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Common reasons patients ask about split dosing include: Nausea after injections Bloating or reflux Severe appetite suppression Fatigue after injections Medication wearing off late in the week Fluctuating hunger levels Difficulty eating enough protein Trouble maintaining hydration For some patients, smaller divided doses may create more stable medication exposure throughout the week

As a result, many citrullination neoantigens would activate MHC class II-dependent T cells that in turn would help B cells produce more ACPA

The FDA guidance clarifies that this exemption exists to ensure patients don't go without necessary medication during a supply disruption