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A proof-of-concept, open-label trial of weekly exenatide (2 mg, 48 weeks, 50 patients) showed an advantage in the unified multiple system atrophy rating scale (UMSARS, parts I and II combined score) at 48 weeks compared with best medically treated participants, but no difference in more objective secondary measures or biomarkers (neurofilament light chain [NfL], CSF -synuclein oligomers) (165)

[1] [4] For patients with diabetes, additional monitoring for diabetic retinopathy is recommended, and those on insulin or sulfonylureas may require dose adjustments to prevent hypoglycaemia