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Quality assessment Since three of the included trials were non-randomized, they were assessed using the ROBINS-I tool

The most common denial reason is insufficient step therapy documentation (52% of denials)

Disadvantages: Expensive ($500-$1500 per 4-week course)

These findings emphasize that targeted antagonism of NMDA receptor signalling lowers body weight independently of MC4R, indicating that this preclinical drug candidate might not only be effective in treating polygenic obesity but also holds potential as an effective weight loss strategy for patients with loss-of-function mutations in MC4R , the most common form of monogenic obesity 32