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Esophageal Ulcers located in the lower esophagus, often from reflux Causes / Risk Factors Helicobacter pylori infection (most common) NSAIDs (ibuprofen, aspirin) Excess stomach acid / hypersecretory conditions Smoking and alcohol consumption Stress (minor role) Zollinger-Ellison syndrome (gastric acidproducing tumor) Symptoms Epigastric pain (burning, gnawing, or hunger-like) Pain may improve or worsen with food: Duodenal: pain often relieved by food Gastric: pain may worsen with food Nausea / vomiting Bloating, belching Loss of appetite / weight loss Heartburn or acid reflux Warning signs (complications) Vomiting blood (hematemesis) Black, tarry stools (melena) Severe, sudden abdominal pain (possible perforation) Diagnosis Endoscopy gold standard, allows visualization and biopsy H

Plaintiffs belong to an employer-sponsored health benefit plan for which CVS Caremark acts as a pharmacy benefit manager (PBM)

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Methods In 10,310 participants from the Atherosclerosis Risk in Communities (ARIC) Study (aged 4670 years, ~55% women, ~20% Black adults) without diabetes at baseline (19901992), we used Cox regression to characterise age- and sex-adjusted associations of prediabetes with ~30 year incidence of complications (composite and separately), including atherosclerotic CVD (ASCVD), heart failure, chronic kidney disease (CKD) and all-cause mortality before and after accounting for intervening incidence of diabetes, modelled as a time-varying variable

Containing ingredients to: Promote muscle retention