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The activity of MC4R is strictly regulated by its endogenous ligands: -melanocyte-stimulating hormone (-MSH) binds to MC4R and transmits anorexigenic and energy-expenditure signals, whereas agouti-related protein (AgRP) exerts an antagonistic effect by binding to the receptor, competitively inhibiting -MSH action and promoting appetite

While clinical trials have provided valuable insights, further research is should determine the optimal use of these agents in different heart failure populations

114 Within Canada, GLP-1RA availability differs based on provincial insurable drug benefit plan restrictions, 90 and likely exacerbated by differential cost

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