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In contrast to the robustness of the redesigned proteases to graft genotypes, the WT enzyme supported systematically lower activity with redesign-grafted genotypes than with its own evolved genotypes

However, emerging evidence shows that variants in genes regulating GLP-1 signaling (GLP1R rs6923761), glucose-dependent insulinotropic polypeptide signaling (GIPR rs1800437), and energy homeostasis (FTO rs9939609, MC4R rs17782313) may correlate with medication efficacy and weight-loss outcomes

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This is because prostaglandins, which are blocked by COX inhibition, are important for proper blood vessel function within the kidneys (Ejaz 2004)