Semaglutide
is
a
class
of
long-acting
glucagon-like
peptide-1
receptor
agonists
(GLP1-RA)
used
for
the
treatment
type
2
diabetes
mellitus
(T2DM)
and
obesity.
We
present
31-year-old
female
patient
with
past
medical
history
T2DM
without
complication
no
long-term
or
current
use
insulin,
3
obesity,
hypertension,
hyperlipidemia,
polycystic
ovary
syndrome
(PCOS),
anxiety,
who
underwent
an
esophagogastroduodenoscopy
(EGD)
in
preparation
bariatric
surgery
while
taking
semaglutide.
Despite
appropriately
following
preoperative
fasting
guidelines
American
Society
Anesthesiologists
(ASA),
endoscopy
revealed
food
residue
gastric
body,
necessitating
abortion
procedure
to
reduce
risk
intraoperative
pulmonary
aspiration.
Given
lack
patients
on
semaglutide
date,
delayed
emptying
being
known
side
effect
among
semaglutide,
anesthesiologists
should
be
aware
alternative
methods
ensure
stomach
mitigate
aspiration
during
general
anesthesia.
New England Journal of Medicine,
Год журнала:
2021,
Номер
384(11), С. 989 - 1002
Опубликована: Фев. 10, 2021
Obesity
is
a
global
health
challenge
with
few
pharmacologic
options.
Whether
adults
obesity
can
achieve
weight
loss
once-weekly
semaglutide
at
dose
of
2.4
mg
as
an
adjunct
to
lifestyle
intervention
has
not
been
confirmed.
JAMA,
Год журнала:
2021,
Номер
325(14), С. 1414 - 1414
Опубликована: Март 23, 2021
The
effect
of
continuing
vs
withdrawing
treatment
with
semaglutide,
a
glucagon-like
peptide
1
receptor
agonist,
on
weight
loss
maintenance
in
people
overweight
or
obesity
is
unknown.To
compare
continued
once-weekly
subcutaneous
2.4
mg,
switch
to
placebo
for
(both
lifestyle
intervention)
adults
after
20-week
run-in
semaglutide
titrated
mg
weekly.Randomized,
double-blind,
68-week
phase
3a
withdrawal
study
conducted
at
73
sites
10
countries
from
June
2018
March
2020
body
mass
index
least
30
(or
≥27
≥1
weight-related
comorbidity)
and
without
diabetes.A
total
902
participants
received
during
run-in.
After
20
weeks
(16
dose
escalation;
4
dose),
803
(89.0%)
who
reached
the
2.4-mg/wk
were
randomized
(2:1)
48
(n
=
535)
switched
268),
plus
intervention
both
groups.The
primary
end
point
was
percent
change
week
68;
confirmatory
secondary
points
changes
waist
circumference,
systolic
blood
pressure,
physical
functioning
(assessed
using
Short
Form
36
Version
2
Health
Survey,
Acute
[SF-36]).Among
completed
period
(with
mean
10.6%)
(mean
age,
46
[SD,
12]
years;
634
[79%]
women;
weight,
107.2
kg
22.7
kg]),
787
(98.0%)
trial
741
(92.3%)
treatment.
With
68
-7.9%
+6.9%
(difference,
-14.8
[95%
CI,
-16.0
-13.5]
percentage
points;
P
<
.001).
Waist
circumference
(-9.7
cm
-10.9
-8.5
cm]),
pressure
(-3.9
mm
Hg
-5.8
-2.0
Hg]),
SF-36
score
(2.5
1.6-3.3])
also
improved
(all
Gastrointestinal
events
reported
49.1%
26.1%
placebo;
similar
proportions
discontinued
because
adverse
(2.4%)
(2.2%).Among
once
weekly,
maintaining
compared
switching
resulted
over
following
weeks.ClinicalTrials.gov
Identifier:
NCT03548987.
JAMA,
Год журнала:
2021,
Номер
325(14), С. 1403 - 1403
Опубликована: Фев. 24, 2021
Importance
Weight
loss
improves
cardiometabolic
risk
factors
in
people
with
overweight
or
obesity.
