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The pharmacokinetic barrier has recently been overcome with the synthesis of the orally active, BBB permeable analog Dihexa (N-hexanoic-tyrosine-isoleucine-(6) aminohexanoic amide) (McCoy et al., 2013)

The Frias 2023 Phase 2 in T2D showed cagrilintide+semaglutide produced a -2.2 percentage-point HbA1c reduction at 32 weeks versus -1.8 for semaglutide alone

The key principle is that any combination therapy should be initiated and monitored under close medical supervision, with dose adjustments made based on glucose monitoring results and individual patient response

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