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At the cellular level, E4 directly targets Mller cells to attenuate reactive gliosis, preserving the critical Bcl-2/Bax and Bcl-xL/Bax pro-survival ratios and consequently mitigating mitochondrial-mediated apoptosis via reduced caspase-3 activation [52]

It may include infection checks, tuberculosis screening, vaccine planning, and symptom review for bowel inflammation

reported higher rates of papilledema resolution by 6 months in the GLP-1 RA group

Cost variability: Both can be costly

Supporting Information Supporting Table 1 depicts the quality of evidence using the GRADE assessment for the primary outcome of weight loss with three doses of tirzepatide vs GLP-1 agonists or placebo

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