Ghusn Wissam, Hurtado Maria D
Internal Medicine Department, Boston Medical Center, Boston, MA, USA.
Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Obes Pillars. 2024 Aug 31;12:100127. doi: 10.1016/j.obpill.2024.100127. eCollection 2024 Dec.
This review investigates the side effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) like liraglutide, semaglutide, and tirzepatide, medications known for their efficacy in promoting weight loss among individuals with obesity. The rationale is rooted in understanding the balance between their therapeutic benefits and associated risks.
This was a comprehensive clinical review, including systematic reviews, meta-analyses, randomized controlled trials (RCTs), and cohort studies. Data were extracted from databases such as PubMed, Scopus, Embase, MEDLINE, and Google Scholar, focusing on the tolerability, severity, and risks of these medications.
GLP-1RAs demonstrated significant weight loss outcomes. In clinical trials, liraglutide showed a placebo-corrected weight loss of around 5 %, semaglutide 12 %, and tirzepatide 18 %. Common side effects were predominantly gastrointestinal, including nausea, diarrhea, constipation, and vomiting. Rare serious adverse events included gallbladder disorders and acute pancreatitis. In, addition, multiple studies identify new risks associated with GLP-1RAs including increased aspiration risk during anesthesia due to delayed gastric emptying and challenges with bowel preparation for colonoscopies.
While GLP-1RAs are effective in managing obesity, their use is associated with gastrointestinal side effects and rare but serious adverse events. The findings underscore the importance of individualized dosing and thorough patient assessment. Continuous research and vigilant monitoring are essential to optimize their safe use. Further studies are needed to refine guidelines, particularly regarding new concerns such as delayed gastric emptying and its implications for anesthesia.
本综述调查了利拉鲁肽、司美格鲁肽和替尔泊肽等胰高血糖素样肽-1受体激动剂(GLP-1RAs)的副作用,这些药物以其在促进肥胖个体体重减轻方面的疗效而闻名。其基本原理在于了解它们的治疗益处与相关风险之间的平衡。
这是一项全面的临床综述,包括系统评价、荟萃分析、随机对照试验(RCT)和队列研究。数据从PubMed、Scopus、Embase、MEDLINE和谷歌学术等数据库中提取,重点关注这些药物的耐受性、严重程度和风险。
GLP-1RAs显示出显著的体重减轻效果。在临床试验中,利拉鲁肽经安慰剂校正后的体重减轻约5%,司美格鲁肽为12%,替尔泊肽为18%。常见副作用主要是胃肠道方面的,包括恶心、腹泻、便秘和呕吐。罕见的严重不良事件包括胆囊疾病和急性胰腺炎。此外,多项研究发现了与GLP-1RAs相关的新风险,包括由于胃排空延迟导致麻醉期间误吸风险增加以及结肠镜检查肠道准备方面的挑战。
虽然GLP-1RAs在管理肥胖方面有效,但其使用与胃肠道副作用以及罕见但严重的不良事件有关。研究结果强调了个体化给药和全面患者评估的重要性。持续研究和密切监测对于优化其安全使用至关重要。需要进一步研究以完善指南,特别是关于胃排空延迟等新问题及其对麻醉的影响。