Back to Search
Start Over
Glucagon-like peptide-1 receptor agonists in type 2 diabetes treatment: are they all the same?
- Source :
-
Diabetes/metabolism research and reviews [Diabetes Metab Res Rev] 2019 Jan; Vol. 35 (1), pp. e3070. Date of Electronic Publication: 2018 Oct 04. - Publication Year :
- 2019
-
Abstract
- Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are an important class of drugs with a well-established efficacy and safety profile in patients with type 2 diabetes mellitus. Agents in this class are derived from either exendin-4 (a compound present in Gila monster venom) or modifications of human GLP-1 active fragment. Differences among these drugs in duration of action (ie, short-acting vs long-acting), effects on glycaemic control and weight loss, immunogenicity, tolerability profiles, and administration routes offer physicians several options when selecting the most appropriate agent for individual patients. Patient preference is also an important consideration. The aim of this review is to discuss the differences between and similarities of GLP-1 RAs currently approved for clinical use, focusing particularly on the properties characterising the single short-acting and long-acting GLP-1 RAs rather than on their individual efficacy and safety profiles. The primary pharmacodynamic difference between short-acting (ie, exenatide twice daily and lixisenatide) and long-acting (ie, albiglutide, dulaglutide, exenatide once weekly, liraglutide, and semaglutide) GLP-1 RAs is that short-acting agents primarily delay gastric emptying (lowering postprandial glucose) and long-acting agents affect both fasting glucose (via enhanced glucose-dependent insulin secretion and reduced glucagon secretion in the fasting state) and postprandial glucose (via enhanced postprandial insulin secretion and inhibition of glucagon secretion). Other advantages of long-acting GLP-1 RAs include smaller fluctuations in plasma drug concentrations, improved gastrointestinal tolerability profiles, and simpler, more convenient administration schedules (once daily for liraglutide and once weekly for albiglutide, dulaglutide, the long-acting exenatide formulation, and semaglutide), which might improve treatment adherence and persistence.<br /> (© 2018 John Wiley & Sons, Ltd.)
- Subjects :
- Exenatide therapeutic use
Glucagon-Like Peptide 1 analogs & derivatives
Glucagon-Like Peptide 1 therapeutic use
Glucagon-Like Peptides analogs & derivatives
Glucagon-Like Peptides therapeutic use
Humans
Immunoglobulin Fc Fragments therapeutic use
Recombinant Fusion Proteins therapeutic use
Treatment Outcome
Diabetes Mellitus, Type 2 drug therapy
Glucagon-Like Peptide-1 Receptor agonists
Hypoglycemic Agents therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1520-7560
- Volume :
- 35
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Diabetes/metabolism research and reviews
- Publication Type :
- Academic Journal
- Accession number :
- 30156747
- Full Text :
- https://doi.org/10.1002/dmrr.3070