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Factor in the rapid clearance mechanism, whereby nasally-applied drugs are cleared with a half-life of approximately 21 minutes, and its clear why only certain peptides can be used nasally

The ability of GLP-1 agonists to reduce the expression of adhesion molecules, such as VCAM-1 on endothelial cells (Section 2.2) directly prevents the initial infiltration of monocytes into the vessel wall, a key initiating event of atherosclerosis (Section 2.1) [9,26,39]

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The combination can potentially intensify side effects, impact blood sugar levels, and interfere with weight loss goals