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Three factors converged, including R&D costs continuing to rise above general inflation, large-scale M&A deals inflating the R&D cost base, and attrition shrinking the overall number of late-stage programs by roughly 4-5%

Another MR study reported that type 2 diabetes and kidney disease increased plasma levels of the GM-dependent metabolite trimethylamine oxide (TMAO) and proposed that the earlier observational evidence of elevated risk of cardiovascular diseases with higher TMAO levels might have been the result of confounding or reverse causality rather than a causal effect [54]