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The impact of GLP-1 medications on the gut microbiota, which is partly mediated by gut IELs, may also affect the intestinal response to inflammation and its interaction with the host immune system, warranting further investigation

And sequence determines outcome

Large clinical trials, including SUSTAIN-6 and PIONEER-6, demonstrated that semaglutide significantly reduced major adverse cardiovascular events compared to placebo, with risk reductions of approximately 24 percent in high-risk populations (20)

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Pediatric Patients Aged 2 to Less Than 6 Years Weighing at Least 20 kg with BBS or POMC, PCSK1, or LEPR Deficiency The recommended starting dosage is 0.5 mg (0.05 mL) injected subcutaneously once daily for 2 weeks in pediatric patients aged 2 to less than 6 years with severe renal impairment and weight of at least 20 kg