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Modern pharmacokinetics has underscored the importance of a loading dose to achieve circulating values above bacterial Minimal Inhibitory Concentrations (MIC) to reduce the risk of resistance 6,7
For example, efpeglenatide, a long-acting GLP-1 RA and an exendin analog linked to an IgG4 Fc fragment, has been explored for once-monthly administration to treat type 2 diabetes
Phase IIb Dose-Finding Clayton et al
These within-class switches are generally simpler than cross-class transitions because the underlying mechanism of action remains the same
There may be unforeseen interactions or cumulative effects that could impact overall safety
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