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Increased competition from regions with more streamlined regulatory environments, such as China: China's favorable regulatory environment, including factors such as the National Reimbursement Drug List (NRDL) expansion, a large pool of treatment-nave patients, and an increase in China-headquartered companies sponsoring trials have attracted a significant portion of clinical trials, particularly Phase 1 and CGTs 2

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symptoms recurred in some patients when the same or another DPP-4 inhibitor was restarted

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Diagnostic and Statistical Manual of Mental Disorders (DSM-5)