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The leading explanation, supported by preclinical work, is that glucagon-receptor agonism drives degradation of PCSK9, which in turn increases hepatic LDL-receptor availability and clears circulating LDL

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Because both are in the same class of GLP-1 receptor agonists, no washout period is required-dulaglutide has a roughly 5-day half-life, and patients can start Wegovy on Day 1 after their last Trulicity dose