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The study found no significant differences in systemic side effects between routes, but noted that injection site reactions were the leading cause of treatment discontinuation (3% of injectable users versus 1% of oral users discontinuing due to GI upset)

New England Journal of Medicine, 375(19), 1834-1844

For symptoms like arm pain, individual variation is the norm, and studies suggest multiple explanations

A vial stored at a rock-steady 4 degrees Celsius will outlast the same formulation subjected to temperature cycling between 2 and 8 degrees multiple times per day

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