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Exenatide

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Abstract

▴ Exenatide is an incretin mimetic. It improves glycaemic control via various glucoregulatory mechanisms, including glucose-dependent insulinotropism, suppression of inappropriately high glucagon levels, delayed gastric emptying and reduction of food intake.

▴ In three large, well designed, phase III trials in adults with type 2 diabetes mellitus and suboptimal glycaemic control despite treatment with metformin and/or a sulfonylurea, mean changes from baseline in glycosylated haemoglobin (HbA1c) significantly favoured subcutaneous exenatide 5 or 10μg twice daily over placebo after 30 weeks’ treatment (primary endpoint).

▴ Relative to placebo, reductions from baseline in bodyweight were significantly greater with twice-daily exenatide 5 μg (in two studies) or 10μg (in all three studies).

▴ Post hoc completer analyses revealed that the beneficial effects of exenatide on HbA1c and body-weight were maintained for up to 82 weeks.

▴ Adjunctive therapy with subcutaneous exenatide 10μg twice daily improved glycaemic control to a similar extent as insulin glargine in patients with type 2 diabetes suboptimally controlled with metformin plus a sulfonylurea in a large, well designed, 26-week, phase III trial.

▴ Subcutaneous exenatide was generally well tolerated in patients with type 2 diabetes. The incidence of hypoglycaemia in patients receiving exenatide plus metformin was similar to that seen in placebo plus metformin recipients; however, in patients receiving a sulfonylurea (with or without metformin), the incidence of hypoglycaemia was numerically higher with exenatide than with placebo.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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    Gillian M. Keating

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Keating, G.M. Exenatide. Drugs 65, 1681–1692 (2005). https://doi.org/10.2165/00003495-200565120-00008

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