Evidence Updates
On August 5 the FDA cleared oveporexton (Orzeyful) for narcolepsy type 1 — the first approved drug of its kind. Narcolepsy type 1 is caused by losing orexin, the signal that keeps you awake; every existing treatment stimulates the brain broadly instead, working around the hole rather than filling it. This one replaces the missing signal.
The FDA approved Lipfendra (enlicitide) on July 16 — the first once-daily oral PCSK9 inhibitor (cholesterol medication).
NAD+, A Phase II trial gave nicotinamide riboside to 52 older adults with mild cognitive impairment for 12 weeks. Blood NAD doubled but cognition, total cerebral blood flow, and blood pressure were all unchanged. Read more at our NAD+ entry.
Watchlist
What the FDA does with the peptide vote. Last issue's advisory committee recommended six of seven peptides; the agency itself has not decided, and it is free to decline. Nothing about the legal status has changed yet.
Retatrutide, and who actually gets it. The most effective weight-loss drug yet tested (~30% at two years) won't be filed with the FDA until early 2027. Lilly opened a compassionate-use route this month after doctors pushed — but you need a BMI over 35, failure on the highest tolerated dose of an approved drug, and two life-threatening complications. Almost nobody asking will qualify.