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There are even cases in which the activity of PK as measured in vitro is higher than normal, but a kinetically abnormal enzyme with low in vivo activity in erythrocytes is responsible for the hemolytic anemia

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Another oral, non-peptide GLP-1 RA (lotiglipron) has also been withdrawn from development as in early phase clinical trials resulted in elevated liver enzymes which could indicate liver toxicity [30]