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Less common but clinically significant adverse effects include acute pancreatitis, gallbladder disease, hypoglycemia (particularly when combined with insulin or sulfonylureas), acute kidney injury (especially with severe gastrointestinal losses), and changes in heart rate

Cost considerations may influence treatment decisions and adherence for some individuals, particularly those on fixed incomes or with limited financial resources

Whether these safety signals translate equivalently to MC4R -deficient patients - who are predominantly children and adolescents with a distinct metabolic phenotype - remains unknown

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mTOR: mechanistic target of rapamycin