Exenatide Once Weekly for Management of Type 2 Diabetes: A Review

IF 3.1 Q2 PHARMACOLOGY & PHARMACY Clinical Pharmacology : Advances and Applications Pub Date : 2022-02-01 DOI:10.2147/CPAA.S288846
Jun Inaishi, Y. Saisho
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引用次数: 3

Abstract

Abstract Exenatide is one of the exendin-based glucagon-like peptide 1 receptor agonists (GLP-1RAs) and is currently available in two formulations, ie, exenatide twice daily (BID), a short-acting GLP-1RA, and exenatide once weekly (QW), a long-acting GLP-1RA. Clinical efficacy and safety of exenatide 2 mg QW in patients with type 2 diabetes (T2DM) has been demonstrated in the DURATION study program. Exenatide QW has been shown to achieve greater HbA1c reduction compared with exenatide BID, with less injection frequency and greater treatment satisfaction. However, exenatide QW failed to show a significant cardiovascular risk reduction in a cardiovascular outcome trial (CVOT), the EXSCEL trial, while other GLP-1RAs have shown positive CV outcomes. Furthermore, exenatide QW has been shown to be inferior to liraglutide and semaglutide with respect to HbA1c or body weight reduction in the head-to-head trials. Thus, although the long-term efficacy and safety of exenatide QW have been demonstrated, exenatide QW might be selected with lower priority within the class of GLP1-RAs for the management of T2DM, especially for patients at high CV risk. On the other hand, exenatide QW is now expected to be a treatment option for children with T2DM or patients with Parkinson’s disease. This review provides an overview of the current evidence regarding the clinical efficacy and safety of exenatide QW and discusses the current perspectives on exenatide QW for treatment of T2DM.
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艾塞那肽治疗2型糖尿病每周1次:综述
艾塞那肽是一种基于exendin的胰高血糖素样肽1受体激动剂(GLP-1RAs),目前有两种剂型,即每日两次(BID),一种短效GLP-1RA,以及每周一次(QW),一种长效GLP-1RA。艾塞那肽2mg QW治疗2型糖尿病(T2DM)的临床疗效和安全性已在DURATION研究项目中得到证实。与艾塞那肽BID相比,艾塞那肽QW已显示出更大的HbA1c降低效果,注射频率更少,治疗满意度更高。然而,在心血管结局试验(CVOT),即EXSCEL试验中,艾塞那肽QW未能显示出显著的心血管风险降低,而其他GLP-1RAs则显示出积极的心血管结局。此外,在头对头试验中,艾塞那肽QW已被证明在HbA1c或体重降低方面不如利拉鲁肽和西马鲁肽。因此,尽管艾塞那肽QW的长期疗效和安全性已得到证实,但在GLP1-RAs类药物中,艾塞那肽QW的优先级可能较低,可用于T2DM的治疗,特别是对于CV风险较高的患者。另一方面,艾塞那肽QW现在有望成为2型糖尿病儿童或帕金森病患者的治疗选择。本文综述了目前关于艾塞那肽QW的临床疗效和安全性的证据,并讨论了艾塞那肽QW治疗T2DM的最新观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
14
审稿时长
16 weeks
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