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胰高血糖素样肽-1 受体激动剂在肥胖和糖尿病儿科患者中的应用:提供者的观点。

Use of glucagon-like peptide-1 receptor agonists for pediatric patients with obesity and diabetes: The providers' perspectives.

机构信息

Division of Pediatric Endocrinology, Department of Pediatrics, Georgetown University, Washington, District of Columbia, USA.

Division of Pediatric Endocrinology, Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA.

出版信息

Pediatr Diabetes. 2021 Sep;22(6):872-875. doi: 10.1111/pedi.13234. Epub 2021 Jun 7.

Abstract

BACKGROUND

Glucagon-like peptide-1 receptor agonists (GLP-1RA) have been widely used in adults with Type 2 diabetes (T2D) and obesity. We sought to evaluate the experience of pediatric endocrinology providers with GLP-1RA and factors that guide them on whether and how to prescribe these medications.

METHODS

We surveyed the members of the Pediatric Endocrine Society regarding the use of GLP-1RA in their practice.

RESULTS

The respondents (n = 102) were predominantly from academic centers (84%) and 75%reported using GLP-1RA in pediatric patients, mostly to treat T2D and obesity. Patient tolerance for the medication was reported to be the driving factor determining the duration of treatment. Gastrointestinal side effects were observed more commonly than local reactions or elevation of pancreatic enzymes. Lack of clinical experience was reported to be a major barrier for prescribing GLP-1RA, particularly among those with more than 5 years of clinical experience. Finally, liraglutide was used more often (93%) than other GLP-1RA.

CONCLUSIONS

The use of GLP-1RA has increased in pediatric patients. Recent Food and Drug Administration approval of liraglutide for pediatric obesity will likely further increase its prescription rate. Providers should be vigilant about side effects and adjust the doses of GLP-1RA accordingly. More efforts should be made by professional societies to educate pediatric endocrinology providers about the proper use of GLP-1RA and enhance their confidence in prescribing these medications.

摘要

背景

胰高血糖素样肽-1 受体激动剂(GLP-1RA)已广泛用于 2 型糖尿病(T2D)和肥胖症的成人患者。我们旨在评估儿科内分泌科医生使用 GLP-1RA 的经验,以及指导他们是否以及如何开具这些药物的因素。

方法

我们对儿科内分泌学会的成员进行了关于 GLP-1RA 在其实践中使用的调查。

结果

受访者(n=102)主要来自学术中心(84%),75%的人报告在儿科患者中使用 GLP-1RA,主要用于治疗 T2D 和肥胖症。患者对药物的耐受性被认为是决定治疗持续时间的主要因素。与局部反应或胰腺酶升高相比,更常观察到胃肠道副作用。缺乏临床经验被报告为开具 GLP-1RA 的主要障碍,特别是在具有 5 年以上临床经验的医生中。最后,利拉鲁肽的使用频率(93%)高于其他 GLP-1RA。

结论

GLP-1RA 在儿科患者中的使用有所增加。最近美国食品和药物管理局批准利拉鲁肽用于治疗儿科肥胖症,可能会进一步增加其处方率。提供者应警惕副作用,并相应调整 GLP-1RA 的剂量。专业协会应更加努力,教育儿科内分泌科医生正确使用 GLP-1RA,并增强他们开具这些药物的信心。

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