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The initial step of the synthesis involves the conversion of cholesterol to pregnenolone by cytochrome P450 side-chain cleavage enzyme 11A1 on mitochondrial membrane

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Endocrinology 155 (5), 18171826

The two drugs are also competing head to head in obesity, where Novo Nordisk sells its drug as Wegovy and Lilly's is called Zepbound

Subsequent assay studies indicated that (R)-3-amino-1-(2-benzoyl-1,2-diazepan-1-yl)-4-(2,4,5-trifluorophenyl) butan-1-one (40) possesses strong in vitro activity, favorable selectivity, and in vivo efficacy in mouse models (Figure 6)