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A 2023 meta-analysis in JAMA Internal Medicine found a possible association with medullary thyroid carcinoma specifically, but the absolute risk remained very low

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It works through different central nervous system pathways and does not directly inhibit COX enzymes in the same way, making it a less disruptive choice for pain management in this context

The magnitude of risk reduction was slightly greater among non-diabetic patients, suggesting that the difference in fracture risk might be independent of glycemic control