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At the end of 40 or 42 weeks (study time varied by trial), urine albumin-to-creatinine ratio (UACR) was significantly reduced among participants assigned to tirzepatide 5, 10, or 15 mg as compared with those assigned to all pooled comparators (placebo, semaglutide, insulin degludec, and insulin glargine) with adjusted mean percent changes of 19.3% [95% CI 12.525.5%], 22.0% [95% CI 15.328.1%], and 26.3% [95% CI 20.032.0%], respectively, with a greater reduction observed in participants with a UACR 30 mg/g at baseline [96]

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Here, we utilise sequence-derived in silico mutagenesis to rationally design a new peptide therapeutic and investigate its ability to simultaneously activate GIPR, GLP-1R and GCGR as a synergistic triple agonist (Table S1)

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