Current Opinion in Endocrinology & Diabetes and Obesity最新文献

Perspectives on early health economic evaluations of RNA therapies targeted at lipoprotein(a).

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-13 DOI: 10.1097/MED.0000000000000904

Angela Burvill, Gerald F Watts, Zanfina Ademi

{"title":"Perspectives on early health economic evaluations of RNA therapies targeted at lipoprotein(a).","authors":"Angela Burvill, Gerald F Watts, Zanfina Ademi","doi":"10.1097/MED.0000000000000904","DOIUrl":"https://doi.org/10.1097/MED.0000000000000904","url":null,"abstract":"Purpose of review: Early health economic evaluations of new medications are useful, as they consider the implications for health services.We reviewed recent literature on expected clinical outcomes of lowering of elevated plasma lipoprotein(a) [Lp(a)] in secondary prevention, which is essential information on effectiveness for economic evaluations.We reviewed a recent early economic evaluation of RNA therapies targeted at Lp(a).Recent findings: RNA-based therapies, if approved, would likely be used initially in adults with established atherosclerotic cardiovascular disease (ASCVD) and very high Lp(a). Adults with ASCVD have high absolute risk of recurrent events and elevated Lp(a) serves as a risk-enhancing factor.Potent lowering of Lp(a) in secondary prevention may be associated with significant relative risk reductions of coronary heart disease or ASCVD events; this needs confirmation in currently ongoing and future clinical trials.One economic evaluation has estimated the value of olpasiran and pelacarsen, at various willingness-to-pay thresholds, compared with standard-of-care secondary prevention.Summary: Early economic evaluations estimate longer-term clinical benefits and cost consequences associated with new medications.Existing casual evidence of Lp(a) and cardiovascular disease can be used in early economic evaluations as best available evidence, while awaiting results from major cardiovascular outcomes trials.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An overview of persistent chylomicronemia: much more than meets the eye.

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-10 DOI: 10.1097/MED.0000000000000903

Miriam Larouche, Gerald F Watts, Christie Ballantyne, Daniel Gaudet

{"title":"An overview of persistent chylomicronemia: much more than meets the eye.","authors":"Miriam Larouche, Gerald F Watts, Christie Ballantyne, Daniel Gaudet","doi":"10.1097/MED.0000000000000903","DOIUrl":"https://doi.org/10.1097/MED.0000000000000903","url":null,"abstract":"Purpose of review: The aim of this review is to provide an overview of severe hypertriglyceridemia presenting in the form of chylomicronemia that persists despite treatment of secondary causes and the use of conventional lipid-lowering treatment.Recent findings: Persistent chylomicronemia is a rare syndromic disorder that affects carriers of bi-allelic combinations of pathogenic gene variants impairing lipoprotein lipase (LPL) activity, as well as a significant number of individuals who do not meet this genetic criterion. It is associated with a high risk of acute pancreatitis and other morbidities. Effective innovative treatments for severe hypertriglyceridemia are being developed and are becoming available. Patients with persistent chylomicronemia of any cause respond equally to next-generation therapies with LPL-independent mechanisms of action and do not generally respond to conventional LPL-dependent treatments.Summary: Not all individuals with persistent chylomicronemia carry a proven pathogenic combination of gene variants that impair LPL activity. Documenting the clinical characteristics of people with persistent chylomicronemia and their response to emerging therapies is essential to correctly establish their risk trajectory and ensure equitable access to personalized treatment.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-01 Epub Date: 2024-12-20 DOI: 10.1097/MED.0000000000000897

引用次数: 0

Overview of diabetes agents in cardiovascular disease: it takes an orchestra to play Tchaikovsky in symphony. 糖尿病在心血管疾病中的作用概述：柴可夫斯基的交响乐需要一个管弦乐队来演奏。

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-01 Epub Date: 2024-11-11 DOI: 10.1097/MED.0000000000000892

Wann Jia Loh

{"title":"Overview of diabetes agents in cardiovascular disease: it takes an orchestra to play Tchaikovsky in symphony.","authors":"Wann Jia Loh","doi":"10.1097/MED.0000000000000892","DOIUrl":"10.1097/MED.0000000000000892","url":null,"abstract":"Purpose of review: The aim of this review was to discuss the use and concerns of diabetes agents, clinical targets, and key aspects to be considered in the management of patients with type 2 diabetes mellitus (T2DM), and at high risk or established cardiovascular disease (CVD).Recent findings: The recent European and American guidelines recommended SGLT2 inhibitors and GLP-1 receptor agonists as the preferred first-line diabetes agents in patients with T2DM and CVD. This is a paradigm shift from using metformin as first-line therapy. Amid their widespread use, however, there are also concerns about their side effects. With the rapidly growing diabetes regimens available, questions arise about how best to approach the management of patients with T2DM and CVD.Summary: To reduce CVD morbidity and mortality in patients with T2DM and at high or very high risk for CVD, the two key diabetes agents SGLT2i and/or GLP1-based therapies should be offered. Although lacking cardiovascular benefit, other diabetes agents remain necessary for many patients with T2DM for their glucocentric effects; Metformin and pioglitazone are useful in severe insulin resistance, while insulin therapy is often necessary in advanced diabetes; GLP1-RA is cautioned in patients with active gastrointestinal and mental health conditions, while DPP4 inhibitor is likely a well tolerated option in a challenging psychosocial setting. Other important aspects that should be considered include obesity, chronic kidney disease, women's cardiovascular health, and psychosocial factors.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"32 1","pages":"3-11"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

