胰高血糖素样肽-1受体激动剂双重和三联疗法在肥胖症和心血管疾病中的作用演变

Evolving Role of Double and Triple Therapy With GLP-1 Receptor Agonists in Obesity and Cardiovascular Disease.

作者信息

Sedrak Phelopater, Verma Raj, Verma Meena, Connelly Kim A

机构信息

Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.

School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Can J Cardiol. 2025 Apr 29. doi: 10.1016/j.cjca.2025.03.037.

DOI:10.1016/j.cjca.2025.03.037

PMID:40311673

Abstract

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have emerged as a transformative class of therapies, expanding their clinical utility far beyond glycemic control. Initially developed for the treatment of diabetes, these agents are now recognised as potent therapies for managing overweight and obesity, atherosclerosis, and heart failure. This review explores the evolution of GLP-1RA-based therapies, with a focus on novel advances such as dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists ("double G") and triple receptor agonists incorporating glucagon modulation ("triple G"). We also provide an overview of completed and ongoing clinical trials investigating the role of GLP-1RAs in atherosclerosis and heart failure. These developments underscore the expanding therapeutic landscape of GLP-1RAs and their growing significance in cardiometabolic medicine.

摘要

胰高血糖素样肽-1受体激动剂（GLP-1RAs）已成为一类具有变革性的疗法，其临床应用范围已远远超出血糖控制。这些药物最初是为治疗糖尿病而开发的，现在被认为是治疗超重和肥胖、动脉粥样硬化及心力衰竭的有效疗法。本综述探讨了基于GLP-1RA的疗法的演变，重点关注新型进展，如双重GLP-1和葡萄糖依赖性促胰岛素多肽（GIP）受体激动剂（“双G”）以及纳入胰高血糖素调节的三联受体激动剂（“三联G”）。我们还概述了已完成和正在进行的临床试验，这些试验研究了GLP-1RAs在动脉粥样硬化和心力衰竭中的作用。这些进展凸显了GLP-1RAs不断扩大的治疗领域及其在心脏代谢医学中日益重要的地位。