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Dominguez tends to start people on whichever medication might be most effective for a patient, rather than prescribing a less effective drug first
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Three situations require modification: Renal impairment (eGFR below 60 mL/min/1.73 m) Tirzepatide is not renally cleared (it's metabolized by proteolysis), so renal impairment doesn't directly affect drug levels
Preclinical and observational evidence, as well as some small studies, suggested potential benefits of GLP-1 agonists, but this large trial does not confirm clinical efficacy in early Alzheimers. Have the authors taken confounding factors into account
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