Low patient adherence and early discontinuation also play a role, limiting the perceived value of covering these therapies
Indeed, there may be synergy between FGF-21 and GCG receptor agonism, due to their similar metabolic actions, particularly related to brown adipose tissue differentiation and activation [32], with FGF21 having additional actions in the liver, reducing hepatic lipogenesis and enhancing hepatic insulin sensitivity [66, 67]
But it almost certainly reduces the gastrointestinal rebound effects that some researchers report after abrupt cessation, including paradoxical increases in appetite, changes in bowel habits, and blood sugar fluctuations
Diarrhea occurs in approximately 30% of patients taking semaglutide 2.4 mg (Wegovy) and 19-23% of patients taking tirzepatide (Zepbound) according to FDA prescribing information
& Chevreux, G
In clinical trials, Tesamorelin did not significantly worsen overall glucose tolerance