Mechanism of Action
GLP-1 receptor agonism. Enhances glucose-dependent insulin secretion, suppresses glucagon, delays gastric emptying, promotes satiety via central appetite regulation.
Clinical Use
T2D management (Victoza), chronic weight management (Saxenda). CV risk reduction in T2D with established CVD.
Contraindications
MTC or MEN2 history. Pancreatitis history. Severe GI disease.
Evidence Summary
FDA-approved 2010 (T2D), 2014 (obesity). LEADER CVOT demonstrated CV mortality reduction. Establishes evidence floor for the incretin class.
Key Studies
- 1.Marso et al., NEJM 2016 (LEADER Trial) — MACE HR 0.87 (p=0.01). CV death HR 0.78. All-cause mortality HR 0.85. n=9,340
- 2.SCALE Obesity Program — consistent 4-6 kg weight loss vs placebo over 56 weeks. n=5,908
Evidence Gaps
Largely superseded by semaglutide and tirzepatide for weight loss efficacy. Daily injection vs weekly dosing is a patient adherence disadvantage.
Emerging Research
Primarily serves as historical comparator and evidence floor for the GLP-1 class.