Many drugs and drug candidates are suboptimal because of short duration of action. For example, peptides and proteins often have serum half-lives of only minutes to hours. One solution to this problem involves conjugation to circulating carriers, such as PEG, that retard kidney filtration and hence increase plasma half-life of the attached drug. We recently reported an approach to half-life extension that uses sets of self-cleaving linkers to attach drugs to macromolecular carriers. The linkers undergo β-eliminative cleavage to release the native drug with predictable half-lives ranging from a few hours to over 1 y; however, half-life extension becomes limited by the renal elimination rate of the circulating carrier. An approach to overcoming this constraint is to use noncirculating, biodegradable s.c. implants as drug carriers that are stable throughout the duration of drug release. Here, we use β-eliminative linkers to both tether drugs to and cross-link PEG hydrogels, and demonstrate tunable drug release and hydrogel erosion rates over a very wide range. By using one β-eliminative linker to tether a drug to the hydrogel, and another β-eliminative linker with a longer half-life to control polymer degradation, the system can be coordinated to release the drug before the gel undergoes complete erosion. The practical utility is illustrated by a PEG hydrogel-exenatide conjugate that should allow once-a-month administration, and results indicate that the technology may serve as a generic platform for tunable ultralong half-life extension of potent therapeutics.click chemistry | regenerative medicine | tetra-PEG C onjugation of drugs to macromolecular carriers is a proven strategy for improving pharmacokinetics. In one approach, the drug is covalently attached to a long-lived circulating macromolecule-such as PEG-through a linker that is slowly cleaved to release the native drug (1, 2). We have recently reported such conjugation linkers that self-cleave by a nonenzymatic β-elimination reaction in a highly predictable manner, and with half-lives of cleavage spanning from hours to over a year (3). In this approach, a macromolecular carrier is attached to a linker that is attached to a drug or prodrug via a carbamate group (1; Scheme 1); the β-carbon has an acidic carbon-hydrogen bond (C-H) and also contains an electron-withdrawing "modulator" (Mod) that controls the pK a of that C-H. Upon hydroxide ion-catalyzed proton removal to give 2, a rapid β-elimination occurs to cleave the linkercarbamate bond and release the free drug or prodrug and a substituted alkene 3. The rate of drug release is proportional to the acidity of the proton, and that is controlled by the chemical nature of the modulator; thus, the rate of drug release is controlled by the modulator. It was shown that both in vitro and in vivo cleavages were linearly correlated with electron-withdrawing effects of the modulators and, unlike ester bonds commonly used in releasable linkers (2), the β-elimination reaction was not catalyzed by general bases or ser...