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将胰高血糖素样肽-1(GLP-1)受体激动剂分为基础型和餐时型有依据吗?

Is there a justification for classifying GLP-1 receptor agonists as basal and prandial?

作者信息

Miñambres Inka, Pérez Antonio

机构信息

Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, San Antoni Mª Claret, 167, 08025 Barcelona, Spain.

Centro de Investigación Biomédica en Red, Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.

出版信息

Diabetol Metab Syndr. 2017 Jan 18;9:6. doi: 10.1186/s13098-017-0204-6. eCollection 2017.

Abstract

Several GLP-1 receptor agonists are currently available for treatment of type 2 diabetic patients. Based on their pharmacokinetic/pharmacodynamic profile, these drugs are classified as short-acting GLP-1 receptor agonists (exenatide and lixisenatide) or long-acting GLP-1 receptor agonists (exenatide-LAR, liraglutide, albiglutide, and dulaglutide). In clinical practice, they are also classified as basal or prandial GLP-1 receptor agonists to differentiate between patients who would benefit more from one or another based on characteristics such as previous treatment and the predominance of fasting or postprandial hyperglycemia. In the present article we examine available data on the pharmacokinetic characteristics of the various GLP-1 agonists and compare their effects with respect to the main parameters used to evaluate glycemic control. The article also analyzes whether the differences between the different GLP-1 agonists justify their classification as basal or prandial.

摘要

目前有几种GLP-1受体激动剂可用于治疗2型糖尿病患者。根据其药代动力学/药效学特征,这些药物可分为短效GLP-1受体激动剂(艾塞那肽和利司那肽)或长效GLP-1受体激动剂(长效艾塞那肽、利拉鲁肽、阿必鲁肽和度拉鲁肽)。在临床实践中,它们也被分为基础或餐时GLP-1受体激动剂,以便根据先前治疗情况以及空腹或餐后高血糖的优势等特征,区分哪些患者从一种或另一种药物中获益更多。在本文中,我们研究了各种GLP-1激动剂药代动力学特征的现有数据,并比较了它们在用于评估血糖控制的主要参数方面的效果。本文还分析了不同GLP-1激动剂之间的差异是否证明它们可分为基础或餐时用药是合理的。

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Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.司美格鲁肽与 2 型糖尿病患者的心血管结局
N Engl J Med. 2016 Nov 10;375(19):1834-1844. doi: 10.1056/NEJMoa1607141. Epub 2016 Sep 15.
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Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes.利拉鲁肽与2型糖尿病患者的心血管结局
N Engl J Med. 2016 Jul 28;375(4):311-22. doi: 10.1056/NEJMoa1603827. Epub 2016 Jun 13.

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