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10.1039/c3ra41270a 189 LiuF.WangL.ZhaiX.JiS.YeJ.ZhuZ.et al (2023a)

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A polymorphism in the methionine synthase reductase (MTRR) enzyme, responsible for maintaining adequate levels of cob(III)alamin, is known contribute to a moderate increase in Hcy levels (Gaughan et al., 1993)

Verdict: Direct comparison difficult due to different trial designs, but retatrutide's advantage appears substantial even accounting for flexible vs fixed dosing