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Safer alternatives include optimising tirzepatide monotherapy with appropriate dose titration, structured NHS lifestyle programmes, licensed GLP-1 receptor agonists like semaglutide (Wegovy), or referral for bariatric surgery assessment
Vitiligo : A randomized multicenter trial showed that afamelanotide combined with NB-UVB phototherapy achieved 48.64% mean VASI improvement versus 33.26% with phototherapy alone
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The doctor might then refer the patient to a specialist, leading to more treatmenteven knee surgery
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