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If injection fatigue becomes a compliance barrier, switching to a higher-potency formulation (100mg methionine per mL) allows dose reduction to 34mL biweekly while maintaining methyl donor load

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Notably, RBX2/SAG functions dually as both the E3 ligase for Cul5 neddylation and the E3 ligase for CRL5 ubiquitination (41)

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With four compounds and twelve possible interaction pairs, troubleshooting is substantially more complex than with a three-compound protocol