Exenatide: difference between revisions
Diff·revision 18 → 19·11:05, 12 Jul 2025
Difference between revision 18 and revision 19 of Exenatide. 6 lines changed; the page grew by 1,059 bytes.
| Revision 18 — 13:15, 17 Jun 2025 CiteBot (talk) bot: normalise citation format 4,472 bytes ±0 | Revision 19 — 11:05, 12 Jul 2025 AnaesthesiaAoife (talk) clarify that the peptide backbone is acylated rather than PEGylated 5,531 bytes +1,059 | ||
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| 35 | The suspension also requires reconstitution and vigorous mixing immediately before injection, a preparation burden that later single-solution products removed. | 35 | The suspension also requires reconstitution and vigorous mixing immediately before injection, a preparation burden that later single-solution products removed. |
| 36 | 36 | ||
| + | 37 | == Clinical position == | |
| + | 38 | Exenatide reduces glycated haemoglobin by roughly 0.8–1.5 percentage points depending on formulation and background therapy, with modest weight reduction. The EXSCEL cardiovascular outcome trial of the extended-release product reported a hazard ratio of 0.91 (95% CI 0.83–1.00) for the primary composite, narrowly failing conventional significance for superiority while establishing non-inferiority.{{r|holman2017}} | |
| + | 39 | ||
| + | 40 | That result is worth noting whenever a cardiovascular benefit is described as a class effect: within the same class, [[LEADER trial|LEADER]] and [[SELECT trial|SELECT]] were positive, EXSCEL was neutral, and the outcome trial of lixisenatide was neutral. Whether the differences reflect molecule, dose, population or duration is unresolved.{{r|holman2017}} | |
| + | 41 | ||
| 37 | == References == | 42 | == References == |
| 38 | {{reflist}} | 43 | {{reflist}} |
| 39 | <ref name="nielsen2004">Nielsen LL, Young AA, Parkes DG. "Pharmacology of exenatide (synthetic exendin-4): a potential therapeutic for improved glycemic control of type 2 diabetes." ''Regulatory Peptides'' 117(2):77–88 (2004). PMID 14700743.</ref> | 44 | <ref name="nielsen2004">Nielsen LL, Young AA, Parkes DG. "Pharmacology of exenatide (synthetic exendin-4): a potential therapeutic for improved glycemic control of type 2 diabetes." ''Regulatory Peptides'' 117(2):77–88 (2004). PMID 14700743.</ref> |
| 40 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> | 45 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> |
| + | 46 | <ref name="holman2017">Holman RR, Bethel MA, Mentz RJ, et al. "Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes." ''New England Journal of Medicine'' 377(13):1228–1239 (2017). DOI:10.1056/NEJMoa1612917. PMID 28910237.</ref> | |
| 41 | <ref name="usp1503">United States Pharmacopeia, General Chapter <1503>, ''Quality Attributes of Synthetic Peptide Drug Substances''.</ref> | 47 | <ref name="usp1503">United States Pharmacopeia, General Chapter <1503>, ''Quality Attributes of Synthetic Peptide Drug Substances''.</ref> |
| 42 | 48 |