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It's about hitting the circadian window where NNMT (nicotinamide N-methyltransferase) inhibition actually shifts substrate oxidation from glucose to fat

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Less ideal candidates include: Patients who are doing well on standalone semaglutide without significant nausea or body composition concerns

10.1105/tpc.010538 102 PnueliL.LiangH.RozenbergM.MittlerR

Clinical pilot data derived from distinct populations indicated that 58% of elderly patients with chronic knee pain achieved sustained pain relief beyond 6 months following a single injection (Lee and Padgett, 2021), while 83.3% of middle-aged to elderly women with refractory interstitial cystitis experienced complete symptom resolution after a single intravesical dose (Lee et al., 2024)

All of the participants had recurrent or metastatic breast cancer that was progressing despite two or more chemotherapy regimens directed specifically at HER2