Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
Trends Endocrinol Metab. 2018 Apr;29(4):238-248. doi: 10.1016/j.tem.2018.01.011. Epub 2018 Feb 17.
Several new glucose-lowering medications have been approved, such as dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and sodium glucose cotransporter-2 inhibitors. Among GLP-1RAs, lixisenatide, a short-acting drug, did not show cardiovascular (CV) benefits in patients with Type 2 diabetes mellitus (T2D) and acute coronary syndrome. Extended-release exenatide was also not significantly better for CV outcomes. By contrast, once daily liraglutide and once weekly semaglutide, both long-acting GLP-1RAs, decreased the incidence of major adverse CV events and mortality. This Review attempts to explain favorable CV results with some, but not all, GLP-1RAs, to aid in their differential prescription with the aim of further reducing the adverse CV burden of T2D.
几种新的降糖药物已经获得批准，如二肽基肽酶-4 抑制剂、胰高血糖素样肽-1 受体激动剂（GLP-1RAs）和钠-葡萄糖共转运蛋白 2 抑制剂。在 GLP-1RAs 中，短效药物利西那肽并未显示出在 2 型糖尿病（T2D）和急性冠状动脉综合征患者中的心血管（CV）益处。延长释放艾塞那肽在 CV 结局方面也没有显著改善。相比之下，每日一次的利拉鲁肽和每周一次的司美格鲁肽，都是长效 GLP-1RA，降低了主要不良 CV 事件和死亡率的发生率。本综述试图用一些而不是全部 GLP-1RA 来解释有利的 CV 结果，以帮助它们的差异处方，旨在进一步降低 T2D 的不良 CV 负担。
