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**AC3174** is a synthetic peptide analogue of exendin-4, designed to act as a glucagon-like peptide-1 receptor (GLP-1R) agonist. It exhibits pharmacologic activity similar to exenatide, including antihypertensive, cardioprotective, insulin-sensitizing, and renoprotective effects in preclinical models. In animal studies, AC3174 improved survival, reduced blood pressure, improved cardiac parameters, normalized fasting insulin, improved insulin resistance, and protected kidney function. It has also been shown to decrease plasma glucose and body fat, and improve exercise capacity and respiratory efficiency in models of cardiac dysfunction. AC3174’s mechanism of action centers on mimicking the effect of endogenous GLP-1, promoting insulin secretion in response to elevated glucose, reducing glucagon secretion, slowing gastric emptying, inducing vasodilation and diuresis, and providing organ-protective effects. The original development was led by Amylin Pharmaceuticals, with later involvement from AstraZeneca.
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