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Narrative review of topiramate: Clinical uses and pharmacological considerations

These observations suggest a combined mechanism of action for peptide 20 that uses conserved residues for ligand recognition and specific residues to induce conformational changes unique to each receptor, leading to a highly potent and balanced multi-targeting agonist for GIPR, GLP-1R and GCGR with a cAMP signaling profile similar to that of GIP, GLP-1 and GCG (Fig