Effect of Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RA) on Alcohol Consumption, Metabolism and Liver Parameters in Patients With Obesity and Fatty Liver Disease

There is evidence that alcoholic beverage consumption significantly interacts with food energy intake. Furthermore, there is accumulating evidence showing independent, combined, and modifying effects of alcohol and metabolic factors on the onset and progression of chronic liver disease. Preclinical and clinical data have showed that GLP-1 RA can decrease alcohol consumption, particularly in obese patients. Moreover there is evidence that liraglutide can improve the liver sinusoidal milieu in pre-clinical models of cirrhosis.
In this study, the investigators aim to assess if patients treated with liraglutide and receiving counselling will achieve a significantly higher alcohol abstinence compared to patients only receiving counselling.

开始日期2025-01-01

申办/合作机构

Insel Gruppe AG

ChiCTR2400088178 / Suspended临床4期IIT

Observation and mechanism of liraglutide in the treatment of obese/overweight patients with type 2 diabetes mellitus complicated with depression

开始日期2024-09-01

申办/合作机构-

NCT06533527 / RecruitingN/AIIT

Randomized Trial of Holding vs. Continuing Incretin-based Therapies Before Upper Endoscopy

To assess whether holding incretin-based therapy before endoscopy reduces the likelihood of clinically relevant Residual Gastric Volume (RGV).
Primary Outcomes:
* Residual gastric volume that precludes adequate endoscopic examination
* Residual gastric volume that necessitates premature termination of the endoscopy procedure
* Need for endotracheal intubation due to stomach contents.
* Occurrence of aspiration events requiring extended observation/monitoring, unplanned therapeutics, and/or hospital admission
Secondary Outcomes:
* Presence of any solid food
* Presence of moderate liquid content
* Increased RGV(Residual Gastric Volume) defined as any amount of solid content or > 0.8 mL/Kg of fluid content (measured from the aspiration/suction canister).
* Differences in primary and secondary outcomes between different medications

开始日期2024-07-31

申办/合作机构

The Cleveland Clinic Foundation

100 项与利拉鲁肽相关的临床结果

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100 项与利拉鲁肽相关的转化医学

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100 项与利拉鲁肽相关的专利（医药）

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3,901

项与利拉鲁肽相关的文献（医药）

2025-01-01·JOURNAL OF AFFECTIVE DISORDERS

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and suicidality: A replication study using reports to the World Health Organization pharmacovigilance database (VigiBase®)

Article

作者: Le, Gia Han ; Mansur, Rodrigo B. ; Rhee, Taeho Greg ; Rosenblat, Joshua D. ; McIntyre, Roger S ; Ho, Roger ; McIntyre, Roger S. ; Rosenblat, Joshua D ; Kwan, Angela T.H. ; Teopiz, Kayla M ; Wong, Sabrina ; Cao, Bing ; Kwan, Angela T H ; Teopiz, Kayla ; Mansur, Rodrigo B

INTRODUCTION:

Reports of suicidality associated with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have been reported to the European Medicines Agency (EMA) and the United States Food and Drug Administration (FDA). We previously reported an increased reporting odds ratio (ROR) of some measures of suicidality with semaglutide and liraglutide using the FDA Adverse Event Reporting System (FAERS). Notwithstanding the increased ROR, causality between GLP-1 RAs exposure and any aspect of suicidality is not established.

RESEARCH DESIGN AND METHODS:

The analysis herein aims to extend a previous analysis of the FAERS by evaluating the ROR for suicidality reported to the World Health Organization (WHO) Pharmacovigilance Database (VigiBase). We aimed to characterize the ROR of suicidality associated with GLP-1 RAs, as extrapolated from spontaneous reports. As per our previous report, the ROR was considered significant when the lower limit of the 95 % confidence (CI) was >1.0.

