Glucagon-Like Peptide-1 Receptor Agonist Use and Residual Gastric Content Before Anesthesia

JAMA Surgery, Год журнала: 2024, Номер 159(6), С. 660 - 660

Опубликована: Март 6, 2024

Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use is rapidly increasing in the US, driven by its expanded approval for weight management addition to hyperglycemia patients with type 2 diabetes. The perioperative safety of these medications, particularly aspiration risk under anesthesia, uncertain.

Язык: Английский

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Trends in glucagon-like peptide 1 receptor agonist use, 2014 to 2022

Journal of the American Pharmacists Association, Год журнала: 2023, Номер 64(1), С. 133 - 138

Опубликована: Окт. 10, 2023

Abstract

Background

Recent Food and Drug Administration approvals of glucagon-like peptide 1 (GLP-1) receptor agonists linked to substantial weight loss have generated interest in demand projections. However, a longitudinal analysis large, diverse, current, real-world database has not been published.

Objectives

The study objective was determine user frequency GLP-1 agonist products overall by type 2 diabetes (T2D), cardiovascular disease (CVD), overweight or obese status. Secondary monthly growth rate estimation product since first appearance University California Health.

Methods

This retrospective cohort included patients who were dispensed from 2014 2022 the Health Data Warehouse. Exponential rates estimated using log-linear regression model.

Results

Between 2018, only Trulicity Victoza exceeded 5000 annual users. Ozempic users increased 569 2019 7667 2020. Use accelerated with more than 13,310 2021 surpass Trulicity. count 22,891 2022. Wegovy rose 989 2992 Mounjaro 1508 Although generally similar trends observed for T2D, CVD, subgroups, ascent as most frequently used apparent group. 83.9% Ozempic, 119.2% Wegovy, 84.8% Rybelsus, 53.3% Saxenda, 12.9% Adlyxin, 78.8% Trulicity, 254.3% Mounjaro.

Conclusion

loss–associated state-wide health system demonstrated rapid use that represents clear likely durable transition utilization this category. Informed decision making studies are needed ensure evidence-concordant prescribing supply stability.

Язык: Английский

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GLP-1 Agonists for Obesity—A New Recipe for Success?

JAMA, Год журнала: 2024, Номер 331(12), С. 1007 - 1007

Опубликована: Фев. 29, 2024

This Viewpoint discusses the drawbacks of using glucagon-like peptide 1 (GLP-1) agonists to treat obesity and presents an alternative approach initial, staged GLP-1 agonist treatment supported by long-term lifestyle programming, including medically appropriate groceries or meals (“Food Is Medicine”), address cost, health, equity burdens obesity.

Язык: Английский

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Dispensing of Glucagon-Like Peptide-1 Receptor Agonists to Adolescents and Young Adults, 2020-2023

JAMA, Год журнала: 2024, Номер 331(23), С. 2041 - 2041

Опубликована: Май 22, 2024

This study uses data from US retail pharmacies to assess national GLP-1RA dispensing adolescents and young adults 2020-2023.

Язык: Английский

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GPCR drug discovery: new agents, targets and indications

Nature Reviews Drug Discovery, Год журнала: 2025, Номер unknown

Опубликована: Март 3, 2025

Язык: Английский

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Role of lifestyle and glucagon‐like peptide‐1 receptor agonists for weight loss in obesity, type 2 diabetes and steatotic liver diseases

Alimentary Pharmacology & Therapeutics, Год журнала: 2024, Номер 59(S1)

Опубликована: Май 30, 2024

Summary Background The current obesity pandemic has given rise to associated comorbidities and complications, including type 2 diabetes metabolic dysfunction‐associated steatotic liver disease (MASLD). During the last decade, certain glucagon‐like peptide 1 receptor agonists (GLP‐1RA), originally developed as antihyperglycemic drugs, also demonstrated efficacy for weight loss. Aims To review shared pathophysiologic features of common diseases compare therapeutic strategies reduce body related complications. Methods We performed an extensive literature research describe effects lifestyle modification, first‐generation anti‐obesity GLP‐1RA on loss in humans with obesity, MASLD. Results Until recently, treatment been limited which offer moderate degree sustainability few approved drugs are either short term use or forms obesity. Some significantly decrease caloric intake weight. Liraglutide semaglutide have therefore treating people They lead a reduction hepatic fat content inflammation biopsy‐confirmed Possible limitations comprise adverse effects, adherence persistence. Conclusion Certain superior modification inducing markedly changed portfolio additional beneficial disease.

