Pharmaceuticals,
Год журнала:
2025,
Номер
18(3), С. 399 - 399
Опубликована: Март 12, 2025
This
review
addresses
the
role
of
semaglutide
(SMG),
a
GLP-1
receptor
agonist,
in
treatment
obesity
and
its
related
comorbidities.
Originally
developed
for
type
2
diabetes
(DM2),
SMG
has
shown
significant
efficacy
weight
reduction,
with
superior
results
compared
to
other
treatments
same
class.
Its
effects
include
appetite
suppression,
increased
satiety,
improvements
cardiovascular,
renal,
metabolic
parameters.
Studies
such
as
SUSTAIN,
PIONEER,
STEP
highlight
superiority
agonists
anti-obesity
drugs.
The
oral
formulation
showed
promising
initial
results,
higher
doses
(50
mg)
showing
losses
comparable
those
subcutaneous
administration.
Despite
benefits,
there
are
challenges,
regain
after
cessation
treatment,
gastrointestinal
adverse
effects,
variability
response.
Future
studies
should
explore
strategies
mitigate
these
identify
predictive
factors
efficacy,
expand
therapeutic
indications
conditions
insulin
resistance.
constant
innovation
this
class
drugs
reinforces
potential
transform
protocols
chronic
weight-related
diseases.
New England Journal of Medicine,
Год журнала:
2023,
Номер
389(12), С. 1069 - 1084
Опубликована: Авг. 25, 2023
BackgroundHeart
failure
with
preserved
ejection
fraction
is
increasing
in
prevalence
and
associated
a
high
symptom
burden
functional
impairment,
especially
persons
obesity.
No
therapies
have
been
approved
to
target
obesity-related
heart
fraction.MethodsWe
randomly
assigned
529
patients
who
had
body-mass
index
(the
weight
kilograms
divided
by
the
square
of
height
meters)
30
or
higher
receive
once-weekly
semaglutide
(2.4
mg)
placebo
for
52
weeks.
The
dual
primary
end
points
were
change
from
baseline
Kansas
City
Cardiomyopathy
Questionnaire
clinical
summary
score
(KCCQ-CSS;
scores
range
0
100,
indicating
fewer
symptoms
physical
limitations)
body
weight.
Confirmatory
secondary
included
6-minute
walk
distance;
hierarchical
composite
point
that
death,
events,
differences
KCCQ-CSS
C-reactive
protein
(CRP)
level.Download
PDF
Research
Summary.ResultsThe
mean
was
16.6
8.7
(estimated
difference,
7.8
points;
95%
confidence
interval
[CI],
4.8
10.9;
P<0.001),
percentage
−13.3%
−2.6%
−10.7
CI,
−11.9
−9.4;
P<0.001).
distance
21.5
m
1.2
20.3
m;
8.6
32.1;
In
analysis
point,
produced
more
wins
than
(win
ratio,
1.72;
1.37
2.15;
CRP
level
–43.5%
–7.3%
treatment
0.61;
0.51
0.72;
Serious
adverse
events
reported
35
participants
(13.3%)
group
71
(26.7%)
group.ConclusionsIn
obesity,
led
larger
reductions
limitations,
greater
improvements
exercise
function,
loss
placebo.
(Funded
Novo
Nordisk;
STEP-HFpEF
ClinicalTrials.gov
number,
NCT04788511.)
Quick
Take
Semaglutide
Heart
Failure
Obesity
2m
5s
Circulation,
Год журнала:
2023,
Номер
148(20), С. 1636 - 1664
Опубликована: Окт. 9, 2023
A
growing
appreciation
of
the
pathophysiological
interrelatedness
metabolic
risk
factors
such
as
obesity
and
diabetes,
chronic
kidney
disease,
cardiovascular
disease
has
led
to
conceptualization
cardiovascular-kidney-metabolic
syndrome.
The
confluence
within
syndrome
is
strongly
linked
for
adverse
outcomes.
In
addition,
there
are
unique
management
considerations
individuals
with
established
coexisting
factors,
or
both.
An
extensive
body
literature
supports
our
scientific
understanding
of,
approach
to,
prevention
However,
critical
gaps
in
knowledge
related
terms
mechanisms
development,
heterogeneity
clinical
phenotypes,
interplay
between
social
determinants
health
biological
accurate
assessments
incidence
context
competing
risks.
There
also
key
limitations
data
supporting
care
syndrome,
particularly
early-life
prevention,
screening
interdisciplinary
models,
optimal
strategies
lifestyle
modification
weight
loss,
targeting
emerging
cardioprotective
kidney-protective
therapies,
patients
both
impact
systematically
assessing
addressing
health.
This
statement
uses
a
crosswalk
major
guidelines,
addition
review
literature,
summarize
evidence
fundamental
science,
screening,
New England Journal of Medicine,
Год журнала:
2024,
Номер
390(15), С. 1394 - 1407
Опубликована: Март 28, 2024
Obesity
and
type
2
diabetes
are
prevalent
in
patients
with
heart
failure
preserved
ejection
fraction
characterized
by
a
high
symptom
burden.
No
approved
therapies
specifically
target
obesity-related
persons
diabetes.
Nature Medicine,
Год журнала:
2023,
Номер
29(9), С. 2358 - 2365
Опубликована: Авг. 27, 2023
In
the
STEP-HFpEF
trial,
semaglutide
improved
symptoms,
physical
limitations
and
exercise
function
reduced
body
weight
in
patients
with
obesity
phenotype
of
heart
failure
preserved
ejection
fraction
(HFpEF).
