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Consider a supervised dechallenge (temporary discontinuation) only when clinically safe and when the riskbenefit balance becomes unfavourable, documenting symptom response

Feier CV et al

Increasingly, AITD coexists with metabolic disorders such as obesity, insulin resistance, and metabolic dysfunction-associated steatotic liver disease (MASLD), suggesting an interplay between immune dysregulation and metabolic health

You pick a spot, press the needle in, and hope for the best

In severe cases, if sulfur burps accompany other symptoms such as vomiting, weight loss, or severe abdominal pain, it indicates a more severe underlying issue like GERD or a gastrointestinal infection

For the diabetes indication, SUSTAIN is the relevant body of work