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These agents mitigate muscle atrophy by downregulating atrophy-related factors (myostatin, MuRF1, MAFbx) and upregulating myogenic transcription factors (MyoD, MyoG) via PKA/Akt/mTOR signaling

The clinical escalation protocol from the Phase 2 NEJM trial established a specific titration schedule that increases the dose every four weeks, starting low and building to a target maintenance dose

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