Long-Acting Glucagon-Like Peptide 1 Receptor Agonists A review of their efficacy and tolerability

The results achieved with long-acting GLP-1 receptor agonists appear to be superior to those achieved with short-acting GLP-1 receptor agonists, with greater improvements in glycemic control after once-daily liraglutide treatment compared with twice-daily exenatide. Furthermore, exenatide LAR provided better glycemic control than exenatide with comparable weight loss. Trials are ongoing to evaluate the efficacy of exenatide LAR when compared with insulin glargine in patients with type 2 diabetes on a metformin background with or without prior sulfonylurea treatment (DURATION-3; NCT00641056) or used as monotherapy in drug-naive patients (DURATION-4; NCT00676338). As a drug class, long-acting GLP-1 receptor agonists increase glycemic control in patients with type 2 diabetes with a low risk of hypoglycemia because of their glucose-dependent mechanism of action. This drug class has also been demonstrated to promote weight loss and reduce SBP, which could be of benefit to patients with type 2 diabetes, reducing their cardiovascular risk. Furthermore, although nausea is a common side effect with long-acting GLP-1 receptor agonists, it tends to be transient and, overall, long-acting GLP-1 receptor agonists are generally well tolerated. Thus, long-acting GLP-1 receptor agonists may provide an effective therapeutic option for individuals with type 2 diabetes and are well placed to meet the standard of care guidelines set by the ADA in treating more than just blood glucose. © 2011 by the American Diabetes Association.