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Recent evidence suggest that heme has a direct role in hemolysis-associated complement activation (Figure 3)

Following the controversy regarding the potential increase in cardiovascular risk associated with thiazolidinedione therapy, regulatory authorities now require large studies to demonstrate the cardiovascular safety of newly developed glucose-lowering medications

Its use in the UK would therefore constitute off-label prescribing at best, or unlicensed importation in most practical scenarios

Furthermore, since a large number of studies have been published, it is necessary to perform an updated meta-analysis to assess the association of genetic polymorphisms with ATDILI