Sawamura Toshitaka, Mizoguchi Ren, Ohmori Ai, Kometani Mitsuhiro, Yoneda Takashi, Karashima Shigehiro
Division Department of Internal Medicine, Asanogawa General Hospital, 83 Kosakamachi, Kanazawa, Ishikawa 920-8621 Japan.
Department of Health Promotion and Medicine of the Future, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641 Japan.
J Diabetes Metab Disord. 2024 Jul 26;23(2):2105-2113. doi: 10.1007/s40200-024-01472-w. eCollection 2024 Dec.
Tirzepatide belongs to a new class of anti-diabetic agents that stimulate both glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptors, resulting in a greater blood glucose-lowering effect and body weight reduction than glucagon-like peptide-1 analogs. However, data on the effects of switching from glucagon-like peptide-1 analogs to tirzepatide on the blood glucose level, body weight, and liver functions are unavailable.
Data from 40 patients with type 2 diabetes who received a prescription change from dulaglutide to tirzepatide were retrospectively analyzed at the 3 and 6 months after the switch. The analyzed data included glycosylated hemoglobin, body weight, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transpeptidase levels, and fibrosis-4 index.
Six months after the treatment switch, average reductions of 1.2% and 3.6 kg were observed in the glycosylated hemoglobin and body weight, respectively. The change in glycosylated hemoglobin level was negatively correlated with the baseline glycosylated hemoglobin level. However, body weight reduction was observed regardless of the baseline characteristics. Moreover, the aspartate aminotransferase, alanine aminotransferase, and γ-glutamyl transpeptidase levels decreased 6 months after the switch. Reductions in alanine aminotransferase levels was greater in patients with higher baseline aspartate aminotransferase, alanine aminotransferase, and γ-glutamyl transpeptidase levels. Although the fibrosis-4 index did not improve during the study period, a trend toward a decrease was observed in patients with a higher baseline fibrosis-4 index.
Switching from dulaglutide to tirzepatide has a beneficial effect on the blood glucose level, body weight, and liver function in patients with type 2 diabetes.
替尔泊肽属于一类新型抗糖尿病药物，可刺激胰高血糖素样肽-1和葡萄糖依赖性促胰岛素多肽受体，与胰高血糖素样肽-1类似物相比，具有更强的降血糖作用和体重减轻效果。然而，关于从胰高血糖素样肽-1类似物转换为替尔泊肽对血糖水平、体重和肝功能影响的数据尚不可用。
回顾性分析了40例2型糖尿病患者从度拉糖肽转换为替尔泊肽后的处方数据，分析时间为转换后3个月和6个月。分析的数据包括糖化血红蛋白、体重、天冬氨酸转氨酶、丙氨酸转氨酶、γ-谷氨酰转肽酶水平以及纤维化-4指数。
治疗转换6个月后，糖化血红蛋白和体重平均分别降低了1.2%和3.6千克。糖化血红蛋白水平的变化与基线糖化血红蛋白水平呈负相关。然而，无论基线特征如何，均观察到体重减轻。此外，转换6个月后天冬氨酸转氨酶、丙氨酸转氨酶和γ-谷氨酰转肽酶水平下降。基线天冬氨酸转氨酶、丙氨酸转氨酶和γ-谷氨酰转肽酶水平较高的患者，丙氨酸转氨酶水平下降幅度更大。尽管在研究期间纤维化-4指数没有改善，但基线纤维化-4指数较高的患者有下降趋势。
从度拉糖肽转换为替尔泊肽对2型糖尿病患者的血糖水平、体重和肝功能具有有益影响。
