Thanks for contributing, [~Dr--Hamid--ayeshahameed09@ ] ! What do others think of exenatide twice daily (BID), a short-acting GLP-1RA, vs. exenatide once weekly (QW), a long-acting GLP-1RA?

Can use formulation for pt such as two formulations, ie, exenatide twice daily (BID), a short-acting GLP-1RA, and exenatide once weekly (QW), a long-acting GLP-1RA

Key Points
• Source: Clinical Pharmacology: Advances and Applications
• Conclusion/Relevance: “Exenatide is one of the exendin-based glucagon-like peptide 1 receptor agonists (GLP-1RAs) and is currently available in two formulations, ie, exenatide twice daily (BID), a short-acting GLP-1RA, and exenatide once weekly (QW), a long-acting GLP-1RA. Clinical efficacy and safety of exenatide 2 mg QW in patients with type 2 diabetes (T2DM) has been demonstrated in the DURATION study program. Exenatide QW has been shown to achieve greater HbA1c reduction compared with exenatide BID, with less injection frequency and greater treatment satisfaction.”
• Exenatide QW (once weekly) did not exhibit any cardiovascular risk reduction in clinical studies, whereas other GLP-1RAs have demonstrated such outcomes. Exenatide is also less effective than liraglutide and semaglutide with regard to HbA1c or body weight decreases in the head-to-head trials.
• The authors wrote, “Although the long-term efficacy and safety of exenatide QW have been demonstrated, exenatide QW might be selected with lower priority within the class of GLP1-RAs for the management of T2DM.”
• If available, efpeglenatide may be the best choice based on GLP1-Ras involving exendin-4. Treatment can be continued based on glycemic control and no adverse events.
• The FDA approved this agent for children aged 10 to 17 years with T2DM.
• Exenatide QW led to weight loss in patients aged 10 to 18 years with obesity and is expected to be effective for the management of glycemia and body weight. It will also offer the first once-weekly injectable GLP-1RA for children and adolescents.
• Exenatide QW also improved motor scores in individuals with Parkinson disease. The neuroprotective effects with regard to neurodegenerative diseases remain to be elucidated.
• “Further verification of the effects of exenatide QW on children and adults with T2DM or obesity, as well as patients with neurodegenerative disorders, will be needed in the future,” wrote the authors.