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Indeed, there are case reports of monozygotic twins harboring the exact same mutation, both with elevated serum very long chain fatty acids (indicating a similar metabolic defect of peroxisomal lipid processing), where one boy is affected clinically and radiologically, while his twin brother is completely normal (Korenke et al., 1996)

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However, these mechanisms remain speculative in human RA and require validation through dedicated clinical trials

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On the other hand, CJC-1295 offers a prolonged release of growth hormone over time, which may result in wider hormonal changes, while hexarelin is more effective but may produce larger cortisol surges