Table 7.

Summary table of studies of GLP-1 receptor antagonism in PBH.

Study	Population	Intervention	Comparator	Outcome
Salehi, 2014 (10)	Symptomatic RYGB (H-GB), n=9 Asymptomatic RYGB (A-GB), n = 7 Healthy controls, n = 8	Exendin 9–39 IV infusion	Saline infusion	Exendin 9–39 corrected post-prandial hypoglycaemia in all H-GB group.
Craig, 2017 (107)	Symptomatic RYGB, n = 10	Exendin 9–39 IV infusion in cross-over study	Placebo	During 75 g OGTT, exendin 9–39 reduced peak and increased nadir glucose (preventing development of hypoglycaemia).
Craig, 2018 (108)	Symptomatic RYGB, n = 9	Ascending SC dose of exendin 9–39	None	During 75 g OGTT, exendin 9–39 increased nadir glucose by and decreased peak insulin.
Tan, 2020 (109)	Symptomatic RYGB, n = 19 for lyophilised and n = 5 for liquid formulation	Ascending SC doses of exendin 9–39 (avexitide) in lyophilised and liquid formulations	None	During 75 g OGTT, avexitide improved glucose nadir, insulin peak and symptom scores in a dose-dependent manner. Doses ≥20 mg twice a day obviated need for rescue glucose treatment initiated at glucose <2.8 mmol/L.
Craig, 2021 (110)	Symptomatic RYGB, all women and diet-refractory, n = 18	Avexitide 30 mg SC BD or 60 mg SC OD for up to 2 weeks each in cross-over study	Placebo	In mixed-meal testing, avexitide increased nadir glucose by 21–26% and reduced peak insulin by 21–23%. Significant reductions in frequency of hypoglycaemic episodes.

BD, twice a day; IV, intravenous; OD, once a day; OGTT, oral glucose tolerance test; RYGB, Roux-en-Y gastric bypass; SC, subcutaneous.