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What I've seen is, with ipamorelin, rare, but some people do get anaphylaxis, and it's happened

The condition follows a relapsing-remitting course, with periods of active disease (flares) alternating with periods of remission

10.1089/ten.TEB.2009.0296 14 DongX.ZhangT.LiuQ.ZhuJ.ZhaoJ.LiJ.et al (2016)

How the body allocates incoming nutrients between different tissues, specifically whether calories are directed toward muscle storage, fat storage, or energy expenditure

Instead of cycling through flare and recovery, the joint stabilizes at a lower baseline of inflammation

The main visible change is skin darkening over days to weeks