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In autoimmune disorders such as SLE, ANCA-associated vasculitis, RA, Gout, and psoriasis, defective NETs clearance and exposure of autoantigens like citrullinated histones, MPO, and PR3 contribute directly to loss of immune tolerance and sustained inflammation [63]

This rapid degradation occurs primarily through the enzyme dipeptidyl peptidase-4 (DPP-4) and neutral endopeptidase (NEP 24.11), along with renal clearance

Additionally, because the program was delivered as an integrated model as a real-world study without a separate control group for the app, medication, or coaching components, we cannot isolate the incremental effect of the digital coaching component, which would be better evaluated through a more traditional randomized control trial design

Some women find that appetite control becomes more challenging during perimenopause