Glucagon-like Peptide-1 Receptor Agonists Associated Gastrointestinal Adverse Events: A Cross-Sectional Analysis of the National Institutes of Health All of Us Cohort

Pharmaceuticals, Journal Year: 2024, Volume and Issue: 17(2), P. 199 - 199

Published: Feb. 2, 2024

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used diabetes and obesity medications but have been associated with gastrointestinal (GI) adverse events. However, real-world evidence on comparative GI reaction profiles is limited. Objectives: This study aimed to evaluate events among GLP-1 RA users compare semaglutide, dulaglutide, liraglutide, exenatide safety regarding the profile. Methods: retrospective cross-sectional analysis utilized data 10,328 adults diabetes/obesity in National Institutes of Health All Us cohort. New were identified, examined. Logistic regression determined factors Results: The mean age population was 61.4 ± 12.6 years, 65.7% female, 51.3% White, they had a high comorbidity burden. Abdominal pain (57.6%) most common event, followed by constipation (30.4%), diarrhea (32.7%), nausea vomiting (23.4%), bleeding (15.9%), gastroparesis (5.1%), pancreatitis (3.4%). Dulaglutide liraglutide higher rates abdominal pain, constipation, diarrhea, than semaglutide exenatide. Liraglutide highest (4.0% 3.8%, respectively). Compared dulaglutide odds vomiting. They also semaglutide. No significant differences existed or risks between RAs. Conclusions: In this cohort, Differences agents, appearing safer other RAs, except for gastroparesis. These findings can inform selection considering risk factors. Further studies needed causal relationship concomitant medication use.

Language: Английский

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Efficacy of GLP-1 Receptor Agonists on Weight Loss, BMI, and Waist Circumference for Patients With Obesity or Overweight: A Systematic Review, Meta-analysis, and Meta-regression of 47 Randomized Controlled Trials

Diabetes Care, Journal Year: 2025, Volume and Issue: 48(2), P. 292 - 300

Published: Jan. 22, 2025

OBJECTIVE To provide an updated synthesis on effects of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) weight, BMI, and waist circumference incorporating newer randomized controlled trials (RCTs), particularly in individuals with overweight or obesity. RESEARCH DESIGN AND METHODS We systematically searched PubMed, Embase, Cochrane Central Register Controlled Trials (CENTRAL) for RCTs published from inception to 4 October 2024. The search was limited evaluating the use GLP-1 RAs mean differences baseline adults obesity without diabetes. Two independent reviewers performed literature data extraction, resolving disagreements via consensus third-reviewer consultation. RESULTS Forty-seven were included, a combined cohort 23,244 patients. demonstrated weight reduction −4.57 kg (95% CI −5.35 −3.78), BMI −2.07 kg/m2 −2.53 −1.62), −4.55 cm −5.72 −3.38) compared placebo. This effect consistent across diabetes status, RA used, route administration. greatest treatment benefit appeared favor patients who younger, female, diabetes, higher but lower HbA1c, treated over longer duration. Limitations include substantial statistical heterogeneity, part due broad inclusion criteria. However, this heterogeneity may improve generalizability by reflecting wide range study designs patient populations. CONCLUSIONS significant benefits meta-analysis.

Language: Английский

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Type 2 Diabetes Mellitus: New Pathogenetic Mechanisms, Treatment and the Most Important Complications

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(3), P. 1094 - 1094

Published: Jan. 27, 2025

Type 2 diabetes mellitus (T2DM), a prevalent chronic disease affecting over 400 million people globally, is driven by genetic and environmental factors. The pathogenesis involves insulin resistance β-cell dysfunction, mediated mechanisms such as the dedifferentiation of β-cells, mitochondrial oxidative stress. Treatment should be based on non-pharmacological therapy. Strategies increased physical activity, dietary modifications, cognitive-behavioral therapy are important in maintaining normal glycemia. Advanced therapies, including SGLT2 inhibitors GLP-1 receptor agonists, complement these treatments offer solid glycemic control, weight reduced cardiovascular risk. Complications T2DM, diabetic kidney disease, retinopathy, neuropathy, underscore need for early diagnosis comprehensive management to improve patient outcomes quality life.

