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GEP44 was developed based on extensive structure–activity relationship studies and earlier preliminary in vivo studies that demonstrated its greater efficacy at reducing both food intake and body weight compared to the agonist peptide, Ex-4, without triggering gastrointestinal distress (as assessed by kaolin intake and behavioral scoring as a proxy for nausea in rats and direct evidence of emesis in shrews) 16
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Relative contraindications include recurrent pancreatitis, gastroparesis, or ongoing unexplained gastrointestinal symptoms
