Tirzepatide txhaj rau ntshav qab zib thiab poob phaus

Tirzepatide yog ib qho tshiab dual glucose-dependent insulinotropic polypeptide (GIP) thiab glucagon-zoo li peptide-1 (GLP-1) receptor agonist tsim. Nws ob lub hom phiaj yog txhawm rau txhim kho cov tshuaj insulin secretion, txo qis glucagon tso tawm, ncua lub plab zom mov, thiab txhim kho satiety, muab cov txheej txheem kho mob rau hom 2 mob ntshav qab zib mellitus (T2DM) thiab rog rog.

Cov kev tshawb pom tseem ceeb los ntawm kev tshawb fawb soj ntsuam

1. Glycemic tswj

Nyob ntawm ntau yamSURPASStheem 3 kev sim tshuaj, tirzepatide tau qhiakev tswj glycemic zoo duapiv nrog cov tshuaj tiv thaiv kab mob uas twb muaj lawm, suav nrog semaglutide thiab insulin degludec.

• Mean HbA1c txo: mus txog-2.4%tom qab 40-52 lub lis piam.

• Qhov feem ntau ntawm cov neeg koom ua tiavHbA1c < 6.5%, ntsib lossis tshaj ADA cov hom phiaj.

• Kev txhim kho tseem ceeb hauv kev yoo mov hauv plasma qabzib thiab qib qabzib tom qab tau pom.

2. Txo qhov hnyav

Tirzepatide tsis tu ncua uakho mob lub ntsiab lus thiab koob tshuaj-nyob ntawm qhov hnyav poobnyob rau hauv ob qho tib si mob ntshav qab zib thiab cov neeg tsis muaj ntshav qab zib.

• Hauv cov neeg mob T2DM: qhov nruab nrab lub cev qhov hnyav txo tau los ntawm7-12 kg.

• Hauv cov neeg uas tsis yog mob ntshav qab zib mellitus (SURMOUNT-1 sim):

  • 10 mg thiab 15 mg koob tshuaj coj mus rau15-22% txhais tau tias lub cev poob phaus, piv rau lossis tshaj qhov kev phais bariatric.

• Feem ntau cov neeg koom ua tiav yam tsawg kawg nkaus5-10%poob phaus.

3. Kev txhim kho Cardiometabolic

Kev kho Tirzepatide kuj tseem txhim kho cov kab mob metabolic:

• Kev txo qishauv triglycerides, LDL-C, thiab tag nrho cov cholesterol.

• Ncehauv HDL-C.

• Qhov tseem ceebtxo cov ntshav siab systolic thiab diastolic.

• Kev txhim kho ntawm insulin rhiab heev thiab β-cell ua haujlwm.

4. Kev nyab xeeb thiab kam rau ua

Kev nyab xeeb profile tau zoo ib yam nrog rau lwm cov kev kho mob incretin:

• Feem ntau cov teeb meem tshwm sim: me me mus rau nruab nrab cov tsos mob ntawm plab hnyuv (xws li, ntuav, raws plab).

• Tsawg qhov tshwm sim ntawm hypoglycemia, feem ntau yog siv nrog insulin lossis sulfonylureas.

• Tsis muaj kev txhawj xeeb txog kev nyab xeeb loj hauv cov txiaj ntsig ntawm lub plawv.

5. Mechanistic Insights

Tirzepatide qhov tshwj xeebdual receptor agonismamplifies ob qho tib si GIP thiab GLP-1 txoj hauv kev:

• GIP activationTxhim kho cov piam thaj-dependant insulin secretion thiab tuaj yeem txhim kho cov ntaub so ntswg adipose.

• Ua kom GLP-1txhawb kev qab los noj mov thiab qeeb plab hnyuv.

• Lawvsynergistic nyhuvua rau kev txhim kho cov piam thaj nrog kev txo qhov hnyav piv rau cov neeg ua haujlwm ib leeg.

Xaus

Tirzepatide sawv cev rau akev txhim kho hauv kev kho mob metabolic, muabKev ua tau zoo tsis tau pom dua hauv kev tswj glycemic thiab txo qhov hnyavrau cov neeg uas muaj ntshav qab zib hom 2 thiab rog rog.
Nws ob lub incretin mechanism muab ib qho kev sib koom ua ke hais txog cov hauv paus hauv paus ua rau cov metabolism tsis ua haujlwm - hyperglycemia, insulin tsis kam, thiab lub cev hnyav.
Muab nws txoj kev ua tau zoo thiab kev tswj hwm kev nyab xeeb, tirzepatide tuaj yeem hloov kho cov txheej txheem kho mob ntshav qab zib thiab kev rog rog hauv kaum xyoo tom ntej.

Cov ntaub ntawv

• Frias JP et al.,New England Journal of Medicine, 2021 ib.

• Jastreboff AM et al.,New England Journal of Medicine, 2022 (XEEM-1).

• Ludvik B et al.,Lancet, 2021 ib.

• Eli Lilly Clinical Data, SURPASS Trials 1–5.