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The Discontinuation Hierarchy# Discontinuation rates due to adverse events provide a practical measure of tolerability that matters most to patients: Best tolerated: Ecnoglutide (~2%), Bioglutide (NR but minimal) Well tolerated: Semaglutide (4.3%), CT-388 (5.9%), Tirzepatide (4.3-7.1%) Moderate: Orforglipron (5.3-10.3%) Higher burden: Retatrutide (12.2-18.2%) Titration Matters# GI side effects are strongly concentrated during dose escalation

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Notably, the median PA time of ~6 days (for cases needing extra review) means many patients wait well over a week to start treatment ( [5] )