Exenatide extended-release (
exenatide ER) [
Bydureon(®)] is a
glucagon-like peptide-1 receptor agonist, approved for the treatment of
type 2 diabetes mellitus. It is injected subcutaneously by patients once weekly, with no dose titration required. This article updates an earlier review of
exenatide ER in the management of
type 2 diabetes, focusing on recently published data. In randomized, controlled trials, adjunctive
exenatide ER 2 mg once weekly for 24-30 weeks significantly improved glycaemic control and reduced bodyweight in patients with inadequately controlled
type 2 diabetes despite diet plus exercise and/or oral antihyperglycaemic drugs (OADs). These beneficial effects of
exenatide ER were maintained after up to 6 years of treatment. In patients receiving one or more OADs, addition of
exenatide ER provided better glycaemic control than an immediate-release formulation of
exenatide (
exenatide twice daily),
sitagliptin,
pioglitazone,
insulin glargine or
insulin detemir, and was slightly less effective than
liraglutide. In patients treated with diet plus exercise alone, adjunctive
exenatide ER was noninferior to
metformin and superior to
sitagliptin, but was not noninferior to
pioglitazone.
Exenatide ER was generally well tolerated, with a low inherent risk of hypoglycaemia. The most common adverse events were mild to moderate gastrointestinal events,
injection-site reactions and
headache. Thus,
exenatide ER is a useful treatment option in the management of
type 2 diabetes. It offers a convenient, once-weekly regimen and can be administered by patients via a pen injection system or syringes and needles.