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In real-world settings, additional causes of discontinuation include high out-of-pocket costs, restrictive insurance coverage, prior authorization requirements, and drug shortages [52]

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For example, if a patient has recurrence of a previously resolved medical condition or if they gain more than 5% weight above their goal weight, then they are likely to continue to gain weight, says Lofton

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These benefits were associated with a rebalancing of the cytokine milieureducing pro-inflammatory IL-6, IL-1, and TNF- while elevating anti-inflammatory TGF-1mediated by the suppression of the MAPK signaling pathway [76]