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Of note, in the SURPASS-4 trial, adjudicated major adverse cardiovascular events (MACE) were not increased with tirzepatide compared with insulin glargine over an extended follow-up period of 52 additional weeks after the main trial period of 52 weeks [21]

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These agents mimic the biological action of the native incretin hormone GLP-1 but are structurally modified to resist degradation by the enzyme dipeptidyl peptidase 4 (DPP-4), thereby extending their half-life and duration of action (Zheng et al., 2024