Hamed Khalid, Alosaimi Mohammed N, Ali Bashaer A, Alghamdi Atheer, Alkhashi Taif, Alkhaldi Salman S, Altowarqi Nawaf A, Alzahrani Hayat, Alshehri Abdullah M, Alkhaldi Rami K, Alqahtani Khalid W, Alharbi Nehal H, Alhulayfi Hanan F, Sharifi Shuruq Y, Dighriri Ibrahim M
Department of Clinical Toxicology, Umm Al-Qura University, Mecca, SAU.
Department of Pharmacy, King Abdulaziz Specialist Hospital, Ta'if, SAU.
Cureus. 2024 Sep 1;16(9):e68390. doi: 10.7759/cureus.68390. eCollection 2024 Sep.
Glucagon-like peptide-1 receptor agonists (GLP-1-RAs) are a novel class of medications promising for treating type 2 diabetes mellitus (T2DM) and obesity-related conditions such as cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). This comprehensive literature review examines available research on these medications, focusing on their mechanisms of action, clinical effectiveness, safety profiles, and socioeconomic implications. A comprehensive search was performed using the PubMed, EMBASE, and Cochrane Library databases. Although initially developed for glucose management, these drugs have also demonstrated efficacy in promoting weight loss and reducing the risk of CVD. GLP-1-RAs function similarly to naturally occurring incretins. They stimulate insulin secretion in response to glucose levels, inhibit glucagon release, delay stomach emptying, and generate a sense of fullness via brain pathways. Head-to-head clinical studies have indicated that GLP-1-RAs outperform conventional antidiabetic medicines in terms of glycemic management and weight reduction. According to cardiovascular outcome studies, various drugs in this category have been found to reduce the frequency of severe adverse cardiovascular events. A common side effect is gastrointestinal toxicity, which can be mitigated by gradually increasing the dose. Personalized treatment is likely because the effectiveness, safety, and dose regimens of currently available GLP-1-RAs differ. GLP-1-RAs are a superior choice for patients with T2DM, especially those who already have CVD or require weight-control support. The high cost of these drugs creates hurdles to access and fair healthcare. Current research mainly focuses on increasing therapeutic uses and producing orally delivered medicines with greater potency and bioavailability. Integrating GLP-1-RAs into clinical practice can enhance patient outcomes and reduce the community burden of cardiometabolic disease.
胰高血糖素样肽-1受体激动剂(GLP-1-RAs)是一类新型药物,有望用于治疗2型糖尿病(T2DM)以及肥胖相关疾病,如心血管疾病(CVD)和非酒精性脂肪性肝病(NAFLD)。这篇全面的文献综述审视了关于这些药物的现有研究,重点关注其作用机制、临床疗效、安全性概况以及社会经济影响。使用PubMed、EMBASE和Cochrane图书馆数据库进行了全面检索。尽管这些药物最初是为血糖管理而开发的,但它们在促进体重减轻和降低心血管疾病风险方面也显示出疗效。GLP-1-RAs的功能与天然存在的肠促胰岛素相似。它们根据血糖水平刺激胰岛素分泌,抑制胰高血糖素释放,延迟胃排空,并通过大脑途径产生饱腹感。头对头临床研究表明,在血糖管理和体重减轻方面,GLP-1-RAs优于传统抗糖尿病药物。根据心血管结局研究,已发现该类中的各种药物可降低严重不良心血管事件的发生频率。常见的副作用是胃肠道毒性,可通过逐渐增加剂量来减轻。由于目前可用的GLP-1-RAs的有效性、安全性和剂量方案不同,个性化治疗可能是必要的。对于T2DM患者,尤其是那些已经患有CVD或需要体重控制支持的患者,GLP-1-RAs是更好的选择。这些药物的高成本给获取和公平医疗带来了障碍。当前的研究主要集中在增加治疗用途以及生产效力更高和生物利用度更好的口服药物。将GLP-1-RAs纳入临床实践可以改善患者预后并减轻社区心脏代谢疾病负担。