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28 However, oral therapy does not improve serum methylmalonic acid levels as well as intramuscular therapy, although the clinical relevance is unclear

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The trans-3-hexenoic acid group sterically shields the N-terminal region from dipeptidyl peptidase IV (DPP-IV) cleavage, which is the primary route of GHRH degradation in vivo, resulting in meaningfully improved metabolic stability compared to native GHRH and sermorelin