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Afamelanotide received EMA approval in Europe (2014) and FDA approval in the United States (2019) for EPP making it the only melanocortin peptide to reach full regulatory approval to date

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Metformin, the second most commonly prescribed medication in the US in 2023, was first synthesized by scientists in 1922 and has been widely used to treat type 2 diabetes since the mid-20th century

These include people with inherited metabolic disorders, severe malnutrition, kidney disease requiring dialysis, liver disease, or gastrointestinal conditions that reduce nutrient absorption

The variability in available studies, potential confounding factors, and the severe heterogeneity of conclusions all emphasize the need for more high-quality evidence-based primary research to optimize perioperative management of patients taking GLP-1 RAs

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