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When macrophage clearance is compromised, mitoEV excess accumulation is associated with impaired adaptive thermogenesis, linking immune phagocyte function to mitochondrial quality control at the tissue level (135)

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Notably, tirzepatide (Zepbound) was not approved for weight management in patients with overweight or obesity until shortly before the patient-identification window closed, resulting in most patients in the tirzepatide cohort receiving Mounjaro, which was assumed to be used off-label for chronic weight management in the absence of T2DM

Currently, Survodutide is under development for the treatment of obesity (Phase III) and MASH (Phase II), with BI exclusively responsible for its global development and commercialization (Zealand retains co-promotion rights in Nordic countries)