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One factor that may have contributed to such a result in patients with HFrEF is the increased heart rate caused by GLP-1RAs [21]

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RoB 2: a revised tool for assessing risk of bias in randomised trials

Peptide inhibitors (such as VY-9) occupy hydrophobic pockets (His85, Phe264, etc.) near the cavity entrance, which prevent the substrate L-tyrosine from entering the active cavity and interfere with the coordination between Cu and His residues (such as the chelation of imidazole ring of His85 with Cu), resulting in the loss of enzyme activity (Baskaran et al., 2021

Implementation Strategy Adding all three GLOW peptides to a Retatrutide protocol creates significant complexity