RESULTS:

We searched VigiBase reports from inception to January 2024. The RORs for suicidal ideation were significantly increased for semaglutide (5.82), liraglutide (4.03) and tirzepatide (2.25). For "depression/suicidal", the ROR was significantly increased for semaglutide (14.74) and liraglutide (5.86); and for suicidal behaviour, the ROR was significantly increased for semaglutide (6.52) and liraglutide (3.90). However, for suicide attempts, the ROR was significantly decreased for semaglutide (0.11), dulaglutide (0.075), exenatide (0.047) and liraglutide (0.15). For completed suicide, the ROR was also significantly decreased for semaglutide (0.01), dulaglutide (0.003), exenatide (0.002) and liraglutide (0.008).

CONCLUSION:

Unlike our previous report with FAERS, a mixed pattern of ROR emerged in the WHO VigiBase with respect to suicidality and exposure to select GLP-RAs. Causation between GLP-1 RA exposure and suicidality (either increased or decreased) cannot be ascertained from ROR data.

2024-12-31·JOURNAL OF MEDICAL ECONOMICS

The real-world observational prospective study of health outcomes with dulaglutide and liraglutide in type 2 diabetes patients (TROPHIES): resource use and costs of treatment in clinical practice in France, Germany, and Italy

Article

作者: García-Pérez, Luis-Emilio ; Lebrec, Jérémie ; Boye, Kristina S. ; Guerci, Bruno ; Sapin, Hélène ; Yu, Maria ; Giorgino, Francesco ; Füchtenbusch, Martin ; Federici, Marco Orsini ; Heitmann, Elke ; Barrett, Annabel ; Dib, Anne

AIMS:

To describe healthcare resource utilization (HCRU) and associated costs after initiation of injectable glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy by adult patients with type 2 diabetes (T2D) in the prospective, observational, 24-month TROPHIES study in France, Germany, and Italy.

MATERIALS AND METHODS:

HCRU data for cost calculations were collected by treating physicians during patient interviews at baseline and follow-up visits approximately 6, 12, 18, and 24 months after GLP-1 RA initiation with once-weekly dulaglutide or once-daily liraglutide. Costs were evaluated from the national healthcare system (third-party payer) perspective and updated to 2018 prices.

RESULTS:

In total, 2,005 patients were eligible for the HCRU analysis (1,014 dulaglutide; 991 liraglutide). Baseline patient characteristics were generally similar between treatment groups and countries. The largest proportions of patients using ≥2 oral glucose-lowering medications (GLMs) at baseline (42.9-43.4%) and month 24 (44.0-45.1%) and using another injectable GLM at month 24 (15.3-23.2%) were in France. Mean numbers of primary and secondary healthcare contacts during each assessment period were highest in France (range = 4.0-10.7) and Germany (range = 2.9-5.7), respectively. The greatest proportions (≥60%) of mean annualized costs per patient comprised medication costs. Mean annualized HCRU costs per patient varied by treatment cohort and country: the highest levels were in the liraglutide cohort in France (€909) and the dulaglutide cohort in Germany (€883).

LIMITATIONS:

Limitations included exclusion of patients using insulin at GLP-1 RA initiation and collection of HCRU data by physician, not via patient-completed diaries.

CONCLUSIONS:

Real-world HCRU and costs associated with the treatment of adults with T2D with two GLP-1 RAs in TROPHIES emphasize the need to avoid generalization with respect to HCRU and costs associated with a particular therapy when estimating the impact of a new treatment in a country-specific setting.

2024-12-31·RENAL FAILURE

Liraglutide alleviates high-fat diet-induced kidney injury in mice by regulating the CaMKKβ/AMPK pathway

Article

作者: Qin, Li ; Xuan, Yingli ; He, Ruibin ; Pang, Shiqing ; Mao, Xiao-Lei ; Yuan, Jiang Zi ; Ding, Ting-Ting

OBJECTIVE:

Liraglutide, a glucagon-like peptide-1 receptor agonist, has been shown to regulate blood sugar and control body weight, but its ability to treat obesity-related nephropathy has been poorly studied. Therefore, this study was designed to observe the characteristics and potential mechanism of liraglutide against obesity-related kidney disease.

