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Among the GLP-1RAs, exenatide is the synthetic version of exendin-4, a molecule identified in the Gila monster salivary gland whose amino acid sequence shares 53% identity with human GLP-1

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In the SUSTAIN 6 trial, over 3,297 patients with type 2 diabetes with established chronic kidney disease and/or cardiovascular disease underwent randomization to semaglutide or placebo and were followed for 2 years resulting in a 26% risk reduction in the combined endpoint of rate of cardiovascular disease, nonfatal myocardial infarction, or nonfatal stroke [47]

The retail pharmacies segment contributed the biggest market share of 54% in 2025, driven by the primary dispensing channel for chronic therapy