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doi: 10.1016/S0039-6060(97)90020-9

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In the NEJM Phase 2 trial, participants assigned to an initial dose of 4 mg experienced significantly more adverse events than those who started at 2 mg, even when both groups ultimately reached the same target dose

The most comprehensive review to date, published in JAAOS Global Research & Reviews , reached the same conclusion: Although preclinical studies are promising, there is a current lack of clinical trials (Rahman et al., 2026)