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The binding of prorenin to PRR triggers the phosphorylation of mitogen-activated protein kinases/extracellular regulated kinases 1/2 (MAPK/ERK1/2), which is demonstrated to be an ANG II-independent mechanism involved in the development of diabetic nephropathy ( The ANGIV/AT4/IRAP cascade: ANG IV (derived from the metabolization of ANG II through aminopeptidases A and N) binds the AT4 receptor, which has been identified as the insulin-regulated aminopeptidase (IRAP), but the role of this pathway in the blood pressure and renal regulation is still uncertain ( These new axes have raised great interest because their targeting could provide novel therapeutic strategies for hypertension, cardiovascular and kidney diseases
For a patient already on a statin, adding semaglutide may produce additional lipid improvements beyond what the statin alone is achieving
It is important to note that Ozempic is not licensed for weight management in the UK (unlike Wegovy, which contains the same active ingredient at higher doses)
The SURPASS-CVOT trial showed approximately 12% weight loss with tirzepatide compared with 5% with dulaglutide, along with nearly double the HbA1c reduction
