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Key monitoring strategies used in these trials include: Regular laboratory assessments (liver enzymes, lipase and amylase, renal function markers, HbA1c and glucose) Renal function monitoring, particularly if significant gastrointestinal adverse effects occur and dehydration is a concern Cardiovascular monitoring, including resting heart rate and blood pressure GLP-1 and glucagon receptor agonism can increase resting heart rate, which requires careful evaluation in those with pre-existing cardiac conditions Calcitonin measurement and thyroid ultrasound where specified by trial protocol, to monitor for any signal related to thyroid C-cell changes (noting that routine thyroid function tests are not the specific safety assessment for this risk) Body composition assessments using imaging tools, which are research-protocol-specific rather than routine clinical monitoring, to evaluate changes in lean muscle mass versus fat mass Patient-reported outcome measures to capture quality-of-life changes and symptom burden over time Ophthalmic assessments in participants with pre-existing diabetic retinopathy, given the potential for early worsening with rapid glycaemic improvement The glucagon receptor component of retatrutide introduces additional monitoring considerations

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