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The dual GIP/GLP-1 mechanism of tirzepatide means it cannot be directly substituted with semaglutide doses

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At the AMY 3 R, the RAMP3/CTR interface for the Cagri-bound AMY 3 R appears to be weaker than the rAmy-AMY 3 R where Y37 rAmy forms a H-bond interaction with E74 RAMP3 that stabilises the position of the ECD and the interface between the RAMP3 and CTR ECDs

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