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Instead of universal withholding, the guidance emphasized shared decision-making and targeted risk reduction for patients most likely to have delayed gastric emptying, such as those in the dose-escalation phase, those with notable gastrointestinal symptoms, those on higher doses, and those with comorbid conditions that slow gastric emptying

Notably, non-peptide small-molecule agonists of the GLP-1R are also being developed for oral bioavailability ( in silico evaluation of an -helical peptide (SR18: 18 aa) as a potent agonist of GLP-1R, with native GLP-1 and Semaglutide serving as references

doi: 10.1007/s40261-019-00826-0 6 ElashoffMMatveyenkoAVGierBElashoffRButlerPC