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It acts as a dual agonist at amylin receptors (AMY1R, AMY2R, AMY3R, formed by calcitonin receptor heterodimerized with RAMP1-3) and calcitonin receptors, with structural modifications (e.g., N-terminal fatty acid acylation, proline substitutions) preventing fibril formation, enhancing stability, and enabling once-weekly dosing via albumin binding for prolonged circulation

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In summary, HDV-associated metabolic changes occurring downstream of IFN- production led to metabolic stress and activation of pro-survival metabolic factors ATF4 and mTORC1

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