Scheen André, De Flines Jenny, Paquot Nicolas
Service de Diabétologie, Nutrition et Maladies métaboliques, Département de Médecine, CHU Liège, Belgique.
Rev Med Liege. 2023 Mar;78(3):147-152.
Both physicians and patients dream of an efficacious and safe pharmacological approach to treat obesity. Unfortunately, most anti-obesity drugs prescribed since the fifties were associated with an unfavourable risk profile that led to numerous withdrawals. Medications issued from pharmaco-chemistry that mainly target brain amines to reduce appetite have been abandoned because of potential cardiovascular and neuropsychiatric toxicities. More recently, biological medications emerged, especially GLP-1 (Glucagon-Like Peptide-1) receptor agonists, well-known to manage type 2 diabetes and now recommended at higher doses for the treatment of obesity (liraglutide, semaglutide). A dual agonist that targets both GLP-1 and GIP (Glucose-dependent Insulinotropic Polypeptide) receptors (tirzepatide) appears to be even more potent as glucose-lowering agent and is currently tested as an anti-obesity agent. Many other pharmacological approaches are currently investigated but they should not mask the importance of life-style measurements.
医生和患者都梦想有一种有效且安全的药物治疗方法来治疗肥胖症。不幸的是，自五十年代以来开出的大多数抗肥胖药物都具有不良的风险特征，导致许多药物被撤市。主要针对脑胺以降低食欲的药物化学药物，由于潜在的心血管和神经精神毒性而被淘汰。最近，生物药物出现了，尤其是胰高血糖素样肽-1（GLP-1）受体激动剂，它以治疗2型糖尿病而闻名，现在推荐以更高剂量用于治疗肥胖症（利拉鲁肽、司美格鲁肽）。一种同时靶向GLP-1和葡萄糖依赖性促胰岛素多肽（GIP）受体的双重激动剂（替尔泊肽）似乎作为降糖剂更有效，目前正在作为抗肥胖剂进行测试。目前正在研究许多其他药物治疗方法，但它们不应掩盖生活方式干预的重要性。
