Daily Endocrinology Research Analysis

BACKGROUND: Ecnoglutide is a novel cyclic adenosine monophosphate (cAMP)-biased GLP-1 receptor agonist currently in development for weight management. We aimed to assess the efficacy and safety of once weekly ecnoglutide versus placebo for the treatment of overweight or obesity in Chinese adults. METHODS: This randomised, double-blind, placebo-controlled, phase 3 trial was done at 36 medical centres across China. Eligible adults were aged 18-75 years with overweight or obesity (defined as BMI ≥28 kg/m FINDINGS: Between April 5, 2023, and June 20, 2024, 882 participants were screened and 664 were randomly assigned to receive ecnoglutide 1·2 mg (n=166), ecnoglutide 1·8 mg (n=166), ecnoglutide 2·4 mg (n=167), or placebo (n=165). At week 40, the least-squares mean percentage change in bodyweight was -9·1% (SE 0·8) in the ecnoglutide 1·2 mg group, -10·9% (0·9) in the ecnoglutide 1·8 mg group, and -13·2% (0·8) in the ecnoglutide 2·4 mg group versus 0·1% (0·8) in the placebo group, and the respective estimated treatment differences compared with placebo were -9·2% (97% CI -11·0 to -7·5), -11·1% (-13·1 to -9·1), and -13·3% (-15·3 to -11·3), respectively (all p<0·0001). The proportion of participants who achieved at least a 5% reduction in bodyweight at week 40 was 77% in the ecnoglutide 1·2 mg group, 84% in the ecnoglutide 1·8 mg group, and 87% in the ecnoglutide 2·4 mg group versus 16% of participants in the placebo group, and the respective estimated treatment differences versus placebo were 60% (98% CI 50 to 71), 68% (58 to 78), and 70% (61 to 80; all p<0·0001). Treatment-emergent adverse events were observed in 155 (93%) of 166 participants in the ecnoglutide 1·2 mg group, 154 (93%) of 166 participants in the ecnoglutide 1·8 mg group, 156 (93%) of 167 participants in the ecnoglutide 2·4 mg group, and 139 (84%) of 165 participants in the placebo group. The most common adverse events were mild-to-moderate gastrointestinal related events. Ten participants treated with ecnoglutide discontinued treatment due to adverse events. INTERPRETATION: In adults with obesity or overweight without diabetes (type 1 or 2), individuals administered ecnoglutide had superior and sustained reduction in bodyweight versus placebo with a favourable safety profile, supporting its potential use for weight management. FUNDING: Hangzhou Sciwind Biosciences.

This Pituitary Society Consensus article presents an evidence-based consensus on the management of pituitary incidentaloma, defined as an unexpected sellar or parasellar finding incidentally discovered on an imaging study that was not performed for a clinically suspected pituitary lesion. Recommendations are offered for when endocrinology, neurosurgery and ophthalmology consultation, dedicated pituitary imaging, pituitary hormone testing and visual assessment are warranted for macroadenomas, microadenomas, cystic lesions and empty sella, as well as when surgical resection is indicated for incidental pituitary adenomas and cystic sellar lesions. Special considerations in patients with multiple endocrine neoplasia type 1, children and adolescents, older people, and pregnant women are addressed. The Consensus workshop concluded that diagnostic and management approaches should be individualized to the specific clinical context of an incidentally discovered pituitary lesion. Consultation with a multidisciplinary pituitary tumour centre of excellence should be considered in the presence of new or deteriorating lesion-specific signs or symptoms, particularly when surgical or other adjuvant interventions are being considered and when there is uncertainty about the most appropriate subsequent management.

Hereditary endocrine neoplasia syndromes comprise multiple entities associated with an increased risk for the development of endocrine and nonendocrine neoplasms and other systemic manifestations. These syndromes typically demonstrate autosomal dominant inheritance, and each syndrome is associated with a unique genetic predisposition to a distinct spectrum of tumor susceptibility. Moreover, genotype-phenotype associations within each syndrome may affect the spectrum, penetrance, and age of onset of associated tumors. As many endocrine tumors are benign and/or indolent, a careful approach to monitoring is necessary, wherein the nature, timing of initiation, and frequency of presymptomatic surveillance balance the goal of detecting tumors at a point in which intervention would limit tumor-associated morbidity against the physical, emotional, and financial burdens of surveillance. In this study, we summarize changes in knowledge and practice recommendations related to children with multiple endocrine neoplasia syndromes (types 1, 2A, 2B, 4, and 5), hyperparathyroidism-jaw tumor syndrome, and Carney complex since an initial summary in 2017. These updates reflect the evolving understanding of these complex genetic disorders and aim to improve patient care and outcomes.