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however, current evidence remains limited, heterogeneous, and derived largely from secondary analyses or observational studies rather than dedicated randomized heart failure trials

When IM remains the better choice: acute detoxification protocols where rapid glutathione delivery is required, doses over 2 mL that can't be split, and patients with very low body fat (under 10%) who lack adequate subcutaneous tissue

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The recent FLOW trial with semaglutide in patients with chronic kidney disease and T2DM, with a composite of major kidney disease events as the primary outcome, showed significant reductions in both cardiovascular mortality (HR 0.71