Language: Английский

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Glucagon‐Like Peptide‐1 Receptor Agonists and Liver Outcomes in Patients With MASLD and Type 2 Diabetes

Alimentary Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 10, 2025

ABSTRACT Background and Aims Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) sodium‐glucose cotransporter‐2 inhibitors (SGLT2is) have demonstrated long‐term liver benefits in patients with metabolic dysfunction‐associated steatotic disease (MASLD) type 2 diabetes (T2D). However, no direct comparison between these therapies has been conducted. This study aimed to compare major adverse outcomes (MALOs) GLP‐1 RAs SGLT2is MASLD T2D. Methods Using the TriNetX Research Network, a multinational multi‐institutional database, we identified adults T2D who received their first prescription for either RA or an SGLT2i January 2010 June 2023. We conducted propensity score‐matched (PSM) cohort comparing new users of SGLT2is. The primary outcome was risk MALOs, composite endpoint consisting decompensated cirrhosis events, hepatocellular carcinoma, transplantation. Secondary included all‐cause mortality individual components outcome. Results 15,176 pairs treated SGLT2i. adjusted hazard ratio (HR) MALO associated relative 0.84 (95% confidence interval [CI]: 0.73–0.97; incidence rate: 88.9 versus 105.3 events per 10,000 person‐years), primarily driven by reduction (adjusted HR: 0.83, 95% CI: 0.71–0.96). were lower 0.84, 0.75–0.94). Conclusion are better compared

Language: Английский

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Characterization of glucagon-like peptide-1 (GLP-1) agonist exposures reported to a single United States poison center

Clinical Toxicology, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 4

Published: Jan. 13, 2025

Glucagon-like peptide-1 agonists have gained attention in recent years due to their efficacy managing type II diabetes mellitus and emerging role weight management. The purpose of this study was characterize glucagon-like agonist exposures reported a single United States regional poison center over nine years, including causes exposure, associated clinical effects, potential areas for improving patient education safety. This retrospective cohort analyzed all calls involving submitted from 14 January 2014 1 May 2023. Data were abstracted the electronic medical record center, demographics, call volume, drug involved, frequency hypoglycemia, other side effects. Two hundred thirty-seven cases center. annual number increased sharply period. Most patients ( Unintentional therapeutic errors involved 164 (69.2%) cases. Despite generally mild effects observed study, occurrence hypoglycemia subset patients, often requiring hospitalization, is concern. With reports acquisition these medications through online platforms poorly regulated compounding sources, trend may pose public health risks. demonstrates increasing incidence predominantly unintentional overdoses, which highlights need ongoing education.

Language: Английский

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How ‘miracle’ weight‐loss semaglutide promises to change medicine but can we afford the expense?

British Journal of Pharmacology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 13, 2025

Obesity is a complex and growing global concern, affecting one in eight individuals compromising health, quality of life expectancy. It carries significant metabolic, cardiovascular, oncological, hepatorenal, skeletal psychiatric risks, imposing substantial costs on health‐care systems. Traditional treatments have often been ineffective or led to relapse after lifestyle changes. Whereas bariatric surgery effective, it also involves risks such as mortality hospitalisation. Semaglutide, licensed 2018, synthetic analogue glucagon‐like peptide 1 which regulates glucose metabolism gastrointestinal (GI) motility. Studies show that semaglutide, administered either weekly subcutaneously, daily orally, induces an average weight loss −11.62 kg compared placebo reduces waist circumference by up −9.4 cm. improves blood pressure, fasting levels, C‐reactive protein levels lipid profiles. The most common adverse events are mild‐to‐moderate GI complaints occurring more frequently with administration than doses; hypoglycaemia without intervention. Weight regain follows semaglutide withdrawal. Furthermore, offers cardiovascular benefits for patients established atherosclerotic disease (CVD), lowers the risk kidney outcomes cardiovascular‐related death, resolves nonalcoholic steatohepatitis many cases, positively impacts mental health life. In conclusion, therapy could significantly benefit adults regarding CVD if made widely accessible. Ethical financial considerations must be addressed personalised obesity treatment approaches.