Intensive
lifestyle
intervention
and
pharmacotherapy
are
the
most
effective
noninvasive
weight
approaches.
Objective
To
compare
effects
of
once-weekly
subcutaneous
semaglutide,
2.4
mg
vs
placebo
for
management
as
an
adjunct
to
intensive
behavioral
therapy
initial
low-calorie
diet
adults
Design,
Setting,
Participants
Randomized,
double-blind,
parallel-group,
68-week,
phase
3a
study
(STEP
3)
conducted
at
41
sites
US
from
August
2018
April
2020
without
diabetes
(N
=
611)
either
(body
mass
index
≥27)
plus
least
1
comorbidity
obesity
≥30).
Interventions
Participants
were
randomized
(2:1)
(n
407)
204),
both
combined
a
first
8
weeks
(ie,
30
counseling
visits)
during
68
weeks.
Main
Outcomes
Measures
The
co–primary
end
points
percentage
change
body
5%
more
baseline
by
week
68.
Confirmatory
secondary
included
losses
10%
15%
weight.
Results
Of
611
participants
(495
women
[81.0%],
mean
age
46
years
[SD,
13],
105.8
kg
22.9],
38.0
6.7]),
567
(92.8%)
completed
trial,
505
(82.7%)
receiving
treatment
trial
end.
At
68,
estimated
was
–16.0%
semaglutide
–5.7%
(difference,
−10.3
[95%
CI,
−12.0
−8.6];P
<
.001).
More
treated
lost
(86.6%
47.6%,
respectively;P
A
higher
proportion
group
achieved
(75.3%
27.0%
55.8%
13.2%,
Gastrointestinal
adverse
events
frequent
(82.8%)
(63.2%).
Treatment
discontinued
owing
these
3.4%
0%
participants.
Conclusions
Relevance
Among
obesity,
compared
placebo,
used
diet,
resulted
significantly
greater
Further
research
is
needed
assess
durability
findings.
New England Journal of Medicine,
Год журнала:
2022,
Номер
387(24), С. 2245 - 2257
Опубликована: Ноя. 2, 2022
A
once-weekly,
2.4-mg
dose
of
subcutaneous
semaglutide,
a
glucagon-like
peptide-1
receptor
agonist,
is
used
to
treat
obesity
in
adults,
but
assessment
the
drug
adolescents
has
been
lacking.
Molecular Metabolism,
Год журнала:
2021,
Номер
57, С. 101351 - 101351
Опубликована: Окт. 8, 2021
Glucagon-like
peptide-1
receptor
agonists
(GLP1RA)
augment
glucose-dependent
insulin
release
and
reduce
glucagon
secretion
gastric
emptying,
enabling
their
successful
development
for
the
treatment
of
type
2
diabetes
(T2D).
These
agents
also
inhibit
food
intake
body
weight,
fostering
investigation
GLP1RA
obesity.
Here
I
discuss
physiology
(GLP-1)
action
in
control
animals
humans,
highlighting
importance
gut
vs.
brain-derived
GLP-1
feeding
weight.
The
widespread
distribution
function
multiple
(GLP1R)
populations
central
autonomic
nervous
system
are
outlined,
pathways
controlling
energy
expenditure
preclinical
studies
reduction
both
humans
is
highlighted.
relative
contributions
vagal
afferent
GLP1R+
physiological
anorectic
response
to
compared
reviewed.
Key
data
two
obesity
therapy
(liraglutide
3
mg
daily
semaglutide
2.4
once
weekly)
discussed.
Finally,
emerging
potentially
supporting
combination
with
additional
peptide
epitopes
unimolecular
multi-agonists,
as
well
fixed-dose
therapies,
actions
weight
highly
conserved
obese
adolescents
adults.
well-defined
mechanisms
through
a
single
G
protein-coupled
receptor,
together
extensive
safety
database
people
T2D,
provide
reassurance
surrounding
long-term
use
these
co-morbidities.
may
be
effective
conditions
associated
obesity,
such
cardiovascular
disease
non-alcoholic
steatohepatitis
(NASH).
