胰高血糖素样肽-1受体类似物治疗肥胖。

TouchREVIEWS in endocrinology Pub Date : 2022-03-01 Epub Date: 2022-03-18 DOI:10.17925/EE.2022.18.1.43
David M Williams, Matthew Staff, Stephen C Bain, Thinzar Min
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引用次数: 3

摘要

肥胖在世界范围内日益流行,与显著的发病率和死亡率相关,经常降低生活质量和预期寿命。因此,有一个巨大的和不断增长的个人和经济负担,需要发展更有效的治疗肥胖的方法。胰高血糖素样肽-1受体类似物(GLP-1RAs)被批准用于治疗2型糖尿病(T2D),有大量证据表明这些药物不仅可以改善心血管结局,还可以促进体重减轻。最近更多的证据支持GLP-1RAs利拉鲁肽和semaglutide用于无T2D的肥胖患者。本文讨论了GLP-1RAs在T2D患者中的主要心血管结局试验的结果,即SCALE肥胖和前驱糖尿病研究(利拉鲁肽对非糖尿病性肥胖受试者或伴有合并症的超重受试者体重的影响:SCALE™-肥胖和前驱糖尿病;ClinicalTrials.gov识别码:NCT01272219;调查利拉鲁肽)和STEP研究(西玛鲁肽治疗肥胖患者的效果;各种各样的研究;研究皮下semaglutide)。我们还强调了成本效益的方法对肥胖药物治疗的重要性。临床医生应考虑在肥胖患者中使用GLP-1RAs,特别是那些患有T2D或其他肥胖相关疾病的患者,如高血压和血脂异常。正在进行的试验以及临床和成本效益评估预计将在未来12个月内进行,他们的发现可能会改变目前肥胖药物治疗的现状。
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Glucagon-like Peptide-1 Receptor Analogues for the Treatment of Obesity.

There is an increasing prevalence of obesity worldwide, associated with significant morbidity and mortality, which frequently reduces quality of life and life expectancy. Consequently, there is a substantial and growing personal and economic burden necessitating the development of more effective therapies for obesity. Glucagon-like peptide-1 receptor analogues (GLP-1RAs) are licensed for the treatment of type 2 diabetes (T2D), and there is substantial evidence that these drugs not only improve cardiovascular outcomes but also promote weight loss. More recent evidence supports the use of the GLP-1RAs liraglutide and semaglutide in people with obesity without T2D. This article discusses the results of the major cardiovascular outcome trials for GLP-1RAs in people with T2D, the SCALE Obesity and Prediabetes study (Effect of liraglutide on body weight in non-diabetic obese subjects or overweight subjects with co-morbidities: SCALE™ - Obesity and Pre-diabetes; ClinicalTrials.gov identifier: NCT01272219; investigating liraglutide) and the STEP studies (Semaglutide treatment effect in people with obesity; assorted studies; investigating subcutaneous semaglutide). We also highlight the importance of a cost-effective approach to obesity pharmacotherapy. Clinicians should consider the use of GLP-1RAs in people with obesity, especially those with T2D or other obesity-related diseases, such as hypertension and dyslipidaemia. Ongoing trials, as well as clinical and cost-effectiveness appraisals, are anticipated over the next 12 months, and their findings may change the current landscape of obesity pharmacotherapy.

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