医生对GLP-1受体激动剂的安全性和有效性的认识:心血管风险降低的低估和与临床证据的差异

IF 2.3 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Development and Disease Pub Date : 2025-01-07 DOI:10.3390/jcdd12010019
Srikanth Krishnan, Pratyaksh K Srivastava, Jayram Attaluri, Rebecca Nayeri, Dhananjay Chatterjee, Jay Patel, Ali Nsair, Matthew Budoff, Arash Nayeri
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引用次数: 0

摘要

胰高血糖素样肽-1受体激动剂(GLP-1 RAs)和葡萄糖依赖性胰岛素多肽/GLP-1受体激动剂(GIP/GLP-1 RAs)正在成为肥胖和心脏代谢疾病的有效治疗方法。本研究通过对165名专门从事内科或家庭医学的主治医生进行问卷调查,收到122份回复,评估了医生对西马鲁肽和替西帕肽的安全性和有效性的看法。医生报告的患者平均体重减轻了9.22%,显著低于STEP和SURMOUNT试验分别报告的14.9%和18.5%。估计的副作用率(32.62%)明显低于试验报告的发生率(89.7%和80.5%),而估计的停药率(8.59%)超过试验数据。48.4%的医生认为糖尿病患者对心血管有好处,与随机猜测一致,而非糖尿病患者只有39.3%,明显低于随机猜测的预期。这些结果突出了医生认知和临床证据之间的差异,表明对这些药物的疗效和安全性的理解存在差距。解决这些差距可以提高医生的知识,患者的依从性和临床结果。
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Physician Perceptions of the Safety and Efficacy of GLP-1 Receptor Agonists: Underestimation of Cardiovascular Risk Reduction and Discrepancies with Clinical Evidence.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonists (GIP/GLP-1 RAs) are emerging as effective treatments for obesity and cardiometabolic disease. This study evaluated physician perceptions of the safety and efficacy of semaglutide and tirzepatide through a questionnaire administered to 165 attending physicians specializing in internal or family medicine, with 122 responses received. Physicians reported an average patient weight loss of 9.22%, significantly lower than the 14.9% and 18.5% reported in the STEP and SURMOUNT trials, respectively. Estimated side effect rates (32.62%) were markedly lower than trial-reported rates (89.7% and 80.5%), while estimated discontinuation rates (8.59%) exceeded trial data. Cardiovascular benefits were perceived by 48.4% of physicians in diabetic patients, consistent with random guessing, and by only 39.3% in nondiabetic patients, significantly below random guessing expectations. These results highlight discrepancies between physician perceptions and clinical evidence, suggesting gaps in understanding regarding these agents' efficacy and safety profiles. Addressing these gaps could enhance physician knowledge, patient adherence, and clinical outcomes.

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来源期刊
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
12.50%
发文量
381
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