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It is a more potent and longer-lasting analogue of the endogenous -MSH hormone (Levine et al., JAMA 1991) that stimulates melanocyte activity and melanin production

8 The CCS and the Endocrine Society guidelines both used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework to rate the quality of the evidence informing the recommendations (ranging from very low-quality to high-quality evidence) and the strength of the recommendations (i.e., strong versus weak or conditional)

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