GLP-1RA based therapies in the young and old. GLP-1RA为基础的治疗在年轻人和老年人。

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-01 Epub Date: 2024-12-09 DOI: 10.1097/MED.0000000000000900

Georgia Rigas, Shirley Alexander, Cilla J Haywood

{"title":"GLP-1RA based therapies in the young and old.","authors":"Georgia Rigas, Shirley Alexander, Cilla J Haywood","doi":"10.1097/MED.0000000000000900","DOIUrl":"https://doi.org/10.1097/MED.0000000000000900","url":null,"abstract":"Purpose of review: Obesity is recognized as a \"gateway\" chronic, progressive disease of dysfunctional adipocytes. Glucagon-like peptide-1 receptor agonist-based therapies (GLP1BTs), including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with/without glucose-dependent insulinotropic polypeptide (GIP), have demonstrated clinically significant weight loss and health gains in adults, hence interest in using them in younger and older people. Therefore, reviewing the role of GLP1BTs in these populations is pertinent and timely.Recent findings: Recent American Pediatric Guidelines emphasize the need for early introduction of obesity-management medication (OMM). This review evaluates the recently published data evaluating use of GLP1BTs in young people with obesity and/or youth onset Type 2 diabetes (YOT2D).Large studies of GLP1BTs in adults included those over 65, however no separate trial has looked at this heterogeneous group. This review translates the evidence, as it pertains to those over 65 where possible.Summary: Newer-generation GLP1BTs specifically target pathways involved in energy balance, glycaemic control and other metabolic functions, heralding a new era for the management of younger people.Published cardiovascular outcome trial (CVOT) data presented in this review support the utility of GLP1BTs in the management of older people living with obesity and/or Type 2 diabetes (T2D), with the reassurance of no new safety signals identified. Maturation of the longer-term data and publication of the additional CVOT data in cohorts of differing health complexity will provide further insights.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"32 1","pages":"26-33"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Type 2 diabetes: a contemporary view from the Asian lens. 2 型糖尿病：从亚洲视角看当代问题。

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-01 Epub Date: 2024-11-28 DOI: 10.1097/MED.0000000000000895

Jeyakantha Ratnasingam, Quan Hziung Lim, Siew Pheng Chan

{"title":"Type 2 diabetes: a contemporary view from the Asian lens.","authors":"Jeyakantha Ratnasingam, Quan Hziung Lim, Siew Pheng Chan","doi":"10.1097/MED.0000000000000895","DOIUrl":"10.1097/MED.0000000000000895","url":null,"abstract":"Purpose of review: The aim of this article was to review the up-to-date evidence with regards to the unique features of the Type 2 diabetes (T2D) pathophysiology, complications, response to therapy with the possibility of precision medicine guiding therapeutic decision making in Asia.Recent findings: Asia is the epicenter of diabetes. There have been marked advances with genotyping and phenotyping of the Asian patient with T2D, particularly with young onset diabetes where early beta cell failure and rapid progression of complications are more frequent. As Asians have lower muscle mass and higher adiposity, sarcopenia is increasingly associated with diabetes. Response to lifestyle and pharmacotherapy are generally similar, but unique features exist with different populations. Across Asia, use of guideline directed medical therapy for cardio-renal protection are recommended, but uptake of these newer agents are suboptimal and barriers exist with regards to standardized care.Summary: Although many similarities have been observed across Asia, due to the heterogeneity of populations within Asia, further research is required to streamline and pave the way towards precision medicine. There is an urgent need for region wide consensus to minimize barriers to diabetes care and stigma in diabetes terminology across Asia.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"20-25"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diabetes agents taking centre stage, playing to the beats of Canon in D. 糖尿病药物占据了舞台的中心，伴随着佳能D调的节奏。

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-01 Epub Date: 2024-12-20 DOI: 10.1097/MED.0000000000000898

Wann Jia Loh

引用次数: 0

Precision medicine in diabetes care. 糖尿病护理中的精准医疗。

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-01 Epub Date: 2024-11-20 DOI: 10.1097/MED.0000000000000894

