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This requirement of ECL1 recognition drives the above six key positions in dual or triple agonists (tirzepatide, peptide 20 (MAR423), and retatrutide) to use amino acids similar to those in GLP-1/GCG, while the other positions in the middle region show considerable variability (Fig
However, tirzepatide may have a higher rate of gastrointestinal side effects initially for some individuals
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