METHODS:

Thirty-six C57BL/6J male mice were randomly divided into six groups (n = 6 per group). Obesity-related nephropathy was induced in mice by continuous feeding of high-fat diet (HFD) for 12 weeks. After 12 weeks, liraglutide (0.6 mg/kg) and AMP-activated protein kinase (AMPK) agonists bortezomib (200 μg/kg) were injected for 12 weeks, respectively. Enzyme-linked immunosorbent assay was employed to detect the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, blood urea nitrogen, creatinine in serum, as well as urinary protein in urine. Besides, hematoxylin-eosin staining and periodic acid-Schiff staining were used to observe the pathological changes of kidney tissue; immunohistochemistry, western blot, and real-time quantitative PCR to assess the calmodulin-dependent protein kinase kinase beta (CaMKKβ)/AMPK signaling pathway activation.

RESULTS:

Liraglutide significantly reduced serum lipid loading, improved kidney function, and relieved kidney histopathological damage and glycogen deposition in the mouse model of obesity-related kidney disease induced by HFD. In addition, liraglutide also significantly inhibited the CaMKKβ/AMPK signaling pathway in kidney tissue of HFD-induced mice. However, bortezomib partially reversed the therapeutic effect of liraglutide on HDF-induced nephropathy in mice.

CONCLUSIONS:

Liraglutide has a therapeutic effect on obesity-related kidney disease, and such an effect may be achieved by inhibiting the CaMKKβ/AMPK signaling pathway in kidney tissue.

1,053

项与利拉鲁肽相关的新闻（医药）

2024-11-13

·drugs

Ozempic Could Help Curb Alcoholism

WEDNESDAY, Nov. 13, 2024 -- The blockbuster GLP-1 drug semaglutide ( Ozempic , Wegovy ) could curb drinking for people battling alcohol use disorder , helping them to avoid crises that require hospitalization, new research shows. Numerous studies had already hinted that semaglutide might act on appetite centers in the brain to suppress the urge to drink, just as it does the urge to overeat. Now, researchers in Finland say their nearly nine-year study of almost 228,000 Swedish people with alcohol use disorder who were taking semaglutide had a 36% lower odds of requiring hospitalization. Use of a second drug in the same class of GLP-1 medications, liraglutide ( Victoza ), was linked to a 28% reduction in hospitalizations, the team reported Nov. 13 in the journal JAMA Psychiatry . The study couldn't prove cause and effect, only associations. However, based on these and prior findings, the researchers say that "clinical trials are urgently needed to confirm these findings." The research was led by Dr. Markku Lähteenvuo , of the University of Eastern Finland. Besides the finding that both semaglutide and liraglutide appeared to help keep people with alcohol use disorder out of the hospital, the study also found that semaglutide, in particular, was linked to a decreased risk for suicide. The researchers also noted that the two GLP-1 drugs appeared to outperform standard anti- alcoholism medications, such as naltrexone, disulfiram and acamprostate, in lowering hospitalizations among people with alcohol use disorder, although better studies are needed to confirm that. The Finnish group noted that better treatments for alcohol use disorder are desperately needed, "because existing treatments may not be suitable for all patients." Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

