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Gastrointestinal side effects remain common, titration strategies require patience, and certain patientsespecially those with medullary thyroid carcinoma, severe gastroparesis, or history of pancreatitismay not qualify for therapy

Risk-of-bias assessment The methodological quality of included RCTs was assessed utilizing the Cochrane Risk of Bias 2 (RoB2) tool [18], while observational studies were evaluated with the Risk Of Bias In Non-randomized Studiesof Interventions (ROBINS-I) [19]

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101 Both endogenous purine metabolism and dietary intake contribute to uric acid production