Current Treatment Options in Psychiatry, Journal Year: 2024, Volume and Issue: 12(1)
Published: Dec. 9, 2024
Language: Английский
JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(7), P. e2421305 - e2421305
Published: July 5, 2024
Importance Thirteen human malignant neoplasms have been identified as obesity-associated cancers (OACs), ie, the presence of excess body fat is associated with increased risk developing cancer and worse prognosis in patients these specific tumors. The glucagon-like peptide receptor agonist (GLP-1RA) class pharmaceuticals are effective agents for treatment type 2 diabetes (T2D) achieving weight loss, but association GLP-1RAs incident 13 OACs unclear. Objective To compare each T2D who were prescribed vs insulins or metformin. Design, Setting, Participants This retrospective cohort study was based on a nationwide multicenter database electronic health records (EHRs) 113 million US patients. population included 1 651 452 had no prior diagnosis GLP-1RAs, insulins, metformin during March 2005 to November 2018. Data analysis conducted April 26, 2024. Exposures Prescription Main Outcomes Measures Incident (first-time) occurring 15-year follow-up after exposure examined using Cox proportional hazard Kaplan-Meier survival analyses censoring applied. Hazard ratios (HRs), cumulative incidences, 95% CIs calculated. All models adjusted confounders at baseline by propensity-score matching covariates. Results In (mean [SD] age, 59.8 [15.1] years; 827 873 [50.1%] male 775 687 [47.0%] female participants; 5780 [0.4%] American Indian Alaska Native, 65 893 [4.0%] Asian, 281 242 [17.0%] Black, 707 [0.8%] Native Hawaiian Other Pacific Islander, 000 780 [60.6%] White participants), compared insulin significant reduction 10 OACs, including gallbladder (HR, 0.35; CI, 0.15-0.83), meningioma 0.37; 0.18-0.74), pancreatic 0.41; 0.33-0.50), hepatocellular carcinoma 0.47; 0.36-0.61), ovarian 0.52; 0.03-0.74), colorectal 0.54; 0.46-0.64), multiple myeloma 0.59; 0.44-0.77), esophageal 0.60; 0.42-0.86), endometrial 0.74; 0.60-0.91), kidney 0.76; 0.64-0.91). Although not statistically significant, HR stomach less than among took those 0.73; 0.51-1.03). reduced postmenopausal breast thyroid cancer. Of that showed decreased taking insulin, HRs 1, significant. Compared metformin, any cancers, an 1.54; 1.27-1.87). Conclusions Relevance this study, lower risks types T2D. These findings provide preliminary evidence potential benefit prevention high-risk populations support further preclinical clinical studies certain OACs.
Language: Английский
Citations
71
Gastroenterology, Journal Year: 2024, Volume and Issue: 167(4), P. 689 - 703
Published: April 29, 2024
Hepatocellular carcinoma (HCC) is a leading cause of cancer death. HCC preventable with about 70% attributable to modifiable risk factors. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), Food and Drug Administration-approved medications for treating type 2 diabetes mellitus (T2DM), have pleiotropic effects on counteracting factors HCC. Here we evaluate the association GLP-1RAs incident in real-world population.
Language: Английский
Citations
40
Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)
Published: May 28, 2024
Abstract Alcohol use disorders are among the top causes of global burden disease, yet therapeutic interventions limited. Reduced desire to drink in patients treated with semaglutide has raised interest regarding its potential benefits for alcohol disorders. In this retrospective cohort study electronic health records 83,825 obesity, we show that compared other anti-obesity medications is associated a 50%-56% lower risk both incidence and recurrence disorder 12-month follow-up period. Consistent reductions were seen stratified by gender, age group, race without type 2 diabetes. Similar findings replicated population 598,803 These provide evidence benefit AUD real-world populations call further randomized clinical trials.
