Compared with the structure of human GLP-1(7-37), the amino acid sequence of dulaglutide contains glycine at position 8, glutamic acid at position 22, and glycine at position 36.113 It was then fused to the constant region (Fc) of modified human immunoglobulin G4 (IgG4) via a -(Gly-Gly-Gly-Gly-Ser) 3-Ala- bridge and exhibits an average biological half-life of 90 h.105 Dulaglutide is the first large-molecule GLP-1RA, and the weekly dosing frequency of dulaglutide can greatly improve patient compliance.33,78,104,114 Semaglutide Semaglutide is a long-acting GLP-1RA agent used once weekly to improve glycemic control in patients with T2DM.115 Compared with the structure of human GLP-1(7-37), the amino acid sequence of semaglutide contains diaminoisobutyric acid at position 8, arginine at position 34, and acylated lysine at position 26.31 Semaglutide has a longer aliphatic chain and increased hydrophobicity, but its hydrophilicity is greatly enhanced by PEG modification of the short chain

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In fact, clinical weight loss trials with tirzepatide monotherapy show 2022% body weight reduction over 68 weeksresults that rival or exceed most multi-agent protocols reported in the literature
Russian preclinical literature is the main evidence base