Polyagonists in Type 2 Diabetes Management.

IF 5.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Current Diabetes Reports Pub Date : 2024-01-01 Epub Date: 2023-12-27 DOI:10.1007/s11892-023-01530-2
H A Dissanayake, N P Somasundaram
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引用次数: 0

Abstract

Purpose of the review: This review summarizes the new developments in polyagonist pharmacotherapy for type 2 diabetes.

Recent findings: Several dual- and triple-agonists targeting different pathogenic pathways of type 2 diabetes have entered clinical trials and have led to significant improvements in glycaemia, body weight, fatty liver, and cardio-renal risk factors, with variable adverse event profiles but no new serious safety concerns. Combining agents with complementary and synergistic mechanisms of action have enhanced efficacy and safety. Targeting multiple pathogenic pathways simultaneously has led to enhanced benefits which potentially match those of bariatric surgery. Tirzepatide, cotadutide, BI456906, ritatrutide, and CagriSema have entered phase 3 clinical trials. Outcomes from published clinical studies are reviewed. Efficacy-safety profiles are heterogeneous between agents, suggesting the potential application of precision medicine and need for personalized approach in pharmacological management of type 2 diabetes and obesity. Polyagonism has become a key strategy to address the complex pathogenesis of type 2 diabetes and co-morbidities and increasing number of agents are moving through clinical trials. Heterogeneity in efficacy-safety profiles calls for application of precision medicine and need for judicious personalization of care.

Abstract Image

2 型糖尿病管理中的多效肽。
综述的目的:本综述总结了多受体激动剂药物治疗 2 型糖尿病的新进展:一些针对 2 型糖尿病不同致病途径的双效和三效受体激动剂已进入临床试验阶段,并显著改善了血糖、体重、脂肪肝和心肾风险因素,不良反应情况各不相同,但没有新的严重安全性问题。将具有互补和协同作用机制的药物联合使用,可提高疗效和安全性。同时针对多种致病途径可提高疗效,有可能与减肥手术的疗效相媲美。替扎帕肽、科他度肽、BI456906、利他鲁肽和卡格瑞赛马已进入 3 期临床试验。本文回顾了已发表的临床研究结果。不同药物的疗效和安全性不尽相同,这表明了精准医学的潜在应用以及在 2 型糖尿病和肥胖症的药物治疗中采用个性化方法的必要性。多拮抗剂已成为解决 2 型糖尿病和并发症复杂发病机制的关键策略,越来越多的药物正在进行临床试验。疗效和安全性的异质性要求应用精准医学,并需要明智的个性化护理。
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来源期刊
CiteScore
9.80
自引率
0.00%
发文量
52
审稿时长
6-12 weeks
期刊介绍: The goal of this journal is to publish cutting-edge reviews on subjects pertinent to all aspects of diabetes epidemiology, pathophysiology, and management. We aim to provide incisive, insightful, and balanced contributions from leading experts in each relevant domain that will be of immediate interest to a wide readership of clinicians, basic scientists, and translational investigators. We accomplish this aim by appointing major authorities to serve as Section Editors in key subject areas across the discipline. Section Editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year on their topics, in a crisp and readable format. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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