Language: Английский
Citations
33
Alzheimer s & Dementia, Journal Year: 2024, Volume and Issue: unknown
Published: Oct. 24, 2024
Abstract INTRODUCTION Emerging preclinical evidence suggests that semaglutide, a glucagon‐like peptide receptor agonist (GLP‐1RA) for type 2 diabetes mellitus (T2DM) and obesity, protects against neurodegeneration neuroinflammation. However, real‐world its ability to protect Alzheimer's disease (AD) is lacking. METHODS We conducted emulation target trials based on nationwide database of electronic health records (EHRs) 116 million US patients. Seven were emulated among 1,094,761 eligible patients with T2DM who had no prior AD diagnosis by comparing semaglutide seven other antidiabetic medications. First‐ever occurred within 3‐year follow‐up period was examined using Cox proportional hazards Kaplan–Meier survival analyses. RESULTS Semaglutide associated significantly reduced risk first‐time diagnosis, most strongly compared insulin (hazard ratio [HR], 0.33 [95% CI: 0.21 0.51]) weakly GLP‐1RAs (HR, 0.59 0.37 0.95]). Similar results seen across obesity status, gender, age groups. DISCUSSION These findings support further studies assess semaglutide's potential in preventing AD. HIGHLIGHTS 40% 70% risks medications, including GLP‐1RAs. lower AD‐related medication prescriptions. reductions Our provide supporting the clinical benefits mitigating initiation development T2DM. delaying or
Language: Английский
Citations
23
Frontiers in Pharmacology, Journal Year: 2025, Volume and Issue: 16
Published: March 10, 2025
Randomized controlled trials (RCTs) are the gold standard for evaluating efficacy and safety of both pharmacological non-pharmacological interventions. However, while they designed to control confounders ensure internal validity, their usually stringent inclusion exclusion criteria often limit generalizability findings broader patient populations. Moreover, RCTs resource-intensive, frequently underpowered detect rare adverse events, sometimes narrowly focused due highly environments. In contrast, real-world data (RWD), typically derived from electronic health records (EHRs) claims databases, offers a valuable counterpart answering research questions that may be impractical address through RCTs. Recognizing this, US Food Drug Administration (FDA) has increasingly relied on evidence (RWE) RWD support regulatory decisions post-market surveillance. Platforms like TriNetX, leverage large-scale RWD, facilitate collaborations between academia, industry, healthcare organizations, constitute an in-depth tool retrieval analysis RWD. TriNetX’s federated network architecture allows real-time, privacy-compliant access, significantly enhancing ability conduct retrospective studies refine clinical trial designs. With access currently over 150 million EHRs, TriNetX proven particularly effective in filling gaps left by RCTs, especially context diseases, endpoints, diverse As role continues expand, stands out as critical complements traditional trials, bridging gap environments practice. This review provides comprehensive methodologies applications platform, highlighting its potential contribution advance care outcomes.
Language: Английский
Citations
2
Brain Sciences, Journal Year: 2024, Volume and Issue: 14(6), P. 617 - 617
Published: June 20, 2024
Glucagon-like peptide-1 (GLP-1) is involved in a range of central and peripheral pathways related to appetitive behavior. Hence, this study explored the effects glucagon-like receptor agonists (GLP-1 RAs) on substance behavioral addictions, including alcohol, caffeine, nicotine, cannabis, psychostimulants, compulsive shopping, sex drive/libido. Data were collected from various social platforms. Keywords GLP-1 RAs substance/behavioral addiction used extract relevant comments. The employed mixed-methods approach analyze online discussions posted December 2019 June 2023 using specialized web application. Reddit entries focus here due limited data other platforms, such as TikTok YouTube. A total 5859 threads comments extracted six subreddits, which included about drugs associated brand names. To obtain posts, keywords potential use behavior selected. Further analysis two main steps: (1) manually coding posts based users’ references impact non-substance habits, excluding irrelevant or unclear comments; (2) performing thematic dataset keywords, AI-assisted techniques followed by manual revision generated themes. Second, was performed keyword-related dataset, In total, 29.75% alcohol-related; 22.22% caffeine-related; 23.08% nicotine-related clearly stated cessation intake these substances following start prescription. Conversely, mixed results found for cannabis intake, only limited, anecdotal made available cocaine, entactogens, dissociative drugs’ misuse. Regarding 21.35% reported shopping interruption, whilst sexual drive/libido elements reportedly increased several users. current appeared be useful tool gaining insight into complex topics addiction-related disorders; some RA-related mental health benefits could also inferred here. Overall, it that may show target both craving maladaptive/addictive behaviors, although further empirical research needed.
