Once-Weekly Exenatide for Type 2 Diabetes

In January 2012, a formulation of exenatide that requires only a once-weekly injection (Bydureon) was approved by the FDA. In this manufacturer-funded, placebo-controlled study, about 800 patients with type 2 diabetes (mean glycosylated hemoglobin [HbA_1c], 8.5%) were randomized to receive once-weekly exenatide (2 mg subcutaneously), metformin, pioglitazone, or sitagliptin.

After 26 weeks, mean HbA_1c fell by about 1.5% in the exenatide, metformin, and pioglitazone groups and by about 1.2% in the sitagliptin group. Mean reduction in weight was 2 kg with exenatide and metformin and 0.8 kg with sitagliptin, but weight increased by 1.5 kg with pioglitazone. No patients experienced major hypoglycemia during the study.