临床结果

2024-11-12

·药渡

大卖203亿美元的「司美格鲁肽」与捷报频传的「诺和诺德」

来源：药渡撰文：梧念编辑：维他命 2024年11月6日，诺和诺德发布三季度财报，前三季度营收2047亿丹麦克朗，合294.6亿美元，同比增长23%。净利润727.58亿丹麦克朗，合104.7亿美元，同比增长18%。其中，司美格鲁肽注射降糖版Ozempic销售额864.89亿丹麦克朗，合124.37亿美元，同比增长32%；司美格鲁肽口服降糖版Rybelsus销售额163.84亿丹麦克朗，合23.56亿美元，同比增长29%；司美格鲁肽减重版Wegovy销售额383.40亿美元，合55.13亿美元，同比增长77%。司美格鲁肽合计销售额203.06亿美元，占到诺和诺德营收的69%。一个世纪前诺和诺德从最初生产胰岛素开启了它的商业帝国，历经百年，诺和诺德已建立起全球生产布局，五大战略生产基地位于丹麦、美国、法国、巴西和中国。所有药物均在这些基地内生产并供给全球患者。这包括约占全球一半的胰岛素产品、用于治疗糖尿病和肥胖症的GLP-1类药物以及用于治疗血友病和生长障碍等罕见病的药物。司美格鲁肽是诺和诺德继利拉鲁肽后上市的第二款GLP-1R激动剂，也是继利拉鲁肽后全球第二款获得肥胖和2型糖尿病（T2DM）双适应症的GLP-1R激动剂。司美格鲁肽有注射液和口服制剂两种剂型，分为Ozempic（注射，周制剂，针对2型糖尿病）、Rybelsus（口服，日制剂，针对2型糖尿病）以及Wegovy（注射，周制剂，针对肥胖）。近期，诺和诺德捷报频传。 PART. 01 司美格鲁肽再登NEJM 减肥药物还显著改善关节炎 2024年10月30日，哥本哈根大学和诺和诺德公司的研究人员在国际顶尖医学期刊《新英格兰医学杂志》（NEJM）发表了题为：Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis的研究论文。图1. 《新英格兰医学杂志》发表论文，来源：NEJM 临床研究表明，司美格鲁肽在显著减轻体重方面成效卓著，对于肥胖相关的膝关节炎所引发的疼痛亦能显著缓解（其止痛效果与阿片类药物旗鼓相当），同时还能提升患者参与运动的能力。这当属首次证实GLP-1受体激动剂类的新型减肥药物能够用于治疗关节炎。在该研究中，研究团队于五大洲的11个国家和地区招募了407名膝骨关节炎患者参与其中，并将这些患者随机划分为两组，两组分别每周接受司美格鲁肽或安慰剂的治疗。与此同时，他们还接受了有关健康饮食和运动方面的咨询服务。试验初始阶段，所有的参与者均处于肥胖状态，历经为期68周的治疗之后，和安慰剂组的参与者相较而言，司美格鲁肽组的参与者体重减轻幅度更大（司美格鲁肽治疗组体重减轻了13.7%，而安慰剂组仅减轻了3.2%），并且报告了更为显著的疼痛程度降低——疼痛量表的评分平均下降了41.7分，然而安慰剂组仅下降27.5分。另外，司美格鲁肽组的参与者在日常生活能力方面（例如爬楼梯）也实现了更大程度的改善。图2. 司美格鲁肽组显著改善关节炎所引发的疼痛，来源：NEJM 总的来讲，此次临床试验的结果显示，在伴有中度至重度疼痛的肥胖合并膝骨关节炎患者当中，每周一次的司美格鲁肽治疗，极大幅度地减轻了体重，明显减轻了膝骨关节炎相关的疼痛。研究团队指出，司美格鲁肽治疗所带来的这种良好改善，或许部分源自体重减轻致使膝盖负荷的降低。但与此同时，司美格鲁肽还具备抗炎的作用，这或许能够解释患者的疼痛得以显著缓解的原因。 PART. 02 减肥药所有剂量在美上市有望剔除出FDA短缺清单根据FDA10月30日发布的药品短缺数据库更新，诺和诺德减肥注射剂Wegovy和糖尿病药物Ozempic现已在美国上市。这一更新提高了FDA将其从短缺名单中彻底删除的可能性。“此次更新是我们在产能方面进行大量投资以及与FDA持续沟通的结果。我们逐步增加美国市场供应的策略正在奏效。”一位发言人表示“我们将继续优先考虑对患者的持续护理，密切监测市场动态和处方趋势”。此外发言人补充说明道，短缺的结束证明了诺和诺德“有意逐步增加美国市场供应的做法正在奏效”。