Duration: 72 weeks Enrollment: 3,127 patients Randomization: 3:3:3:4 (6 mg, 12 mg, 36 mg, placebo) The 36 mg group used a prolonged titration schedule starting at 1 mg, reaching 36 mg only by week 20 This extended titration reflects a deliberate strategy to mitigate anticipated gastrointestinal adverse effects
As part of the antioxidant defence system, GSH participates in conjugation reactions catalyzed by glutathione-S-transferases (GSTs), in the reduction of hydrogen peroxide (H O ) and lipid hydroperoxides (LOOH) catalyzed by glutathione peroxidases (Gpxs), and the reduction 2 2 of protein-disulfi des (PrSSG) catalyzed by glutaredoxins (Grxs)
ANOVA with intergroup comparisons by t test was used for group comparisons
Clinical Safety Screens Performed MTC personal AND family history in the comorbidity multi-select MEN-2 personal AND family history separately Substance / opioid screen with three-month opiate window + free-text dose, frequency, dates Suicidality and recent suicide attempt as exclusionary opt-out Active cancer treatment and cancer-free-for-five-years exclusionary End-stage kidney and liver disease opt-out Severe GI screen (gastroparesis, blockage, IBD) Pancreatitis history in the multi-select Self-reported blood pressure range and resting heart rate Past 2-month GLP-1 use (semaglutide / tirzepatide / none) No validated PHQ-2 or PHQ-9 depression instrument suicidality is captured as a binary exclusionary opt-out and severe depression is a checkbox on the comorbidity multi-select, but the validated brief screening scale is not used