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Strain-specific evidence is evolving

This review examines the biological mechanisms underlying GLP-1 RA therapy in MASLD/MASH, analyzes the mechanistic distinctions between mono-, dual-, and triple agonists, and synthesizes current clinical evidence supporting their utilization in individuals with this condition

Because of this mechanism, tirzepatide has gained attention as one of the most advanced medications currently available for medical weight management

Finally, Section 396 of the FDCA expressly authorizes off-label use: Nothing in this chapter shall be construed to limit or interfere with the authority of a health care practitioner to prescribe or administer any legally marketed device to a patient for any condition or disease within a legitimate health care practitioner-patient relationship. Because physicians lawfully may prescribe off-label, there also is no question that pharmacies lawfully may fill the orders they receive

Alternatives might include switching to a different GLP-1 medication (some patients tolerate one better than another despite similar mechanisms), reducing the maintenance dose to a level that produces fewer GI effects while still providing benefit, or transitioning to tirzepatide or another agent in the class