In the first subgroup (ALC vs placebo), three studies 15,21,23 reported no AEs in either arm, and one 16 found no between-group difference
Health 17 , 2136 (2020)
Instead of universal withholding, the guidance emphasized shared decision-making and targeted risk reduction for patients most likely to have delayed gastric emptying, such as those in the dose-escalation phase, those with notable gastrointestinal symptoms, those on higher doses, and those with comorbid conditions that slow gastric emptying

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