这表明，随着美国对药物的需求持续飙升，诺和诺德增加每周药物供应的努力开始取得成效[3-4]。图3. FDA药品短缺数据库，来源：FDA 美国数据显示，大约八分之一的美国成年人尝试过减肥药，超过1500万人正在使用处方药。诺和诺德公司5月份于福克斯商业新闻中报道显示，每周至少有25,000名美国人开始服用这种药物。诺和诺德现在正在定期向美国各州的批发商运送所有剂量的Ozempic和Wegovy。 PART. 03 EMA建议更新Wegovy®标签以反映心衰症状的减轻及改善 2024年9月19日诺和诺德公司宣布，欧洲药品管理局（EMA）人用医药产品委员会（CHMP）已通过Wegovy®（司美格鲁肽2.4 mg）在欧盟的标签更新积极意见。此次更新将纳入数据，显示Wegovy®结合标准治疗，可在伴/不伴2型糖尿病的肥胖相关射血分数保留型心力衰竭（HFpEF）患者中减轻心衰相关症状并改善体能限制和运动功能。积极意见基于STEP HFpEF和STEP HFpEF-DM试验结果，这些试验表明Wegovy®相较于安慰剂，在肥胖相关HFpEF患者中是一种有效的治疗方法。在这两项试验中，Wegovy®相较于安慰剂均展示出了更大程度的心衰相关症状减轻和体能限制的改善，同时实现了更大的体重降幅。无论受试者基线年龄、性别、种族、民族、体质指数（BMI）、所处区域、收缩压、左心室射血分数及合并心衰治疗方案如何，上述获益均保持一致。此外，从基线到第52周，接受Wegovy®治疗的受试者相较于接受安慰剂治疗的受试者在运动功能方面实现了更大程度的提高。诺和诺德全球开发执行副总裁Martin Holst Lange表示：“建议更新Wegovy®EMA产品标签对于肥胖相关HFpEF患者来说是一项重要进展，这些患者目前的治疗选择非常有限。Wegovy®可改善患者与健康相关的生活质量，可以让他们以更好的身体功能开展各种日常活动。” PART. 04 中国市场潜力巨大财务增长未来可期利好消息不断传出，诺和诺德此前在中国的布局显示出了巨大的市场潜力，中国已经成为超重/肥胖增长最快的国家之一。肥胖已成为全球十大慢病之一，引发一系列健康问题，加重医疗负担。2030年中国归因于超重/肥胖的医疗费用将达4180亿元，防治肥胖刻不容缓。药物治疗是肥胖治疗市场中的有效方式，但减肥药多因副作用退市，直到GLP-1药物出现。整体来说，减肥药物消费属性强，受医保影响小，因此在国内也有广阔市场空间。表4. 司美格鲁肽全球销售额变化，来源：药渡数据结合已有销售数据，诺和诺德高管表示：“我们对2024年的销售增长感到高兴，这使我们能够提高对公司全年的展望。增长由用于糖尿病和肥胖症治疗的GLP-1类药物的需求增长所驱动，我们将继续向更多的患者提供创新治疗药物。随着学界及消费者对其认知的不断加深，预计2024年底诺和诺德的财务报告将表现出巨大的增长潜力”。参考文献： [1] https://www-nature-com.libproxy1.nus.edu.sg/articles/d41586-024-03512-0 [2]https://www.cnbc.com/2024/10/30/novo-nordisks-ozempic-wegovy-now-available-after-shortages.html [3] https://www.novonordisk.com.cn/news---media.html [4]https://www.cnbc.com/2024/10/30/novo-nordisks-ozempic-wegovy-now-available-after-shortages.html *声明：本文仅是介绍医药疾病领域研究进展或简述研究概况或分享医药相关讯息，并非也不会进行治疗或诊断方案推荐，也不对相关投资构成任何建议。内容如有疏漏，欢迎沟通指出！传奇抗癌药物「曲妥珠单抗」：或将纳入2025版《中国药典》众药企三季度财报亮点纷呈，恒瑞医药位列净利润榜首！ “狂飙”的核药：重磅BD不断、产能扩张、研发热情空前高涨

