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

PURPOSE: The 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. METHODS: The medical literature was searched to identify relevant data on the pharmacology and clinical effects of exenatide once weekly. FINDINGS: Exenatide 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. IMPLICATIONS: The characteristics of exenatide once weekly make it a treatment option for patients with type 2 diabetes.