Table 2.

Comparative characteristics of currently marketed ^a , short‐ and longer‐acting, injectable GLP‐1 RAs

GLP‐1 RA agent	Based on	Molecular formula Molecular weight (kilodaltons)	SC dosing			T max	t 1/2	Homology to native GLP‐1 (%)	Presence of antibodies to agent/GLP‐1 (%)	Renal dosing	Elimination	CL (L/h)
			Timing	Initial dose	Regular dose
Exenatide BID b , 29	Exendin‐4 11 , 97	C184H282N50O60S 4.2	BID within 1 h before morning and evening meals (approx. 6 h or more apart)	5 mcg BID	5 or 10 mcg BID	2.1 h	2.4 h	53 98	38	Creatinine CL < 30 mL/min not recommended	Renal/proteolysis	9.1
Lixisenatide c , 30	Exendin‐4 11 , 97	C215H347N61O65S 4.9	QD within 1 h before the first meal of the day	10 mcg	20 mcg	1‐3.5 h	3 h	50 11 , 97 , 98	70	eGFR < 15 mL/min/1.73 m2 not recommended	Renal/proteolysis	35
Liraglutide d 27	Modified human GLP‐1	C172H265N43O51 3.8	QD at any time of day, with or without food	0.6 mg	1.2 or 1.8 mg	8‐12 h	13 h	97	8.6	No dose adjustment	No specific organ	1.2
Exenatide ER e 19	Exendin‐4	C184H282N50O60S 4.2	QW at any time of day, with or without food	2.0 mg	2.0 mg	Peaks around 2 and 6‐7 weeks	5 days	53 98	Not explicitly stated in the PI	eGFR < 30 mL/min/1.73 m2 not recommended	Renal/proteolysis	9.1
Dulaglutide f 21	Modified human GLP‐1	Not explicitly stated in the PI 63	QW at any time of day, with or without food	0.75 mg	0.75 or 1.5 mg	24‐72 h (median, 48 h)	5 days	90	1.6	No dose adjustment	Endogenous metabolism	0.111 (0.75 mg) and 0.107 (1.5 mg)
Semaglutide g 20	Modified human GLP‐1	C187H291N45O59 4.1	QW at any time of day, with or without food	0.25 mg	0.5 or 1.0 mg	1‐3 days	7 days	94	1	No dose adjustment	Urine and faeces	0.05

Long‐acting GLP‐1 RAs indicated as bold text.

Abbreviations: BID, twice‐daily; CL, clearance; eGFR, estimated glomerular filtration rate; ER, extended‐release; GLP‐1 RA, glucagon‐like peptide‐1 receptor agonist; GLP‐1, glucagon‐like peptide‐1; mcg, micrograms; mg, milligrams; PI, prescribing information; QD, once‐daily; QW, once‐weekly; SC, subcutaneous; t _1/2, elimination half‐life; ⁵ T _max, time to maximum plasma concentration.

^aAlbiglutide is not included in this table, as it was withdrawn from the market in summer 2018.

^bByetta^®; Amylin Pharmaceuticals; approved in 2005.

^cAdlyxin^®; Sanofi‐Aventis; approved in 2016. Lixisenatide is also available in combination with insulin glargine under the name Soliqua^®/Suliqua^®.

^dVictoza^®; Novo Nordisk; approved in 2010. Liraglutide is also available in combination with insulin degludec under the name Xultophy^®.

^eBydureon^®; AstraZeneca; approved in 2012.

^fTrulicity^®; Eli Lilly and Company; approved in 2014.

^gOzempic^®; Novo Nordisk; approved in 2017.