Pemvidutide is a balanced dual agonist, meaning that it does not preferentially activate GLP1R or GR over the other [39]
TGR5 and FXR are expressed in enteroendocrine L-cells in the intestine
The Broader Landscape: Other medications, such as Zepbound and Mounjaro (tirzepatide), operate on a dual-hormone mechanism (GLP-1 and GIP) to achieve similar metabolic results
Effectiveness and safety of semaglutide for weight loss in patients with inflammatory bowel disease and obesity
As such, novel materials must not only enhance stability and targeting but also exhibit low immunogenic potential
Taken together, the figure highlights a key mechanistic principle underlying the therapeutic rationale for multi-agonist strategies: while GLP-1R monotherapy achieves meaningful metabolic and hepatic benefits exclusively through indirect, systemic pathways, the addition of GIPR and - most importantly - GCGR co-agonism introduces complementary and increasingly direct hepatic mechanisms, providing the pharmacological basis for the superior efficacy observed with dual and triple agonists in MASLD/MASH
