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Presented for research literature review only Endo M et al

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This deficiency can result from conditions such as pernicious anemia, certain gastrointestinal disorders, or a diet low in animal products

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Given the substantial resource demands of drug development, large sample sizes, extended trial durations, and the financial and physiological burden of certain treatments (e.g., monoclonal antibodies targeting A), it is ethically and scientifically imperative to identify patients for whom benefit is plausible and to avoid unnecessary exposure of those unlikely to respond