GLP-1-raws li kev kho mob rau poob phaus: Mechanisms, Efficiency, thiab Research Advance

Tshuaj	Lub ntsiab lus qhia	Kev tswj hwm	Qhov hnyav poob qis
Liraglutide	Mob ntshav qab zib hom 2, rog rog	Kev txhaj tshuaj txhua hnub	5-8%
Semaglutide	Mob ntshav qab zib hom 2, rog rog	Txhua lub lis piam txhaj tshuaj / qhov ncauj	10-15%
Tirzepatide	Mob ntshav qab zib hom 2, rog rog	Kev txhaj tshuaj txhua lub lim tiam	15-22%
Retatrutide (hauv kev sim)	Obesity (tsis yog mob ntshav qab zib)	Kev txhaj tshuaj txhua lub lim tiam	Txog li 24%

Txoj Kev:Cov tshuaj evolution yog nce los ntawm ib leeg GLP-1 receptor agonists → dual GIP / GLP-1 agonists → triple agonists (GIP / GLP-1 / GCGR).

3. Kev sim tshuaj loj thiab cov txiaj ntsig

Semaglutide - STEP Kev sim

• STEP 1 (NEJ, 2021)

  • Cov neeg koom nrog: Cov neeg laus uas muaj rog, tsis muaj ntshav qab zib

  • koob tshuaj: 2.4 mg txhua lub lim tiam (subcutaneous)

  • Cov txiaj ntsig: txhais tau tias lub cev hnyav txo ntawm14.9%ntawm 68 lub lis piam vs. 2.4% nrog cov placebo

  • ~ 33% ntawm cov neeg koom ua tiav ≥20% poob phaus.

• KAUJ RUAM 5 (2022)

  • Ua kom pom kev poob phaus ntau dua 2 xyoos thiab txhim kho hauv kev pheej hmoo cardiometabolic.

Tirzepatide - SURMOUNT & SURPASS Programs

• SURMOUNT-1 (NEJM, 2022)

  • Cov neeg koom nrog: Cov neeg laus uas muaj rog, tsis muaj ntshav qab zib

  • koob tshuaj: 5 mg, 10 mg, 15 mg txhua lub lim tiam

  • Cov txiaj ntsig: txhais tau tias poob phaus15-21%tom qab 72 lub lis piam (dose-dependent)

  • Ze li ntawm 40% ua tiav ≥25% qhov hnyav txo.

• SURPASS Trials (Cov neeg mob ntshav qab zib)

  • Kev txo qis HbA1c: mus txog2.2%

  • Concurrent nruab nrab yuag poob ntawm10-15%.

4. Kev Noj Qab Haus Huv Ntxiv thiab Kev Pab Cuam Metabolic

• Txo hauvntshav siab, LDL-cholesterol, thiabtriglycerides

• Txovisceralthiabmob plab rog(kev txhim kho hauv NAFLD)

• Tsawg kev pheej hmoo ntawmkab mob plawv(eg, MI, stroke)

• Kev ncua sij hawm los ntawm prediabetes mus rau hom 2 mob ntshav qab zib

5. Kev nyab xeeb Profile thiab kev txiav txim siab

Cov kev phiv tshwm sim (feem ntau yog me me mus rau nruab nrab):

• xeev siab, ntuav, tsam plab, cem quav

• qab los noj mov

• Transient gastrointestinal tsis xis nyob

Ceeb toom / contraindications:

• Keeb kwm ntawm pancreatitis los yog medullary thyroid carcinoma

• Cev xeeb tub thiab pub niam mis

• Kev siv tshuaj maj mam titration pom zoo los txhim kho kev kam rau siab

6. Cov lus qhia txog kev tshawb fawb yav tom ntej

1. Lwm tiam multi-agonists:

   • Triple agonists tsom rau GIP / GLP-1 / GCGR (xws li,Retatrutide)

2. Oral GLP-1 formulations:

   • High-dose qhov ncauj semaglutide (txog 50 mg) nyob rau hauv kev ntsuam xyuas

3. Combination kho mob:

   • GLP-1 + insulin lossis SGLT2 inhibitors

4. Cov lus qhia dav dav ntawm metabolic:

   • Tsis-alcoholic fatty siab kab mob (NAFLD), polycystic zes qe menyuam syndrome (PCOS), pw tsaug zog apnea, tiv thaiv kab mob plawv

7. Cov lus xaus

GLP-1-raws li cov tshuaj sawv cev rau kev hloov pauv los ntawm kev tswj ntshav qab zib kom ua tiav metabolic thiab tswj qhov hnyav.
Nrog cov neeg sawv cev zoo liSemaglutidethiabTirzepatide, uas tsis yog phais qhov hnyav tshaj 20% tau ua tiav.
Yav tom ntej multi-receptor agonists xav tias yuav txhim kho kev ua tau zoo, ua haujlwm ntev, thiab cov txiaj ntsig cardiometabolic.