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Retatrutide represents the current pinnacle of this "modular" metabolic engineering, but its utility must be measured against the established benchmarks of dual-agonists

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In 2018, the recommendations of the international evidence-based guidelines for the assessment and management of PCOS [1] indicated that, although its use is generally off label, metformin can be considered in addition to lifestyle in women with PCOS and Body Mass Index (BMI) 25 kg/m 2 to potentiate weight loss and to improve endocrine and metabolic outcomes