Si Hua Clara Tan, Wann Jia Loh, Su Chi Lim

{"title":"Precision medicine in diabetes care.","authors":"Si Hua Clara Tan, Wann Jia Loh, Su Chi Lim","doi":"10.1097/MED.0000000000000894","DOIUrl":"10.1097/MED.0000000000000894","url":null,"abstract":"Purpose of review: This review highlights emerging evidence supporting the premise of precision diabetes care including but not limited to monogenic diabetes and discuss potential opportunities, challenges, and limitations for clinical adoption.Recent findings: Driven by a single gene mutation, monogenic diabetes remains the best use-case for precision diabetes care. However, the increasing prevalence of diabetes among adolescents and young adults in an obesogenic environment makes triaging potential patients for genetic screening clinically challenging. High-dimensional molecular biomarkers (i.e., multiomics) can improve the risk prediction for incident type 2 diabetes (T2D), over and above a well established prediction model based on clinical variables alone. Machine learning approaches using clinical variable-based clustering methods have generated novel and reproducible T2D subgroups with distinct phenotypic and omics characteristics that are associated with differential long-term outcomes. This stratification-strategy may inform clinical decisions. However, on-going discussion and research will be needed to understand the clinical utility of sub-phenotyping T2D for precision care.Summary: Precision diabetes care has extended from uncommon monogenic diabetes to T2D which will need more complex approaches like multiomics and machine-learning methods. The successful clinical translation will require cumulative evidence and close collaboration among the stake holders.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"12-19"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interactions between antidiabetes medications and heart-brain axis. 抗糖尿病药物与心脑轴的相互作用。

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-02-01 Epub Date: 2024-12-06 DOI: 10.1097/MED.0000000000000896

Leong Tung Ong, Ching-Hui Sia

{"title":"Interactions between antidiabetes medications and heart-brain axis.","authors":"Leong Tung Ong, Ching-Hui Sia","doi":"10.1097/MED.0000000000000896","DOIUrl":"10.1097/MED.0000000000000896","url":null,"abstract":"Purpose of review: The heart - brain axis (HBA) is the physiological interactions between the cardiovascular and nervous systems through autonomic nerves, hormones, and cytokines. Patients diagnosed with diabetes mellitus have an increased risk of the cardiovascular and neurological diseases. However, recent evidence demonstrated that different antidiabetic drugs may delay cognitive impairment and improve cardiovascular outcomes. This review examines the impact of antidiabetic drugs on the HBA in patients with diabetes.Recent findings: Metformin improves the cardiovascular and cognitive outcomes through adenosine 5'-monophosphate-activated protein kinase activation. Sodium-glucose cotransporter-2 inhibitors reduce inflammation, oxidative stress by inhibiting the NLRP3 inflammasome thereby reducing the incidence of heart failure and formation of beta-amyloid and neurofibrillary tangles in the brain. Dipeptidyl peptidase-4 inhibitors exhibit neuroprotective effects in Alzheimer's disease by reducing amyloid-beta and tau pathology and inflammation but may exacerbate heart failure risk due to increased sympathetic activity and prolonged β-adrenergic stimulation. Glucagon-like peptide-1 receptor agonists exhibit neuroprotective effects in Alzheimer's and Parkinson's diseases by reducing neuroinflammation, but may increase sympathetic activity, potentially elevating heart rate and blood pressure, despite their cardioprotective benefits.Summary: Antidiabetes medications have the potential to improve cardiovascular and cognitive outcomes; however, additional studies are required to substantiate these effects.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"34-43"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Testosterone and male contraception. 睾酮与男性避孕

IF 2.6 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2024-12-01 Epub Date: 2024-08-19 DOI: 10.1097/MED.0000000000000880

Arthi Thirumalai, Stephanie T Page

{"title":"Testosterone and male contraception.","authors":"Arthi Thirumalai, Stephanie T Page","doi":"10.1097/MED.0000000000000880","DOIUrl":"10.1097/MED.0000000000000880","url":null,"abstract":"Purpose of review: Rates of unintended pregnancy have remained relatively stagnant for many years, despite a broad array of female contraceptive options. Recent restrictions on access to abortion in some countries have increased the urgency for expanding contraceptive options. Increasing data suggest men are keen to utilize novel reversible male contraceptives.Recent findings: Despite decades of clinical research in male contraception, no reversible hormonal product currently exists. Nestorone/testosterone, among other novel androgens, shows promise to finally move to pivotal Phase 3 studies and introduction to the marketplace.Summary: Hormonal male contraception utilizes androgens or androgen-progestin combinations to exploit negative feedback that regulates the hypothalamic-pituitary-testicular axis. By suppressing release of gonadotropins, these agents markedly decrease endogenous testosterone production, lower intratesticular testosterone and suppress spermatogenesis. The addition of a progestin enhances the degree and speed of sperm suppression. The androgen component preserves a state of symptomatic eugonadism in the male. There is growing demand and acceptance of male contraceptive options in various forms. As these formulations progress through stages of drug development, regulatory oversight and communication with developers around safety and efficacy standards and garnering industry support for advancing the production of male contraceptives will be imperative.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"236-242"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0