title: An overview of new GLP-1 receptor agonists for type 2 diabetes.
abstract: BACKGROUND
  The increasing prevalence of type 2 diabetes mellitus (T2DM) and the eventual need for multiple medications in most patients stimulated the development of new drug classes to reduce plasma glucose levels. The GLP-1 receptor agonists (GLP-1RAs) are established as an option for treatment of T2DM after metformin. They are also effective in reducing body weight but current GLP-1RAs have to be given by subcutaneous injection daily or once weekly.
  
  
  METHODS
  This review focuses on the new GLP-1RAs currently undergoing development, some of which require less frequent subcutaneous administration and others that are being developed in oral formulations that may favor patient adherence.
  
  
  CONCLUSIONS
  The new GLP-1RAs may have the benefit of requiring less frequent subcutaneous dosing or being active by oral administration. However, cardiovascular outcome trials have shown that DPP4 inhibitors are neutral for cardiovascular events and the first cardiovascular outcome trial with lixisenatide reported similar results, whereas the trial with the SGLT2 inhibitor empagliflozin showed a reduction in cardiovascular events. These findings in patients with high cardiovascular risk may favor the use of SGLT2 inhibitors as a second line treatment after metformin but there should still be an important role for novel GLP-1RAs, especially when weight reduction is required.
authors.affiliation: a Research Center for Translational Medicine , Shanghai East Hospital Affiliated to Tongji University School of Medicine , Shanghai , China.|b Department of Medicine & Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin , Hong Kong.
authors.forename: Brian
authors.initials: B
authors.lastname: Tomlinson
authors.affiliation: b Department of Medicine & Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin , Hong Kong.
authors.forename: Miao
authors.initials: M
authors.lastname: Hu
authors.affiliation: a Research Center for Translational Medicine , Shanghai East Hospital Affiliated to Tongji University School of Medicine , Shanghai , China.
authors.forename: Yuzhen
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: c Division of Cardiology, Department of Internal Medicine , Wan Fang Hospital, Taipei Medical University , Taipei city , Taiwan.
authors.forename: Paul
authors.initials: P
authors.lastname: Chan
authors.affiliation: d Department of Cardiac Surgery , Shanghai East Hospital, Tongji University , Shanghai , China.
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Liu
mesh_terms: D000284:Administration, Oral; D000818:Animals; D001835:Body Weight / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D015195:Drug Design; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D055118:Medication Adherence; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D007004:Hypoglycemic Agents; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: Efpeglenatide; GLP-1; GLP-1 receptor agonist; glymera; semaglutide; type 2 diabetes mellitus