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The reality of oral administration for musculoskeletal indications is straightforward: the peptide disperses through the digestive system before it reaches the injury site, and what arrives at a tendon or joint after that journey is a fraction of what a subcutaneous injection placed near the tissue delivers

Aggregation changes the apparent molecular weight and can reduce bioactivity

[3] The therapeutic window depends entirely on getting the ratio of GCGR-to-GLP-1R activity right too much glucagon signaling relative to GLP-1 could worsen glucose control