Bin Dayel Faten F, Alanazi Rakan J, Alenazi Miteb A, Alkhalifah Sahar, Alfaifi Mohammed, Alghadeer Sultan, Alwhaibi Abdulrahman
Department of Pharmacology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
Pharmacy Practice Department, College of Pharmacy, Alfaisal University, Riyadh 11533, Saudi Arabia.
Healthcare (Basel). 2025 Jul 26;13(15):1827. doi: 10.3390/healthcare13151827.
Although semaglutide (Ozempic) is being prescribed off-label to individuals with obesity, some concerns have arisen regarding its use, particularly regarding the risk of thyroid and pancreatic disorders. Therefore, it is crucial to screen patients' medical and family disease histories, as well as certain clinical parameters, before initiating this treatment for obesity or weight management. However, there is limited research investigating whether pretreatment assessment is adopted in clinical practice. This is a single-center retrospective study involving adults who were prescribed semaglutide for obesity or weight management. Demographic data, comorbid conditions, semaglutide-related lab work, and disease history assessments, including pancreatitis, thyroid abnormalities, oculopathy, neuropathy, and any family history of thyroid cancer, were evaluated and documented prior to treatment initiation. In total, 715 patients were included in the study, with an average age of 40.2 ± 12.0 years, and 49.5% of participants were male. The average weight and BMI prior to using semaglutide were 99.8 ± 18.1 kg and 36.3 ± 8.3 kg/m, respectively, with predominantly overweight and obese individuals (collectively 91.3%). Approximately 69% of patients had 3-5 complications, with a high prevalence of cardiovascular and metabolic diseases before using semaglutide. Although HbA1c, serum creatinine, TSH, T3, T4, triglycerides, HDL, LDL, total cholesterol, and total bilirubin were monitored prior to semaglutide use, none of the patients' pancreatic lipase, amylase, or calcitonin levels were measured. Although it is important to investigate all personal and family disease histories, including thyroid abnormalities, thyroid cancer, pancreatitis, retinopathy, eye problems, and neuropathy prior to semaglutide initiation, checks were only conducted in 1.8% of patients, despite 98.6% having at least one of the diseases assessed pretreatment. The current pretreatment assessment approach for patients prescribed semaglutide for weight reduction is underdeveloped, particularly with regard to assessing the influence of disease history on semaglutide use. This predisposes patients to a risk of severe clinical outcomes, including thyroid cancer, pancreatitis, and retinopathy.
尽管司美格鲁肽（Ozempic）正在被超适应证处方给肥胖个体，但人们对其使用产生了一些担忧，尤其是关于甲状腺和胰腺疾病的风险。因此，在开始这种肥胖治疗或体重管理之前，筛查患者的病史、家族病史以及某些临床参数至关重要。然而，关于临床实践中是否采用治疗前评估的研究有限。这是一项单中心回顾性研究，纳入了被处方司美格鲁肽用于肥胖或体重管理的成年人。在开始治疗前，对人口统计学数据、合并症、司美格鲁肽相关实验室检查结果以及病史评估（包括胰腺炎、甲状腺异常、眼病、神经病变以及甲状腺癌家族史）进行了评估和记录。该研究共纳入715例患者，平均年龄为40.2±12.0岁，49.5%的参与者为男性。使用司美格鲁肽前的平均体重和BMI分别为99.8±18.1kg和36.3±8.3kg/m²，主要为超重和肥胖个体（共占91.3%）。约69%的患者有3至5种并发症，使用司美格鲁肽前心血管和代谢疾病的患病率较高。尽管在使用司美格鲁肽前监测了糖化血红蛋白、血清肌酐、促甲状腺激素、T3、T4、甘油三酯、高密度脂蛋白、低密度脂蛋白、总胆固醇和总胆红素，但未检测任何患者的胰腺脂肪酶、淀粉酶或降钙素水平。尽管在开始使用司美格鲁肽之前调查所有个人和家族病史（包括甲状腺异常、甲状腺癌、胰腺炎、视网膜病变、眼部问题和神经病变）很重要，但尽管98.6%的患者在治疗前评估中至少有一种被评估的疾病，但仅对1.8%的患者进行了检查。目前为减肥而处方司美格鲁肽的患者的治疗前评估方法不完善，特别是在评估病史对司美格鲁肽使用的影响方面。这使患者面临严重临床后果的风险，包括甲状腺癌、胰腺炎和视网膜病变。
