Table 1 Main differences between short- and long-acting GLP-1 receptor agonists
From: Is there a justification for classifying GLP-1 receptor agonists as basal and prandial?
Short-acting | Long-acting | |
|---|---|---|
Drugs | Exenatide Lixisenatide | Liraglutide Exenatide-LAR Albiglutide Dulaglutide |
Half-life | 2–5 h | 12 h to several days |
Increased secretion of insulin | + | ++ |
Decreased secretion of glucagon | + | + |
Decreased gastric emptying | ++ | + |
Decreased fasting plasma glucose | + | ++ |
Decreased postprandial glycemia | +/++a | +a |
Weight loss | + | +/++ |
Effects (head-to-head studies) | ||
Reduction in HbA1c | ||
Exenatide–exenatide-LAR | −1.5% (0.1) | −1.9% (0.1) |
Exenatide–liraglutide | −0.79% (0.08) | −1.12% (0.08) |
Lixisenatide–liraglutide | Not evaluableb | Not evaluableb |
Exenatide–dulaglutide | −0.99% (0.06) | −1.51% (0.06) |
Reduction in fasting plasma glucose | ||
Exenatide–exenatide-LAR | −1.4 (0.2) mmol/L | −2.3 (0.2) mmol/L |
Exenatide–liraglutide | −0.6 (0.2) mmol/L | −1.61 (0.2) mmol/L |
Lixisenatide–liraglutide | −0.34 (0.15) mmol/L | −1.3 (0.15) mmol/L |
Exenatide–dulaglutide | −1.33 (0.11) mmol/L | −2.39 (0.11) mmol/L |
Reduction in hyperglycemia after breakfast | ||
Exenatide–exenatide-LAR | –6.9 (0.5) mmol/Lc | –5.3 (0.5) mmol/Lc |
Exenatide–liraglutide | –1.33 mmol/Ld | |
Lixisenatide–liraglutide | –3.9 (0.2) mmol/Le | –1.4 (0.2) mmol/Le |
Exenatide–dulaglutide | Similar reduction | |
Reduction in hyperglycemia after lunch and dinner | ||
Exenatide–exenatide-LAR | Not evaluable | |
Exenatide–liraglutide | No differences in meals | |
Lixisenatide–liraglutide | Lower glucose levels with liraglutide | |
Exenatide–dulaglutide | Higher glucose levels with exenatide | |
Weight loss | ||
Exenatide–exenatide-LAR | –3.6 (0.5) kg | –3.7 (0.5) kg (NS) |
Exenatide–liraglutide | –2.87 (0.33) kg | –3.24 (0.33) kg (NS) |
Lixisenatide–liraglutide | Not evaluableb | Not evaluableb |
Exenatide–dulaglutide | –1.07 (0.29) kg | –1.3 (0.29) kg |