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This would (and does) result in muscle fatigue and eventual failure

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The result is impaired BH4 recycling less BH4 available to maintain eNOS in its coupled, NO-producing configuration independent of the direct homocysteine-mediated BH4 oxidation described above

Combination strategy : Rather than treating muscle wasting as a standalone indication, the field has pivoted to combining anti-myostatin therapy with GLP-1 agonists -- addressing the muscle loss side effect of an existing blockbuster drug class