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新型双重葡萄糖依赖性胰岛素促分泌素和胰高血糖素样肽-1(GLP-1)受体激动剂替西帕肽可暂时延缓胃排空,类似于选择性长效 GLP-1 受体激动剂。

The novel dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist tirzepatide transiently delays gastric emptying similarly to selective long-acting GLP-1 receptor agonists.

机构信息

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA.

Diabetes Division, Katholisches Klinikum Bochum, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany.

出版信息

Diabetes Obes Metab. 2020 Oct;22(10):1886-1891. doi: 10.1111/dom.14110. Epub 2020 Jul 13.

Abstract

The effect of dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist (RA) tirzepatide on gastric emptying (GE) was compared to that of GLP-1RAs in non-clinical and clinical studies. GE was assessed following acute and chronic treatment with tirzepatide in diet-induced obese mice versus semaglutide or long-acting GIP analogue alone. Participants [with and without type 2 diabetes (T2DM)] from a phase 1, 4-week multiple dose study received tirzepatide, dulaglutide or placebo. GE was assessed by acetaminophen absorption. In mice, tirzepatide delayed GE to a similar degree to that achieved with semaglutide; however, these acute inhibitory effects were abolished after 2 weeks of treatment. GIP analogue alone had no effect on GE or on GLP-1's effect on GE. In participants with and without T2DM, once-weekly tirzepatide (≥5 and ≥4.5 mg, respectively) delayed GE after a single dose. This effect diminished after multiple doses of tirzepatide or dulaglutide in healthy participants. In participants with T2DM treated with an escalation schedule of tirzepatide 5/5/10/10 or 5/5/10/15 mg, a residual GE delay was still observed after multiple doses. These data suggest that tirzepatide's activity on GE is comparable to that of selective GLP-1RAs.

摘要

双重葡萄糖依赖性胰岛素促分泌多肽 (GIP) 和胰高血糖素样肽-1 (GLP-1) 受体激动剂 (RA) 替西帕肽对胃排空 (GE) 的影响在非临床和临床研究中与 GLP-1RAs 进行了比较。在饮食诱导肥胖小鼠中,急性和慢性使用替西帕肽与单独使用司美格鲁肽或长效 GIP 类似物相比,评估了 GE。来自一项为期 4 周的 1 期、多剂量研究的参与者[伴有或不伴有 2 型糖尿病 (T2DM)]接受了替西帕肽、度拉糖肽或安慰剂治疗。通过乙酰氨基酚吸收评估 GE。在小鼠中,替西帕肽延迟 GE 的程度与司美格鲁肽相似;然而,这些急性抑制作用在治疗 2 周后消失。单独使用 GIP 类似物对 GE 或 GLP-1 对 GE 的作用没有影响。在伴有或不伴有 T2DM 的参与者中,每周一次的替西帕肽(分别为≥5 和≥4.5 mg)在单次给药后延迟 GE。在健康参与者中,多次给予替西帕肽或度拉糖肽后,这种作用会减弱。在接受替西帕肽 5/5/10/10 或 5/5/10/15 mg 递增剂量方案治疗的 T2DM 参与者中,多次给药后仍观察到残留的 GE 延迟。这些数据表明,替西帕肽对 GE 的作用与选择性 GLP-1RAs 相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a8b/7539915/4fc8a6858df5/DOM-22-1886-g001.jpg

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