采用每周一次注射 GLP-1 受体激动剂治疗管理 2 型糖尿病的多方面特性。
Managing the multifaceted nature of type 2 diabetes using once-weekly injectable GLP-1 receptor agonist therapy.
机构信息
Pacific University Oregon School of Pharmacy, Hillsboro, OR, USA.
出版信息
J Clin Pharm Ther. 2020 Sep;45 Suppl 1(Suppl 1):7-16. doi: 10.1111/jcpt.13229.
WHAT IS KNOWN AND OBJECTIVE
As a highly prevalent chronic condition associated with complications and high mortality rates, it is important for pharmacists to have a comprehensive understanding of the impact of type 2 diabetes (T2D) and available treatment options. The use of injectable glucagon-like peptide 1 receptor agonists (GLP-1 RAs) is recommended as an effective and convenient treatment regimen for improving glycaemic control in individuals with T2D, with a good safety profile; however, the wider extent of its potential benefits often are unknown to clinical pharmacists. The objective of this article is to provide an overview of the impact of T2D on individuals and to discuss the multifaceted role of once-weekly (QW) GLP-1 RAs in addressing these challenges.
METHODS
This is a narrative review of the published literature regarding the use of injectable GLP-1 RAs in managing health complications in people with T2D.
RESULTS AND DISCUSSION
Recent findings reveal additional benefits of GLP-1 RAs in managing T2D complications, including atherosclerotic cardiovascular (CV) disease, retinopathy, neuropathy, and nephropathy. Dulaglutide and semaglutide have been shown to provide additional CV benefit in patients at high risk of CV events compared with standard of care/placebo and may offer renal protection in patients with chronic kidney disease. Cost-effectiveness studies, taking into consideration these different complications, have shown that QW GLP-1 RAs were cost-effective compared with other therapies. GLP-1 RAs may also help to improve overall health-related quality of life, reducing the risk of depression and 'diabetes distress', and limiting the risk of hypoglycaemia.
WHAT IS NEW AND CONCLUSION
From the literature, this appears to be the first review of the evidence supporting the multifaceted role of QW GLP-1 RAs in T2D, with particular emphasis on their use in comorbid conditions, as well as associated potential financial and well-being benefits. The results suggest that QW GLP-1 RAs may be an attractive treatment option for improving glycaemic control in T2D, especially in individuals with (or at risk of) additional comorbidities or health complications.
已知和目的
作为一种与并发症和高死亡率相关的高发慢性疾病，药剂师全面了解 2 型糖尿病（T2D）的影响和可用的治疗选择非常重要。使用胰高血糖素样肽 1 受体激动剂（GLP-1 RAs）作为改善 T2D 患者血糖控制的有效且方便的治疗方案，具有良好的安全性，然而，临床药剂师通常不了解其潜在益处的更广泛程度。本文的目的是概述 T2D 对个体的影响，并讨论每周一次（QW）GLP-1 RAs 在解决这些挑战中的多方面作用。
方法
这是一篇关于 GLP-1 RAs 在治疗 T2D 患者健康并发症方面的已发表文献的综述。
结果与讨论
最近的研究结果揭示了 GLP-1 RAs 在管理 T2D 并发症方面的额外益处，包括动脉粥样硬化心血管（CV）疾病、视网膜病变、神经病变和肾病。与标准护理/安慰剂相比，在有高心血管事件风险的患者中，度拉鲁肽和司美格鲁肽已被证明提供了额外的 CV 益处，并且在慢性肾脏病患者中可能具有肾脏保护作用。考虑到这些不同的并发症，成本效益研究表明，QW GLP-1 RAs 比其他疗法更具成本效益。GLP-1 RAs 还可以帮助改善整体健康相关的生活质量，降低抑郁和“糖尿病困扰”的风险，并降低低血糖的风险。
创新与结论
从文献来看，这似乎是第一篇关于支持 QW GLP-1 RAs 在 T2D 中的多方面作用的证据的综述，特别强调了它们在合并症中的应用，以及相关的潜在经济和福祉益处。结果表明，QW GLP-1 RAs 可能是改善 T2D 患者血糖控制的一种有吸引力的治疗选择，尤其是在有（或有风险）额外合并症或健康并发症的患者中。
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