Language: Английский
Citations
15
Pharmacological Research, Journal Year: 2024, Volume and Issue: 207, P. 107312 - 107312
Published: July 18, 2024
Addiction is a chronic relapsing disease with high morbidity and mortality. Treatments for addiction include pharmacological psychosocial interventions; however, currently available medications are limited in number efficacy. The glucagon-like-peptide-1 (GLP-1) system emerging as potential novel pharmacotherapeutic target alcohol other substance use disorders (ASUDs). In this review, we summarize discuss the wealth of evidence from testing GLP-1 receptor (GLP-1R) agonist preclinical models humans ASUDs, possible mechanisms underlying impact GLP-1R agonists on alcohol/substance use, gaps knowledge, future directions. Most research has been conducted relation to use; psychostimulants, opioids, nicotine have also investigated. Preclinical suggests that reduce related outcomes. main proposed reward processing, stress, cognitive function, well broader satiety, changes gastric motility, glucose homeostasis. More in-depth mechanistic studies warranted. Clinical their findings less conclusive; most support safety efficacy ASUD treatment. Identifying preferred compounds, subgroups who responsive some key questions translate promising data into clinical settings. Several trials underway test people ASUDs.
Language: Английский
Citations
13
Annals of Internal Medicine, Journal Year: 2024, Volume and Issue: 177(8), P. 1016 - 1027
Published: July 29, 2024
Reports of reduced desire to smoke in patients treated with semaglutide, a glucagon-like peptide receptor agonist (GLP-1RA) medication for type 2 diabetes mellitus (T2DM) and obesity, have raised interest about its potential benefit tobacco use disorders (TUDs).
Language: Английский
Citations
13
JAMA Psychiatry, Journal Year: 2024, Volume and Issue: unknown
Published: Nov. 13, 2024
Importance Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption. Objective To test whether the risk of hospitalization due use disorder (AUD) is decreased during GLP-1 agonists compared with periods nonuse for same individual. Design, Setting, Participants This cohort study was an observational conducted nationwide in Sweden using data from January 2006 December 2023. The population-based identified registers inpatient care, specialized outpatient sickness absence, disability pension. were all residents aged 16 64 years who had a diagnosis AUD. Exposures primary exposure individual (compared agonists), secondary medications indication Main Outcomes Measures outcome AUD analyzed Cox regression within-individual model. Secondary outcomes any substance (SUD)–related hospitalization, somatic suicide attempt. Results included 227 866 individuals AUD; 144 714 (63.5%) male 83 154 (36.5%) female, mean (SD) age 40.0 (15.7) years. Median (IQR) follow-up time 8.8 (4.0-13.3) A total 133 210 (58.5%) experienced hospitalization. Semaglutide (4321 users) associated lowest (AUD: adjusted hazard ratio [aHR], 0.64; 95% CI, 0.50-0.83; SUD: aHR, 0.68; 0.54-0.85) liraglutide (2509 second 0.72; 0.57-0.92; 0.78; 0.64-0.97) both SUD Use medication modestly (aHR, 0.98; 0.96-1.00). 0.68-0.90) 0.79; 0.69-0.91) also hospitalizations but not attempts (semaglutide: 0.55; 0.23-1.30; liraglutide: 1.08; 0.55-2.15). Conclusions Relevance Among patients comorbid obesity/type diabetes, semaglutide substantially lower than officially approved medications. be effective treatment AUD, clinical trials are urgently needed confirm these findings.
Language: Английский
Citations
12
Psychopharmacology, Journal Year: 2024, Volume and Issue: unknown
Published: June 17, 2024
Abstract Rationale Glucagon-like peptide-1 (GLP-1) receptor agonists reduce alcohol consumption in rodents and non-human primates. Semaglutide is a new long-acting GLP-1 agonist, widely used the clinic against type 2 diabetes obesity. It also reported to intake rodents. Objectives This study investigates possible inhibitory effect of semaglutide on alcohol-preferring African green monkeys. Methods We performed vehicle-controlled male monkeys that had demonstrated preference for alcohol. In selected voluntary drinking, was measured ten days at baseline (Monday Friday two weeks). During this period, access 4 h per day free water 24 day. After weeks measurements, were randomized or vehicle. Each group consisted monkeys, groups balanced with respect intake. Following treated escalating doses (up 0.05 mg/kg) vehicle subcutaneously twice weekly during which period not available. uptitration, daily 20 weeks), measured. exposure treatment (0.05 mg/kg weekly) continued three followed by one-week washout period. Results Compared vehicle, significantly reduced There no signs emetic events changes Conclusions These data demonstrate first time potent reducing primates further substantiate need clinical trials investigating patients alcohol-use disorder.
Language: Английский
Citations
11