Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: Their Use and Differential Features

Version 4 2020-02-17, 20:10

Version 3 2020-01-15, 02:29

Version 2 2019-12-23, 00:16

Version 1 2019-12-05, 00:30

online resource

posted on 2020-02-17, 20:10 authored by Katherine Lyseng-Williamson

Available in English, and as German and Spanish translations:

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Compliance with ethical standards

Funding The preparation of this review was not supported by any external funding.

The translated versions of the article were made possible thanks to an independent educational grant from Novo Nordisk A/S.

Conflicts of interest K.A. Lyseng-Williamson is an employee of Adis International/Springer Nature, is responsible for the article content and declares no conflicts of interest.

Additional information about this Adis Drug Review can be found here

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are well established as effective adjuncts to lifestyle modification in the treatment of type 2 diabetes (T2D) as monotherapy or in combination with oral glucose-lowering drugs ± insulin. The six subcutaneous GLP-1RA formulations (i.e. twice-daily exenatide, once-daily liraglutide and lixisenatide, and once-weekly dulaglutide, exenatide and semaglutide) currently available in the EU and USA have many similarities, but also some unique features and properties. By stimulating GLP-1 receptors, GLP-1RAs increase insulin secretion and suppress glucagon release in a glucose-dependent manner, thereby improving clinical and patient-reported outcomes related to glycaemic control and weight. They also have been shown to reduce, or at least not increase, the risk of major cardiovascular outcomes. GLP-1RAs are generally well tolerated, with gastrointestinal and injection-site reactions being the most troublesome drug-related adverse events, and are associated with a very low intrinsic risk of hypoglycaemia. Treatment with GLP-1RAs should be customized to meet the clinical needs and personal preferences of the individual.