Not everyone tolerates the highest effective dose
Chung ES, Packer M, Lo KH, Fasanmade AA, Willerson JT, Anti-TNF Therapy Against Congestive Heart Failure Investigators (2003) Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF therapy against congestive heart failure (ATTACH) trial
Semaglutide is not recommended during pregnancy itself, as safety data in pregnant patients is limited
No insurance is required, and HSA/FSA accounts are eligible, making consistent treatment affordable