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Other approaches to ligand modifications for the GcgR and the GLP-1R have assessed evoking “partial” or “biased” agonism, which are suggested to capitalize on ligand-stimulated partial activation of the signaling system as a whole (partial agonism), or selective engagement and amplification of certain signaling pathways over others within the GPCR signaling milieu (ligand bias) [104]
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44 Subsequently, there have been postmarketing reports of severe cases of joint pain in patients receiving DPP-4 inhibitor therapy