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It works by mimicking the hunger hormone ghrelin and binding to ghrelin receptors in the pituitary

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For patients receiving a combination of a GLP-1 receptor agonist and an SGLT-2 inhibitor, continuous use was determined by overlapping prescription durations of both drug classes and allowing a 60 day grace period to bridge consecutive non-overlapping prescriptions

It's not an easy switch but there are some patients, perhaps those who could benefit from losing 6-8%, who have tried other means and might benefit