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Authorship All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published: Sandro Gentile, Giuseppina Guarino, Teresa Della Corte, Giamiero Marino, Ersilia Satta, Carmine Romano, Carmelo Alfarone, Clelia lamberti and Felice Strollo

Adverse reactions reported in greater than or equal to 2% of QSYMIA-treated adults and more frequently than in the placebo group are shown in Table 1

Elevated ROS levels are also observed in granulosa cells from endometriosis patients (101)

The TRIUMPH-1 trial showed the 4 mg dose to have lower discontinuation rates due to side effects, even less than placebo

Obesity, insulin resistance and fatty liver may further amplify this cycle by increasing inflammatory signaling, altering bile-acid metabolism and reducing metabolic reserve