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Dulaglutide: A Review in Type 2 Diabetes

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Abstract

Dulaglutide (Trulicity™) is a once-weekly subcutaneously administered glucagon-like peptide-1 (GLP-1) receptor agonist produced by recombinant DNA technology and approved in numerous countries as an adjunct to diet and exercise for the treatment of adults with type 2 diabetes (T2DM). In randomized controlled trials in patients with T2DM, dulaglutide monotherapy was noninferior to once-daily subcutaneous liraglutide monotherapy and significantly more effective than oral metformin monotherapy in improving glycemic control at 26 weeks. When used in combination with other agents (including metformin, metformin and a sulfonylurea, metformin and oral pioglitazone, and prandial insulin ± metformin), dulaglutide was noninferior to once-daily liraglutide and significantly more effective than once-daily oral sitagliptin, twice-daily subcutaneous exenatide, and once-daily subcutaneous insulin glargine in terms of improvements in glycated hemoglobin from baseline at 26 or 52 weeks, in trials of 26–104 weeks’ duration. Moreover, dulaglutide 1.5 mg once weekly, but not 0.75 mg once weekly, was associated with consistent reductions form baseline in bodyweight. Improvements in glycemic control and bodyweight were maintained during long-term treatment (up to 2 years). Dulaglutide was generally well tolerated, with a low inherent risk of hypoglycemia. The most frequently reported adverse events in clinical trials were gastrointestinal-related (e.g., nausea, vomiting, and diarrhea). Thus, dulaglutide is a useful option for the treatment of adult patients with T2DM.

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Acknowledgments

During the peer review process, the manufacturer of the dulaglutide was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Celeste B. Burness & Lesley J. Scott

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  1. Celeste B. Burness
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Correspondence to Celeste B. Burness.

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The preparation of this review was not supported by any external funding.

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Celeste Burness and Lesley Scott are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.

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The manuscript was reviewed by: D. S. H. Bell, Southside Endocrinology, University of Alabama Medical School, Birmingham, Alabama, USA; S. R. Bloom, Department of Investigative Medicine, Imperial College London, London, UK; G. Dimitriadis, 2nd Department of Internal Medicine, Research Institute and Diabetes Center, “Attikon” University Hospital, Athens University Medical School, Athens, Greece; J. G. Eriksson, Department of General Practice and Primary Health Care, Finland and Helsinki University Central Hospital, Helsinki, Finland; V. C. Woo, Section of Endocrinology and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada.

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Burness, C.B., Scott, L.J. Dulaglutide: A Review in Type 2 Diabetes. BioDrugs 29, 407–418 (2015). https://doi.org/10.1007/s40259-015-0143-4

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