The STEP UP trial, a Phase 3b study published in The Lancet Diabetes & Endocrinology in 2025, evaluated a 7.2 mg weekly injection dose in over 1,400 adults with obesity (BMI of 30 or higher) and without diabetes
Baseline cardiovascular risk factors common in patients with type 2 diabetes and obesity include: Prolonged immobility or sedentary lifestyle History of previous blood clots or thromboembolism Active cancer or recent cancer treatment Recent surgery, particularly orthopedic or abdominal procedures Smoking or tobacco use Hypertension and dyslipidemia Family history of clotting disorders Use of estrogen-containing medications (oral contraceptives, hormone replacement therapy) Pregnancy or postpartum period Chronic inflammatory conditions Patients with obesity face additional thrombotic risk due to chronic low-grade inflammation, endothelial dysfunction, and increased prothrombotic factors
For example, after a 12-week cycle, a 4- to 6-week break is often sufficient for biomarkers to normalize
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These tend to emerge early in a protocol and resolve as the body adjusts