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In large obesity trials, incident high blood pressure occurred in fewer than 1% of semaglutide users versus about 2% on placebo, suggesting no clear causal link

OASIS-4 Trial OASIS-4 was a randomized, double-blind, placebo-controlled phase 3 trial of 71 weeks with co-primary analysis at week 64

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The answer comes down to safety, scale, and regulatory precedent

Safety, efficacy, and feasibility of intranasal insulin for the treatment of mild cognitive impairment and Alzheimer disease Dementia: A randomized clinical trial