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The significant prevalence of AITD, a long latent period and the involvement of autoimmune processes in their occurrence, development of concomitant diseases, insufficient effectiveness of the main pharmacotherapy, and a decrease in the quality of life of patients require the development of adequate approaches for the correction of immune processes in order to prevent and treat diseases
This is primarily due to its potential for improved bioavailability through restricting dietary protein [89, 90]
My Approach When Prescribing Here's my general framework not a rigid protocol, but a starting point for the conversation: I Tend to Start with Semaglutide When The patient has established cardiovascular disease (because of the SELECT trial data) Insurance covers semaglutide but not tirzepatide The patient has MASH/fatty liver disease Cost is the primary concern and semaglutide is more accessible I Tend to Start with Tirzepatide When Maximum weight loss is the primary goal The patient has type 2 diabetes (tirzepatide shows greater A1C reduction roughly 2.02.5% vs 1.02.0% for semaglutide) The patient has tried semaglutide with insufficient results Insurance covers both options equally Regardless of which medication we choose, I always emphasize that GLP-1 therapy is most effective when combined with nutritional counseling, physical activity, and behavioral support
Your GP surgery or community pharmacy can advise on appropriate local disposal routes (gov.uk clinical waste guidance)
