Once-weekly 2.4 mg Semaglutide for Weight Management in Obesity: A Game Changer?

TouchREVIEWS in endocrinology Pub Date : 2022-06-01 Epub Date: 2022-06-15 DOI:10.17925/EE.2022.18.1.35
Ides M Colin, Katherine M Gérard
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引用次数: 1

Abstract

The treatment of obesity can no longer be reduced to a simplistic view of weight loss. Metabolic adaptation leads to systematic weight regain following weight-loss efforts, and new obesity treatments should therefore aim to induce long-standing double-digit weight loss, and thus improve and even reverse obesity-associated comorbidities such as type 2 diabetes. Until now, only metabolic surgery has been able to achieve such a goal, but this invasive procedure cannot be offered on a large scale. Among the alternatives, lifestyle interventions and drug therapies have often been disappointing. The recent availability of once-weekly subcutaneous 2.4 mg semaglutide (a glucagon-like peptide-1 receptor agonist; Wegovy™ Novo Nordisk A/S, Bagsværd, Denmark) has changed the scene, and semaglutide is considered a 'game changer' in the treatment of obesity. The results from the phase III STEP (Semaglutide treatment effect in people with obesity) clinical programme have shown that semaglutide provides clinically meaningful and sustained weight loss in ranges much higher than those achieved with previously available pharmacotherapies. These results led to the approval of semaglutide by regulatory authorities as an adjunct to a reduced-calorie diet and increased physical activity in people with obesity or overweight, with at least one weight-related comorbidity. With data from phase II and III clinical trials showing that newer drugs (i.e. the glucagon-like peptide-1 and gastric inhibitory polypeptide dual receptor agonist tirzepatide and the amylin agonist cagrilintide, either alone or combined) produce a greater sustained weight loss than semaglutide, an upstream 'weight-centric' strategy has emerged as a new standard for the treatment of type 2 diabetes.

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每周一次2.4毫克西马鲁肽用于肥胖患者的体重管理:改变游戏规则?
肥胖的治疗不能再被简化为减肥的简单观点。代谢适应导致减肥后的系统性体重恢复,因此新的肥胖治疗应该旨在诱导长期两位数的体重减轻,从而改善甚至逆转肥胖相关的合并症,如2型糖尿病。到目前为止,只有代谢手术能够实现这一目标,但这种侵入性手术无法大规模提供。在替代疗法中,生活方式干预和药物治疗往往令人失望。最近可获得每周一次皮下2.4 mg semaglutide(一种胰高血糖素样肽-1受体激动剂;Wegovy™Novo Nordisk A/S, Bagsværd,丹麦)已经改变了这一场景,semaglutide被认为是肥胖治疗的“游戏规则改变者”。来自III期STEP (Semaglutide治疗肥胖患者的效果)临床项目的结果表明,Semaglutide提供的临床意义和持续的体重减轻范围远远高于以前可用的药物治疗。这些结果导致监管机构批准西马鲁肽作为肥胖或超重人群减少卡路里饮食和增加体力活动的辅助药物,至少有一种与体重相关的合并症。II期和III期临床试验的数据显示,较新的药物(即胰高血糖素样肽-1和胃抑制多肽双受体激动剂tizepatide和amylin激动剂cagrilintide,单独或联合使用)比semaglutide产生更大的持续减肥效果,上游“以体重为中心”的策略已经成为治疗2型糖尿病的新标准。
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