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News
A major concern with GLP-1 weight loss drugs is muscle loss — but a new combo therapy may help. The COURAGE phase 2 trial found that adding trevogrumab, an anti-myostatin monoclonal antibody, to semaglutide (Wegovy) significantly reduced lean mass loss compared to semaglutide alone. Even better, continuing trevogrumab after stopping semaglutide helped restore lean mass close to baseline levels.
One of the biggest trade-offs with GLP-1 weight loss drugs like Wegovy is that they can cause significant muscle loss alongside fat loss. Now, a new combination therapy may offer a solution. The COURAGE phase 2 trial, presented at the European Association for the Study of Diabetes annual meeting, found that adding trevogrumab — a Regeneron monoclonal antibody that blocks myostatin, a protein that limits muscle growth — to semaglutide significantly preserved lean mass compared to semaglutide alone.
Patients with low lean mass at baseline benefited the most from the combination, showing greater muscle preservation than those with normal baseline lean mass on semaglutide alone. Cardiometabolic and glucose outcomes were similar between groups, and GI side effects didn't differ — though muscle spasms were more commonly reported with the combo. A triple combination including garetosmab was discontinued due to safety concerns, including two participant deaths.
By the Numbers:
Why it matters: As GLP-1 therapies become mainstream obesity treatments, preserving muscle mass is a growing clinical priority — especially for older adults and those with low baseline lean mass. Trevogrumab could become a meaningful add-on to protect physical function and metabolic health during weight loss.
