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Specifically: Subgroup analysis suggested that patients co-administered ACh-E inhibitors showed reduced benefit from fosgonimeton The mechanism of this interference is unknown One hypothesis: ACh-E inhibitors upregulate acetylcholine signalling, which might compete with or antagonize Ang IV/c-Met signalling Another hypothesis: Both compounds affect synaptic plasticity through different pathways, and interference could occur at the level of consolidated change Implications for Dihexa While this interaction was observed with fosgonimeton in a clinical trial context, Dihexa users who are also taking ACh-E inhibitors (whether prescribed or over-the-counter cholinergic supplements) should be aware that efficacy may be reduced or effects unpredictable

Design, Synthesis, and in Vitro Evaluation of Novel Aminomethyl-pyridines as DPP-4 Inhibitors