These benefits have been demonstrated in large, well-designed cardiovascular outcome trials, including: Liraglutide (Victoza) the LEADER trial , which showed a significant reduction in cardiovascular death and all-cause mortality Semaglutide (Ozempic) the SUSTAIN-6 trial , demonstrating fewer major adverse cardiovascular events, particularly stroke Dulaglutide (Trulicity) the REWIND trial , which showed a significant reduction in major cardiovascular events even in people without established cardiovascular disease Tirzepatide (Mounjaro) cardiovascular outcome data from the SURPASS-CVOT programme are emerging, with early results suggesting cardiovascular benefit compared with insulin therapy These cardiovascular effects are a key reason why GLP-1based therapies are now recommended earlier in the treatment pathway for people with type 2 diabetes who have established heart disease or are at high cardiovascular risk

The active metabolite of vitamin D, 1, 25 dihydroxyvitamin D3, inhibits transcription of the calcitonin gene by interfering with interaction between transcription complexes that occupy the upstream and downstream enhancers (35)
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Patients who tolerated the molecule poorly at higher injectable doses Some patients respond well to semaglutide or tirzepatide at lower doses, but struggle with side effects as the dose is increased