This
prespecified
analysis
examined
effects
on
dual
primary
endpoints
(change
Kansas
City
Cardiomyopathy
Questionnaire-Clinical
Summary
Score
(KCCQ-CSS)
weight)
confirmatory
secondary
6-minute
walk
distance
(6MWD),
hierarchical
composite
(death,
HF
events,
change
KCCQ-CSS
6MWD)
C-reactive
protein
(CRP))
across
classes
I-III
(body
mass
index
(BMI)
30.0-34.9
kg
m
Circulation,
Год журнала:
2023,
Номер
149(3), С. 204 - 216
Опубликована: Ноя. 12, 2023
Patients
with
heart
failure
(HF)
preserved
ejection
fraction
(HFpEF)
and
obesity
experience
a
high
burden
of
symptoms
functional
impairment,
poor
quality
life.
In
the
STEP-HFpEF
trial
(Research
Study
to
Investigate
How
Well
Semaglutide
Works
in
People
Living
With
Heart
Failure
Obesity),
once-weekly
semaglutide
2.4
mg
improved
symptoms,
physical
limitations,
exercise
function,
reduced
inflammation
body
weight.
This
prespecified
analysis
investigated
effects
on
primary
confirmatory
secondary
end
points
across
range
Kansas
City
Cardiomyopathy
Questionnaire
(KCCQ)
scores
at
baseline
all
key
summary
individual
KCCQ
domains.
Frontiers in Clinical Diabetes and Healthcare,
Год журнала:
2023,
Номер
4
Опубликована: Дек. 8, 2023
Glucagon
like
peptide-1
(GLP-1)
receptor
agonists
are
well
established
drugs
for
the
treatment
of
type
2
diabetes
(T2D).
In
addition
to
glycemic
control,
GLP-1
have
beneficial
other
effects.
They
act
by
binding
receptors,
which
widely
distributed
in
body,
including
cardiomyocytes
and
blood
vessels.
The
aim
this
article
is
provide
a
comprehensive
review
impact
on
cardiovascular
outcomes
risk
reduction.
last
decade,
several
trials
(CVOT)
been
conducted
order
explore
benefit
agonists.
CVOTs
primarily
proved
safety
tolerability
different
agonists,
but
also
showed
specific
drugs.
shown
that
reduce
MACE
patients
with
T2D
compared
placebo.
addition,
they
positive
factors
such
as
obesity
promoting
weight
loss,
pressure
lipid
levels.
Also,
stimulate
endothelium
produce
nitric
oxide,
oxidative
stress,
antiatherogenic
antiinflammatory
Studies
their
kidney
results
previous
encouraging
terms
multiple
effects
However,
further
research
needed
understand
full
potential
all
details
mechanism
action,
will
enable
expand
therapeutic
indications
determine
optimal
use
clinical
practice.
ESC Heart Failure,
Год журнала:
2024,
Номер
unknown
Опубликована: Май 28, 2024
Abstract
In
the
last
years,
major
progress
has
occurred
in
heart
failure
(HF)
management.
The
2023
ESC
focused
update
of
2021
HF
guidelines
introduced
new
key
recommendations
based
on
results
years
science.
First,
two
drugs,
sodium–glucose
co‐transporter‐2
(SGLT2)
inhibitors
and
finerenone,
a
novel
nonsteroidal,
selective
mineralocorticoid
receptor
antagonist
(MRA),
are
recommended
for
prevention
patients
with
diabetic
chronic
kidney
disease
(CKD).
Second,
SGLT2
now
treatment
across
entire
left
ventricular
ejection
fraction
spectrum.
benefits
quadruple
therapy
reduced
(HFrEF)
well
established.
Its
rapid
early
up‐titration
along
close
follow‐up
frequent
clinical
laboratory
re‐assessment
after
an
episode
acute
(the
so‐called
‘high‐intensity
care’
strategy)
was
associated
better
outcomes
STRONG‐HF
trial.
Patients
experiencing
worsening
might
require
fifth
drug,
vericiguat.
STEP‐HFpEF‐DM
STEP‐HFpEF
trials,
semaglutide
2.4
mg
once
weekly
administered
1
year
decreased
body
weight
significantly
improved
quality
life
6
min
walk
distance
obese
preserved
(HFpEF)
or
without
history
diabetes.
Further
data
safety
efficacy,
including
also
hard
endpoints,
needed
to
support
addition
acetazolamide
hydrochlorothiazide
standard
diuretic
regimen
hospitalized
due
HF.
meantime,
PUSH‐AHF
supported
use
natriuresis‐guided
therapy.
options
most
recent
evidence
HF,
specific
drugs
cardiomyopathies
(i.e.,
mavacamten
hypertrophic
cardiomyopathy
tafamidis
transthyretin
cardiac
amyloidosis),
device
therapies,
contractility
modulation
percutaneous
valvulopathies,
finding
from
TRILUMINATE
Pivotal
trial,
reviewed
this
article.
European Heart Journal,
Год журнала:
2024,
Номер
45(35), С. 3254 - 3269
Опубликована: Май 11, 2024
In
the
STEP-HFpEF
trial
programme,
treatment
with
semaglutide
resulted
in
multiple
beneficial
effects
patients
obesity-related
heart
failure
preserved
ejection
fraction
(HFpEF).
Efficacy
may
vary
according
to
baseline
diuretic
use,
and
could
modify
dose.
