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In some embodiments, the osmolarity at a target site of action (e.g., the perilymph) is about the same as the delivered osmolarity (i.e., osmolarity of materials that cross or penetrate the round window membrane) of any formulation described herein
The convenience factor diminishes when efficacy becomes unreliable
These effects often require years to decades to manifest as clinical disease and can be missed entirely in earlyphase or shortterm trials
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