Language: Английский

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Ensuring safety first: GLP‐1RAs in reproductive and endometrial research

Acta Obstetricia Et Gynecologica Scandinavica, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 24, 2025

Language: Английский

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Relationship between advanced lung cancer inflammation index and long-term all-cause, cardiovascular, and cancer mortality among type 2 diabetes mellitus patients: NHANES, 1999–2018

Frontiers in Endocrinology, Journal Year: 2023, Volume and Issue: 14

Published: Nov. 28, 2023

Background Type 2 diabetes mellitus (T2DM) was a major global health threat. As chronic low-grade inflammatory disease, the prognosis of associated with inflammation. The advanced lung cancer inflammation index (ALI) served as comprehensive to assess This study aimed estimate association between ALI and all-cause, cardiovascular disease (CVD), mortality in T2DM patients. Methods We extracted cohort data from National Health Nutrition Examination Survey (NHANES) spanning 1999-2018 for analysis. weighted Kaplan-Meier analysis multivariate-adjusted Cox were utilized evaluate relationship CVD, Restricted cubic spline (RCS) employed their non-linear relationship. Stratified interaction conducted enhance robustness results. Results incorporated total 3,888 An increase reduced risk all-cause CVD patients, but not related mortality. There J-shaped L-shaped relationships respectively. inflection points 90.20 93.06, For values below point, every 10U ALI, both decreased by 9%. Beyond rose 3%, while remained unaffected. Gender-stratified RCS indicated linear negative female whereas trend males aligned overall population. Conclusion Our research initially identified significant correlation increased levels there relation These findings suggested that maintaining (for example, control body weight keep albumin normal range) within certain range clinical settings crucial improving

Language: Английский

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Glucagon‐like peptide‐1 receptor agonists and risk of thyroid cancer: A systematic review and meta‐analysis of randomized controlled trials

Diabetes Obesity and Metabolism, Journal Year: 2023, Volume and Issue: 26(3), P. 891 - 900

Published: Nov. 29, 2023

Abstract Aim To conduct a meta‐analysis of randomized clinical trials (RCTs) to investigate whether there is an association between glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) treatment and thyroid cancer. Materials Methods In this RCTs, we included studies comparing GLP‐1RA with any comparator, lasting at least 52 weeks, reporting the incidence adverse events independently principal endpoint population. All cases cancer were collected. Results We retrieved 64 trials, 26 which reported one incident case was associated significant increase in risk overall (Mantel‐Haenzel odds ratio [MH‐OR] 1.52 [95% confidence interval {CI} 1.01, 2.29]; P = 0.04, I 2 0%), fragility index 1, 5‐year number needed harm 1349. The remained when including only 104 weeks (MH‐OR 1.76 CI 1.00, 3.12]; 0.05). No found for papillary 1.54 0.77, 3.06]; 0.22) or medullary 1.44 0.23, 9.16]; 0.55). Conclusions Our showed that could be moderate relative small absolute risk. Studies longer duration are required assess implications finding.

Language: Английский

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Diabetes Mellitus Secondary to Endocrine Diseases: An Update of Diagnostic and Treatment Particularities

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(16), P. 12676 - 12676

Published: Aug. 11, 2023

Secondary diabetes mellitus is frequently ignored in specialized literature. In this narrative review, the main endocrinopathies accompanied by increased glycemic values are identified, as well mechanisms which excess or deficiency of certain hormones impact beta cell function insulin resistance. The (acromegaly, Cushing’s syndrome, Basedow–Graves’ disease, pheochromocytoma, somatostatinoma and glucagonoma) their characteristics described along with hormone changes on blood sugar, body mass index other parameters associated diabetes. overall information regarding complex molecular that cause risk secondary metabolic syndrome crucial importance order to prevent development disease its complications particularly reduce cardiovascular these patients. purpose study highlight particular features endocrine pathologies an developing diabetes, context personalized therapeutic decision making. epidemiological, physiopathological, clinical approaches presented screening for diseases.

Language: Английский

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