Exenatide Once Weekly: A Review of Pharmacology and Treatment Considerations in Type 2 Diabetes

PurposeThe pathophysiology of type 2 diabetes mellitus is complex and involves multiple organs and hormones, suggesting that successful treatment may require therapies that target multiple mechanisms. Exenatide, a glucagon-like peptide 1 receptor agonist, has a multifaceted mechanism of action involving pancreatic α and β cells, hepatic glucose production, gastric motility, and satiety. Exenatide once weekly (a twice-daily formulation is also available) utilizes continuous release from biodegradable microspheres. This review discusses relevant efficacy and tolerability outcomes with exenatide once weekly in the context of its pharmacology.MethodsThe medical literature was searched to identify relevant data on the pharmacology and clinical effects of exenatide once weekly.FindingsExenatide once weekly, like the twice-daily formulation, has been shown to improve glycemic parameters, promote weight loss, result in beneficial changes in cardiovascular risk factors, and is well-tolerated.ImplicationsThe characteristics of exenatide once weekly make it a treatment option for patients with type 2 diabetes.