Progressive
improvements
efficacy
suggest
that
GLP-1-based
therapies
soon
rival
bariatric
surgery
viable
options
its
complications.
Frontiers in Endocrinology,
Год журнала:
2021,
Номер
12
Опубликована: Авг. 23, 2021
Glucagon
like
peptide-1
(GLP-1)
is
an
incretin
secretory
molecule.
GLP-1
receptor
agonists
(GLP-1RAs)
are
widely
used
in
the
treatment
of
type
2
diabetes
(T2DM)
due
to
their
attributes
such
as
body
weight
loss,
protection
islet
β
cells,
promotion
cell
proliferation
and
minimal
side
effects.
Studies
have
found
that
GLP-1R
distributed
on
pancreatic
other
tissues
has
multiple
biological
effects,
reducing
neuroinflammation,
promoting
nerve
growth,
improving
heart
function,
suppressing
appetite,
delaying
gastric
emptying,
regulating
blood
lipid
metabolism
fat
deposition.
Moreover,
GLP-1RAs
neuroprotective,
anti-infectious,
cardiovascular
protective,
metabolic
regulatory
exhibiting
good
application
prospects.
Growing
attention
been
paid
relationship
between
tumorigenesis,
development
prognosis
patient
with
T2DM.
Here,
we
reviewed
therapeutic
effects
possible
mechanisms
action
nervous,
cardiovascular,
endocrine
systems
correlation
metabolism,
tumours
diseases.
Advances in Therapy,
Год журнала:
2021,
Номер
38(6), С. 2821 - 2839
Опубликована: Май 11, 2021
Obesity
is
a
chronic
disease
associated
with
many
complications.
Weight
loss
of
5–15%
can
improve
obesity-related
Despite
the
benefits
weight
reduction,
there
are
challenges
in
losing
and
maintaining
long-term
loss.
Pharmacotherapy
help
people
obesity
achieve
maintain
their
target
loss,
thereby
reducing
risk
The
prevalence
USA
has
been
increasing
over
past
few
decades,
despite
availability
approved
anti-obesity
medications
(AOMs),
may
not
be
accessing
or
receiving
treatment
at
levels
consistent
prevalence.
Reasons
for
low
initiation
use
AOMs
include
reluctance
public
health
medical
organizations
to
recognize
as
disease,
lack
reimbursement,
provider
inexperience,
misperceptions
about
efficacy
safety
available
treatments.
This
article
aims
inform
primary
care
providers
mechanism
action
one
class
AOMs,
glucagon-like
peptide
1
receptor
agonists
(GLP-1RAs),
longer-term
maintenance
this
class.
GLP-1RA
therapy
was
initially
developed
treat
type
2
diabetes.
Owing
effectiveness
body
weight,
once-daily
subcutaneous
administration
liraglutide
3.0
mg
approved,
once-weekly
semaglutide
2.4
being
investigated
phase
III
trials,
management.
Considerations
regarding
adverse
effects
contraindications
different
drug
classes
provided
guide
decision-making
when
considering
pharmacotherapy
management
patients
obesity.
growing
issue
that
increases
developing
heart
diabetes,
osteoarthritis.
reduce
these
problems
but,
this,
remain
high.
Achieving
challenging
individuals.
There
therefore
need
some
take
them
lose
prevent
regain.
Glucagon-like
(GLP-1RAs)
medication
originally
but
now
used
because
they
effective
helping
weight.
One
GLP-1RA,
liraglutide,
obesity,
another,
semaglutide,
clinical
trials.
GLP-1RAs
work
by
appetite
feelings
hunger,
slowing
release
food
from
stomach,
fullness
after
eating.
Most
tolerate
well.
most
common
side
(nausea,
vomiting,
diarrhea)
usually
mild
occur
first
weeks
treatment,
time.
Because
difficulties
face
lifelong
needed.
In
were
well
tolerated
regain,
good
option
control
lowering
patients'
chances
serious
problems.