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Clinical trials stop after a few years, and some of the currently FDA-approved drugs have only been around for a couple of years

It's the salt modification, which is studied for potentially better stability in the digestive environment

This is the medication working as designed

Relatively modest weight loss (510%) has been shown to have a positive impact on a broad range of metabolic and CV risk factors in patients with overweight or obesity, regardless of their diabetes status [15, 16], but until relatively recently there was limited evidence to suggest a beneficial effect of such weight loss on hard CV outcomes [17]