Dulaglutide: a novel once-weekly glucagon-like peptide-1 receptor agonist

Author(s): Signe V Naver, Espen Jimenez-Solem, Mikkel Christensen, Jon T Andersen & Filip K Knop

Dulaglutide is a novel continuous-acting glucagon-like peptide-1 (GLP-1) receptor agonist developed for the treatment of Type 2 diabetes. It consists of two modified ‘GLP-1’ moieties covalently linked to a human immunoglobulin (IgG) 4-FC heavy chain. The large size of the molecule prolongs plasma half-life and allows for once-weekly administration. Clinical Phase II and III trials show dose-dependent reductions of HbA1c up to 1.6%, reduction in fasting plasma glucose up to 2.7 mmol/l and weight reductions up to 3.2 kg. Presumably, a dose of 1.5 mg once weekly will be the intended dose for treatment. Safety data indicate a low incidence of hypoglycemia and the most frequently reported adverse events are gastrointestinal, primarily nausea, which seem to reduce over time.