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The difference between 21% and 29% weight loss becomes clinically significant at higher starting weights
In UK practice, NICE guidance recognises these benefits, though SGLT2 inhibitors are typically prioritised for cardiorenal protection, with GLP-1 receptor agonists with proven cardiovascular benefit considered when SGLT2 inhibitors are unsuitable
Our assessment: mechanism is sound, preclinical support is strong, clinical translation has been disappointing
Importantly, IVM exerts its acaricidal effect by disrupting -aminobutyric acid (GABA)-dependent neurotransmission in arthropods, causing paralysis and eventual death due to the inability to attach to the host or prolonged cessation of feeding 57
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