Vidal Josep, Flores Lílliam, Jiménez Amanda, Pané Adriana, de Hollanda Ana
Obesity Unit. Endocrinology and Nutrition Department. Hospital Clínic, Barcelona, Spain.
CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Int J Obes (Lond). 2025 Mar;49(3):402-411. doi: 10.1038/s41366-024-01488-5. Epub 2024 Feb 9.
The use of gut-hormone receptors agonists as new therapeutic options for obesity and some of its related comorbidities, such as type 2 diabetes, has resulted in an unprecedented efficacy in the medical management of people living with obesity (PLWO). Appraisal of the safety of these drugs is of utmost importance considering the large number of PLWO, and the potentially long exposure to these pharmacotherapies. In this narrative review we summarize the evidence on the safety of liraglutide, semaglutide, and tirzepatide as derived from randomized clinical trials conducted in adults living with obesity. Additionally, the safety of these drugs is put into perspective with that of other drugs currently approved for the treatment of PLWO. Overall, the available data support a favorable efficacy versus safety balance for gut-hormone hormone receptor analogues in the treatment of these subjects. Nonetheless, it should be acknowledged that in the context of a chronic disease that has reached epidemic proportions, data from randomized clinical trials aimed primarily at proving the efficacy of these drugs may have been insufficient to unveil all the safety issues. Thus, continuous surveillance on the adverse effects of liraglutide, semaglutide, and tirzepatide is required as we use these drugs in a broader population than that represented in currently available clinical trials.
使用肠促激素受体激动剂作为肥胖症及其一些相关合并症（如2型糖尿病）的新治疗选择，已在肥胖症患者（PLWO）的医学管理中产生了前所未有的疗效。鉴于大量的肥胖症患者以及这些药物治疗可能的长期暴露，评估这些药物的安全性至关重要。在这篇叙述性综述中，我们总结了从针对肥胖症成年患者进行的随机临床试验中得出的关于利拉鲁肽、司美格鲁肽和替尔泊肽安全性的证据。此外，将这些药物的安全性与目前批准用于治疗肥胖症患者的其他药物的安全性进行了比较。总体而言，现有数据支持肠促激素受体类似物在治疗这些患者时具有良好的疗效与安全性平衡。尽管如此，应该认识到，在一种已达到流行程度的慢性疾病背景下，主要旨在证明这些药物疗效的随机临床试验数据可能不足以揭示所有安全问题。因此，当我们在比现有临床试验所代表的更广泛人群中使用利拉鲁肽、司美格鲁肽和替尔泊肽时，需要持续监测它们的不良反应。
