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This can predispose to achalasia-like symptoms and worsening of GERD [18, 19]
Instead Grx2, a mitochondrial isoform, exhibits de-glutathionylation activity for peptides and proteins but with a catalytic activity 10-fold lower with respect to Grx1 (Grek et al., 2013)
Those requirements effectively lock down manufacturing capacity for extended periods
These drugs mimic a hormone in the body that helps regulate blood sugar levels and appetite
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Medium-term risk is higher from (1) competitive pipeline entrants in melanocortin-pathway modulation, (2) payer attempts to re-negotiate rebates as budget impact becomes measurable, and (3) future patent and exclusivity cliffs that can enable generic or follow-on substitutes, depending on claim scope and regulatory exclusivity status
First, it may help stabilize the tirzepatide molecule in solution, potentially extending shelf life and maintaining potency
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