[用肠促胰岛素模拟减肥-机会和风险]。

Thomas J Zech, Benjamin Kirchweger, Robert Fürst
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引用次数: 0

摘要

背景:肥胖影响全球越来越多的人,并与严重的代谢、心血管和肿瘤并发症相关。肥胖不仅是个人健康负担,也是社会经济挑战。随着肠促胰岛素模拟药物利拉鲁肽、西马鲁肽和替西帕肽的出现,现在有了一类新的药物,它们首次实现了实质性和临床相关的减肥。目的:探讨胰高血糖素样肽1 (glucagon-like peptide 1, GLP-1)治疗肥胖的疗效、安全性及前景。除了关键的临床试验结果,潜在的风险,使用的限制,典型的副作用和药物相互作用进行了讨论。经济方面也有解释。结果:临床试验显示体重平均减轻15-20%,尤其是替西帕肽非常有效。治疗的积极副作用主要涉及代谢(糖尿病前期和2型糖尿病消退)和心血管疾病。主要的副作用是经常发生的胃肠道疾病,如恶心和呕吐。这些物质的长期安全性尚未得到最终证实。高昂的费用、有限的获取和滥用的可能性构成了额外的挑战。目前正在开发联合制剂和口服药物。结论:肠促胰岛素模拟药物是肥胖症治疗的一项重大进展,但需要仔细选择、密切监测并长期纳入生活方式措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Weight reduction with incretin mimetics-Opportunities and risks].

Background: Obesity affects a growing number of people worldwide and is associated with severe metabolic, cardiovascular and oncological complications. Obesity not only represents an individual health burden but is also a socioeconomic challenge. With the incretin mimetics liraglutide, semaglutide and tirzepatide, a new class of drugs is now available that for the first time enables substantial and clinically relevant weight reduction.

Objective: The article sheds light on the efficacy, safety and prospects of obesity treatment based on glucagon-like peptide 1 (GLP-1). In addition to the results of key clinical trials, potential risks, limitations of use, typical side effects and drug interactions are discussed. Economic aspects are also explained.

Results: Clinical trials show an average weight reduction of 15-20%, with tirzepatide in particular being highly effective. Positive side effects of the treatment mainly concern metabolism (prediabetes and type 2 diabetes regression) and cardiovascular diseases. The main side effects are the frequently occurring gastrointestinal disorders, such as nausea and vomiting. The long-term safety of the substances has not yet been conclusively proven. High costs, limited access and the potential for abuse pose additional challenges. Combination preparations and orally available drugs are currently under development.

Conclusion: Incretin mimetics represent a major advance in the treatment of obesity but require careful selection, close monitoring and long-term integration into lifestyle measures.

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