These medications are biologic therapies containing protein-based molecules that can degrade when exposed to inappropriate temperatures
In the discussion section of the Harvard paper, the authors wrote that GLP-1 RA-induced enhanced sympathetic nervous system activity might influence optic nerve head perfusion and potentially increase the risk of NAION, but, again, Rizzo pointed out that this study was only observational and that potential causative mechanisms need a different kind of investigation
Before reaching the target dose, a typical dosing schedule may look like the following: Month 1: 0.25 mg once weekly for the first month Month 2: 0.5 mg once weekly for the second month Month 3: 1 mg once weekly for the third month Month 4: 1.7 mg once weekly for the fourth month Target maintenance dose: 2.4 mg once weekly Depending on whether or not there are any experienced side-effects may change the dosing schedule for some individuals
Interestingly, His1-Gly2 of exendin-4 exhibited weaker density relative to the rest of the peptide in the cryo-EM map, and this is consistent with the enhanced flexibility observed for this region of the bound peptide in the simulations, likely due to Gly2, as glycine can destabilise -helical conformations
This ensures each injection site rests for at least 812 weeks before being used again, giving tissue time to recover