Scholar Rock said Wednesday its experimental drug apitegromab helped preserve muscle mass in patients taking Eli Lilly's weight-loss treatment Zepbound (tirzepatide), addressing mounting concerns that powerful new obesity medications may cause patients to lose too much lean tissue alongside unwanted fat.Apitegromab is a monoclonal antibody that inhibits myostatin activation by selectively binding the pro- and latent forms of myostatin in skeletal muscle. Scholar Rock is already developing it for spinal muscular atrophy (SMA), which is the company's primary focus and where the drug succeeded in a Phase III trial last year. However, the company is one of a handful of others like Regeneron Pharmaceuticals and Biohaven that are testing whether drugs originally designed for muscle-wasting diseases can also help maintain muscle mass in people who want to lose weight."GLP therapies have been an effective and important innovation for individuals living with obesity and cardiometabolic disorders; however, these treatments can result in substantial loss of lean muscle mass for patients, leading to unwanted health risks," remarked Akshay Vaishnaw, Scholar Rock's president of R&D.The Phase II proof-of-concept study enrolled 102 patients with obesity or who were overweight with weight-related conditions. Patients receiving apitegromab with Zepbound lost 12.3% of their body weight after 24 weeks versus 13.4% for the arm that took Zepbound and a placebo.However, the combo arm achieved 85.3% of total weight reduction coming from fat mass, with lean mass accounting for just 14.6% of the weight lost. The placebo group saw 69.5% of the total weight reduction coming from fat and 30.2% from lean mass.The results reported Wednesday validate "our hypothesis that our platform of highly selective myostatin inhibitors has the potential to support healthier weight loss for millions of patients on GLP therapies," Vaishnaw said.From a safety perspective, Scholar Rock said its drug demonstrated an "encouraging safety profile," with no serious adverse events or discontinuations considered to be related to apitegromab treatment. When asked for more details during a company call, Vaishnaw said, "I think no news is good news… Essentially the safety profile looks very much like whatever we're seeing, in the balance between the arms, associated with the tirzepatide effect on the GI tract, which are well known for GLPs."The biotech plans to advance a next-generation subcutaneous anti-myostatin antibody called SRK-439, with an IND application expected in the second half of 2025. "We remain focused on preparing for the launch of apitegromab, and following its potential approval in SMA, we look forward to studying it in a range of neuromuscular diseases," Vaishnaw said.Regeneron recently reported that its anti-myostatin antibody trevogrumab helped preserve lean mass in a Phase II study with Novo Nordisk's Wegovy (semaglutide), while Roche began testing its myostatin antibody RO7204239 in a Phase II study with Zepbound last month.Industry observers also await closely watched data from Eli Lilly's bimagrumab, acquired via its $2-billion Versanis buy in 2023, and which is set to be presented at the upcoming American Diabetes Association (ADA) meeting. The drug targets activin type II receptors to inhibit myostatin and activin, and is being evaluated in a Phase II study, with or without Zepbound. For more, see – Vital Signs: Regeneron stacks the deck for myostatin targeting ahead of Eli Lilly's ADA reveal.