Exenatide

Abstract

Exenatide (Byetta) is a novel, synthetic, incretin mimetic, glucoregulatory peptide approved in the US and Europe for the treatment of patients with type 2 diabetes mellitus who have inadequate glycaemic control despite receiving treatment with maximum tolerated doses of metformin and/or a sulfonylurea. In randomised, controlled, phase III trials and post hoc completer analyses in this patient population, the addition of subcutaneous exenatide twice daily significantly improved glycaemic control and was associated with progressive and significant bodyweight reduction from baseline for up to 2 years. The overall intensity of glycaemic control with exenatide was similar to that achieved with once-daily insulin glargine or twice-daily biphasic insulin aspart. Exenatide was generally well tolerated. Most adverse events were mild to moderate in severity and gastrointestinal in nature. The overall rate of hypoglycaemia was similar to rates observed with placebo (when administered with metformin) and insulin comparators (when administered with metformin and a sulfonylurea). The addition of exenatide to therapy with metformin and a sulfonylurea provided significant improvements in treatment satisfaction and patients' health-related quality of life (HR-QOL). The drug was also cost effective compared with pioglitazone, glibenclamide (glyburide), insulin glargine (all in combination with metformin and/or a sulfonylurea) and metformin alone. Overall, adjunctive therapy with exenatide is a valuable therapeutic option in patients with type 2 diabetes requiring moderate improvements in glycaemic control despite treatment with metformin and/or a sulfonylurea.

Exenatide compared with long‐acting insulin to achieve glycaemic control with minimal weight gain in patients with type 2 diabetes: results of the Helping Evaluate Exenatide in patients with diabetes compared with Long‐Acting insulin (HEELA) study

“…Exenatide (Byetta) is a synthetic peptide that acts as an incretin mimetic and has been shown in vitro to bind to the glucagon-like peptide-1 (GLP-1) receptor [10]. It shares antidiabetes actions with the naturally occurring hormone GLP-1, including glucose-dependent enhancement of insulin secretion, suppression of inappropriately elevated glucagon levels, slowing of gastric emptying and reduction of food intake [11].…”

Exenatide Use in the Management of Type 2 Diabetes Mellitus

“…In a review of phase-III human clinical trials and post hoc completer analysis exenatide therapy was confirmed to achieve similar improvement in glycemic control to that achieved by once daily insulin glargine or twice daily isophane insulin [26]. The observed side effect profile consisted mainly of mild to moderate nausea, and rates of hypoglycemia were comparable to that of placebo (when combined with metformin) and to insulin comparator (when combined with metformin & SU).…”

Exenatide: A new promising antidiabetic agent

“…Cvetkovic and Polsker[39] have mentioned the results of randomized, controlled, phase 3 trials in T2DM patients. In their study, addition of EX to metformin and/or a sulfonylurea twice-a-day, significantly improved glycemic control and was associated with gradual and important body wt reduction from baseline for up to 2 y.…”