Exenatide once weekly in type 2 diabetes mellitus

Introduction: Exenatide once weekly (EQW) is an injectable glucagon-like peptide-1 receptor agonist that is pending approval at present by regulatory authorities for treatment of type 2 diabetes mellitus. Its glucose-reducing and weight-loss properties, together with minimal hypoglycemia and a once-weekly dosing schedule, make it a potentially attractive treatment option for overweight type 2 diabetics. Areas covered: A literature search using PubMed resulted in a search for all published clinical trials with EQW, entitled the DURATION trials, which are reviewed in this paper. Efficacy and safety data are compared with other available antidiabetes agents. Molecular structure, pharmacokinetics, pharmacodynamics and mechanism of action are also reviewed. Expert opinion: EQW is a potentially attractive medication for overweight type 2 diabetics with efficacy in both glycemic control and weight loss, as well as minimal hypoglycemia. Owing to its route of administration and expected cost compared with generic metformin, it will probably have a role as add-on therapy rather than monotherapy. Additional studies are ongoing to compare its efficacy against liraglutide.