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Eric Topol of Scripps Research Translational Institute was more direct: "These peptides have no data to support their safety and efficacy." The clinical proponents argue that the FDA's safety concerns immunogenicity risk, impurity risk, organ toxicity are theoretically valid but speculative in practice

When we analyze the impact on kidney function, similar to RAAS blockers, the commencement of treatment with SGLT2 inhibitors is characterized by acute, dose-dependent reductions in eGFR ( up to ~5 mLmin 1 1.73 m 2 ) over several weeks (Heerspink et al, Circulation 2016)