What are the Glucagon-like peptide-1 (GLP-1) receptor agonists?

From the Guidelines

GLP-1 receptor agonists include semaglutide, dulaglutide, liraglutide, exenatide, lixisenatide, and tirzepatide, which are used for type 2 diabetes management and weight management. These medications mimic the action of the naturally occurring hormone glucagon-like peptide-1, which stimulates insulin secretion, suppresses glucagon release, slows gastric emptying, and increases satiety 1. The specific formulations of these medications include semaglutide (Ozempic, Wegovy, Rybelsus), dulaglutide (Trulicity), liraglutide (Victoza, Saxenda), exenatide (Byetta, Bydureon), lixisenatide (Adlyxin), and tirzepatide (Mounjaro, Zepbound). Some key points about these medications are:

• They are primarily used for type 2 diabetes management and, in some cases, weight management
• Most GLP-1 agonists are administered as subcutaneous injections at varying frequencies (daily to weekly), though semaglutide is also available in an oral formulation (Rybelsus)
• These medications generally start at lower doses and are titrated upward to minimize gastrointestinal side effects like nausea and vomiting
• They offer benefits beyond glucose control, including cardiovascular protection and weight reduction, making them increasingly important in metabolic health management 1.

From the FDA Drug Label

OZEMPIC is a glucagon-like peptide 1 (GLP-1) receptor agonist TRULICITY® is a glucagon-like peptide-1 (GLP-1) receptor agonist The following are GLP-1 receptor agonists:

• Semaglutide (SQ) 2
• Dulaglutide (SQ) 3

From the Research

GLP-1 Receptor Agonists

• The following are GLP-1 receptor agonists:
  • Exenatide (twice daily and once weekly) 4, 5, 6, 7, 8
  • Liraglutide (once daily) 4, 5, 6, 7, 8
  • Lixisenatide (once daily) 4, 5, 6, 7
  • Dulaglutide (once weekly) 4, 5, 6, 7, 8
  • Albiglutide (once weekly) 4, 5, 6
  • Semaglutide (once weekly and oral) 4, 5, 6, 7

Administration and Efficacy

• These agents can be administered via subcutaneous injection or orally (in the case of semaglutide) 4, 6, 7
• They have been shown to be effective in reducing HbA1c and body weight, with varying degrees of efficacy and tolerability 4, 5, 6, 7, 8

Comparison of GLP-1 Receptor Agonists

• Head-to-head clinical studies have demonstrated differences in the magnitude of effect on A1C and weight, as well as frequency of adverse effects, among the different GLP-1 receptor agonists 7, 8
• Real-world studies have also compared the effectiveness of dulaglutide, liraglutide, and exenatide once weekly, with results suggesting that dulaglutide may have a greater reduction in HbA1c compared to liraglutide 8