Patience is an important part of the process
Although the mechanisms responsible for these alterations are not clear, at least three possibilities in addition to infiltration of macrophages might explain these findings
a PDE-5 inhibitor attenuates the hydrolysis of cyclic guanosine monophosphate (cGMP, also called guanosine 3',5'-cyclic monophosphate), thereby increasing the persistence of cGMP, by inhibiting the activity of endogenous type V phosphodiesterase (PDE-5), it being understood that PDE-5 naturally regulates the degradation of cGMP to 5' guanosine monophosphate (5' GMP) in the corpus cavernosum
A., & SURMOUNT-4 Investigators (2024)
Evidence supporting specific protocol structures remains limited, and individualized assessment is required before extrapolating research findings to clinical practice
Perhaps a more balanced comparison, less subject to indication bias, would be of second-line use of semaglutide with second-line use of a comparable antihyperglycemic medication such as sodium-glucose cotransporter 2 (SGLT2) inhibitors, according to the authors of an editorial accompanying the journal article