Pleiotropy-robust MR estimates the causal effect in the presence of pleiotropy by identifying a patient subgroup for which the genetic variant does not affect the exposure. The pleiotropic effect estimated from this subgroup is then subtracted as an offset from the two-stage least squares (TSLS) estimate.
Requires a perfect "no-relevance subgroup" and the pleiotropic effect must be constant across covariate subgroups.