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[281] [282] A third route starts with ethyl 3-oxobutanoate which through a double alkylation with methyl iodide followed by benzyl chloride can be converted into 2-methyl-3-phenyl-propanoic acid

The cyanobenzyl group at the N1 position of the pyrimidine-2,4-dione compounds is strategically placed in the S 1 domain, and the nitrile group forms a hydrogen bond with Arg125

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In the brain, GLP-1 receptor activation affects areas that regulate appetite and satiety, leading to reduced hunger and increased feelings of fullness