomal dominant polycystic kidney disease, and steroid-induced diabetes. MDPI 📎 MDPI Pharmaceuticals, 2025
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