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In this process, due to the presence of tert-butyl protecting group on the side chain, an extra deprotection step is required

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In an in vitro study, tirzepatide elicited a cAMP response in a human pancreatic -cell line that was significantly higher than that observed for either GLP-1 or GIP alone, indicating a synergistic or additive activation of signaling in pancreatic -cells by GIP and GLP-1 (63)