Язык: Английский

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Glucagon-Like Peptide-1 Agonists and General Anesthesia: Perioperative Considerations and the Utility of Gastric Ultrasound

Cureus, Год журнала: 2024, Номер unknown

Опубликована: Апрель 11, 2024

Glucagon-like peptide-1 (GLP-1) agonists are very popular and useful medications for the treatment of type 2 diabetes mellitus obesity. Potent gastric emptying delay is common with these medications, serving as a major contributor to postprandial glycemic control weight loss benefits medications. Recently, multiple case reports studies indicating safety risks their use in patients planning undergo general anesthesia have been published, retained contents can lead intraoperative aspiration. New guidelines released guide clinical practice anesthesiologists. Some degree preoperative cessation required. At this time, ideal window optimize efficacy while reducing aspiration has not yet well elaborated on. Aspiration still occur despite appropriate fasting taking GLP-1 agonists. Gastric ultrasound appears be an effective objective way preoperatively assessing patient's stomach make decisions regarding anesthetic management prescribed This limited by lack training implementation current anesthesiology practice.

Язык: Английский

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Glucagon-like peptide-1 receptor agonists and stroke: A systematic review and meta-analysis of cardiovascular outcome trials

International Journal of Stroke, Год журнала: 2024, Номер 19(8), С. 876 - 887

Опубликована: Апрель 27, 2024

Background: In patients surviving stroke, approximately 15% and 60% exhibit concurrent diabetes mellitus overweight/obesity, respectively, necessitating heightened secondary prevention efforts. Despite glucagon-like peptide-1 receptor agonists (GLP-1 RAs) demonstrating improved outcomes for those with or obesity, their underutilization persists among eligible individuals. This systematic review meta-analysis investigated the impact of GLP-1 RAs on stroke risk. The findings aim to optimize implementation this therapeutic strategy in obesity. Methods: Following Preferred Reporting Items Systematic Reviews Meta-Analysis (PRISMA) guidelines, we systematically reviewed MEDLINE Scopus until 15 November 2023. Eligible studies included randomized cardiovascular outcome trials (CVOTs) individuals, without type 2 diabetes, either RA placebo. were total strokes, non-fatal fatal strokes. Analyses conducted using RevMan 5.4.1. Results: Among 1369 screened studies, 11 eligible, encompassing 82,140 participants (34.6% women) a cumulative follow-up 247,596 person-years. group, rate was significantly lower compared placebo (RR: 0.85, 95% CI: 0.77–0.93; NNT: 200), showing no heterogeneity interaction administration frequency (daily vs weekly). addition, group exhibited strokes 0.87, 0.79–0.95; 250), based frequency, route (oral subcutaneous), presence. Conclusion: CVOTs participants, demonstrated 16% relative reduction risk finding may increase by specialists individuals comorbid Data access statement: data that support study are available from corresponding author upon reasonable request.

Язык: Английский

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Role of incretins and glucagon receptor agonists in metabolic dysfunction-associated steatotic liver disease: Opportunities and challenges

World Journal of Hepatology, Год журнала: 2024, Номер 16(5), С. 731 - 750

Опубликована: Май 22, 2024

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic worldwide, paralleling rising pandemic of obesity and type 2 diabetes. Due to growing global health burden complex pathogenesis MASLD, a multifaceted innovative therapeutic approach is needed. Incretin receptor agonists, which were initially developed for diabetes management, have emerged as promising candidates MASLD treatment. This review describes pathophysiological mechanisms action sites three major classes incretin/glucagon agonists: glucagon-like peptide-1 glucose-dependent insulinotropic polypeptide glucagon agonists. Incretins directly or indirectly impact various organs, including liver, brain, pancreas, gastrointestinal tract, adipose tissue. Thus, these agents significantly improve glycemic control weight management mitigate pathogenesis. Importantly, this study provides summary clinical trials analyzing effectiveness safety incretin agonists in an in-depth analysis highlighting their beneficial effects on improving function, hepatic steatosis, intrahepatic inflammation. There are emerging challenges associated with use medications real world, particularly adverse events, drug-drug interactions, barriers access, discussed detail. Additionally, highlights evolving role suggests future research directions.

Язык: Английский

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Lessons From Insulin: Policy Prescriptions for Affordable Diabetes and Obesity Medications

Diabetes Care, Год журнала: 2024, Номер 47(8), С. 1246 - 1256

Опубликована: Март 27, 2024

Escalating insulin prices have prompted public scrutiny of the practices drug manufacturers, pharmacy benefit managers, health insurers, and pharmacies involved in production distribution medications. As a result, series policies been proposed or enacted to improve affordability foster greater equity access. These implications for other diabetes obesity therapeutics. Recent legislation, at both state federal level, has capped out-of-pocket payments some patients. Other legislation targeted manufacturers directly requiring rebates on drugs with price increases beyond inflation rates, an approach that may restrain hikes existing In addition, government negotiation pricing, contentious issue, gained traction, Inflation Reduction Act 2022 permitting limited certain high expenditure without generic biosimilar competition, including products However, concerns persist this inadvertently encourage higher launch new Addressing barriers competition also priority such as through increased enforcement against anticompetitive (e.g., “product hopping”) reduced regulatory requirements development market entry. A novel involves production, exemplified by California’s CalRx program, which aims provide insulins significantly prices. Achieving affordable equitable access medications requires multifaceted approach, involving intervention, ongoing policy evaluation refinement, critical examination corporate influences care.

Язык: Английский

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