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Clinical therapeutic effects and challenges of GLP-1 receptor agonists The primary GLP-1RAs used worldwide as anti-obesity drugs are liraglutide (Saxenda, Novo Nordisk) as a once-daily subcutaneous injection and semaglutide (Wegovy, Novo Nordisk) as a once-weekly subcutaneous injection

This can range from the formation of painful gallstones to severe inflammation (cholecystitis) that often necessitates surgical removal of the gallbladder (cholecystectomy)

Two downstream consequences are mechanistically central: nicotinamide is preserved for re-entry into the NAD+ salvage pathway (raising intracellular NAD+ availability), and SAM is preserved for other methylation reactions

A real-world study published in the American Journal of Managed Care (2026) mirrored these findings