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Dosing Recommendations Based on phase 2 trials, the following dosing strategy has been employed: Starting dose: Typically 0.5 mg once weekly, with gradual increases Titration phase: Progressive increases to 1 mg, 2 mg, 4 mg, and potentially up to the maximum dose of 12 mg weekly Maintenance dose: Once the target or maximum tolerated dose is reached, patients continue at that level for ongoing treatment[8] Titration Strategy The gradual dose escalation approach serves several purposes: Minimizes gastrointestinal side effects through gradual adaptation Allows for monitoring of tolerability at each dose level Provides flexibility to pause or slow titration if side effects emerge Different starting doses (2 mg vs 4 mg) were tested, with lower starting doses showing better tolerability[4][8] Following the recommended titration schedule is crucial for maximizing patient adherence and treatment success

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Glutathione reductase (GR), superoxide dismutase (SOD), catalase (CAT), and ascorbate peroxidase (APX) activities were enhanced

However, the effects of standardization, manufacturing scalability, and regulatory frameworks have not yet been fully recognized or handled, requiring further multidisciplinary research andinnovation to address these challenges