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doi: 10.1080/15548627.2023.2261758 239 EfferthT

Mechanism Comparison Shared Pathway Both peptides activate GHSR-1a on pituitary somatotrophs, triggering: GHSR-1a Gq/11 PLC IP + DAG intracellular Ca release PKC activation Ca influx GH vesicle exocytosis This is fundamentally different from how GHRH analogs (CJC-1295, Sermorelin) work (GHRHR Gs cAMP PKA), which is why combining either GHRP with a GHRH analog produces synergistic GH release (Veldhuis et al., 2009)

Fourth, while we focused on initiation, we did not assess medication adherence or persistence, which represent critical additional barriers to effective long-term weight management

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