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Regulatory Milestones 2022 (May) : FDA approval of Mounjaro for type 2 diabetes (5, 10, 15 mg doses) 2023 (November) : FDA approval of Zepbound for chronic weight management (same molecule, obesity-specific branding) 2024 : EMA approval in European Union for both indications 2025 : SURPASS-CVOT cardiovascular outcomes data published, showing MACE benefit Molecular Structure and Chemistry Amino Acid Sequence Tirzepatide is a 39-amino acid peptide based on native human GIP(1-42) with multiple modifications: Modified sequence : Tyr-Aib-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Tyr-Ser-Ile-Leu-Asp-Lys-Ile-Ala-Gln-Lys-Lys*(C-20 diacid via Glu-2xOEG)-Ala-Phe-Val-Gln-Trp-Leu-Ile-Ala-Gly-Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH 2 Single-letter code : Y- Aib -E-G-T-F-T-S-D-Y-S-I- L -D-K-I-A-Q- K K *- A -F-V-Q-W-L-I-A-G-G-P-S-S-G-A-P-P-P-S-NH 2 Where bold indicates non-native substitutions vs

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