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The general principle described in clinical teaching is to establish a baseline, recheck IGF-1 after the early weeks of any protocol, keep it within an age-appropriate reference range rather than pushing it into supraphysiologic territory, and monitor fasting glucose in at-risk patients

Tirzepatide meets these standards, but retatrutide is not quite there yet

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We used FineGray sub-distribution hazard model analyses adjusted for sex and age to assess the association of sociodemographic variables, comorbidities and co-medications (defined in ESM Table 2) with the risk of treatment discontinuation