财报

2024-11-12

·国际糖尿病idiabetes

ObesityWeek 2024 | 同声传递：莫以长短论英雄？有效抗肥胖药物时代减重手术担何角色之辩

ObesityWeek微专辑扫描二维码可查看更多内容编者按近年来，随着肥胖问题的日益严重，治疗肥胖症的方法也在不断创新和发展，尤其是抗肥胖药物取得了显著进展，多种新型药物（如GLP-1受体激动剂司美格鲁肽、GIP/GLP-1受体激动剂替尔泊肽等）获批上市，展现出良好的减重效果。而代谢减重手术作为一种传统的治疗方法，其地位是否会受到冲击？在2024年美国肥胖周（Obesity Week 2024）上，路易斯安那州立大学彭宁顿生物医学研究中心的Philip R. Schauer博士、威尔·康奈尔医学院综合体重控制中心的Beverly Tchang博士就代谢减重手术在有效抗肥胖药物时代的作用展开了激烈辩论。本文撷取辩论精彩内容，与读者共享，同时，《国际糖尿病》特邀辩方之一Schauer博士，深入探讨了在肥胖症综合管理中如何更好地将减重手术和药物治疗结合。思维碰撞中铸就认知：减重手术与抗肥胖药物优劣之辩 Schauer博士认为，与抗肥胖药物相比，代谢减重手术在减重效果、持久性、安全性、成本效益方面更胜一筹。未来相当长一段时间内，代谢减重手术将在肥胖及相关疾病治疗中继续发挥重要作用。在减重幅度和减重效果的持久性方面，代谢减重手术展现出了无可比拟的优势。代谢减重手术通过改变胃肠道结构，直接限制了食物的摄入和/或吸收，从而实现了显著及持续的减重效果。瑞典肥胖受试者研究（SOS）发现，接受代谢减重手术的患者在术后至少20年内都能维持显著的减重效果[1]。而代谢减重手术带来多种益处，包括改善或缓解高血压、血脂异常、阻塞性睡眠呼吸暂停（OSA）、代谢相关脂肪性肝病（MAFLD）等，并降低长期死亡率，减少癌症发生、缓解代谢相关脂肪性肝炎（MASH）纤维化。在T2DM结局方面，研究显示随着时间推移，与接受生活方式干预或药物治疗的患者相比，接受减重手术患者的HbA1c得到更好控制、糖尿病药物应用更少，糖尿病缓解率更高[2]。相比之下，新型抗肥胖药物虽然能在短期内实现减重，但长期依从性和效果尚缺乏充分的数据支持。例如，一项真实世界研究显示，使用司美格鲁肽或利拉鲁肽的患者中，有60%在一年内停止了用药[3]。安全性方面，代谢减重手术的风险正逐年下降，对大量Roux-en-Y胃旁路术和胃袖状切除术病例的分析发现，手术的全因死亡率、30天再入院率和术后并发症发生率均有所下降[4]。生活质量方面，一项系统回顾研究表明，减重手术在健康相关生活质量（HRQOL）方面可提供持续的益处[5]。成本效益方面，澳大利亚健康经济学家小组进行的一项荟萃分析和系统回顾表明，减重手术在长期来看可以节约成本；当将肥胖对工作生产力的影响考虑在内进行间接成本的敏感性分析时，减重手术的成本节约效果更为显著[6]。相反，由于新型抗肥胖药物需要长期使用且部分患者可能因副作用而中断用药，其长期成本效益尚不确定。一项真实世界分析显示，使用GLP-1药物者1年后仅27%在继续用药[7]。 Tchang博士认为，减重手术优于药物治疗，此论断略显草率。GLP-1 RA是一个奇迹，其或将终结代谢减重手术。无论出于对减重效果还是安全性的担忧，部分肥胖症患者并不想进行减重手术；大脑通过一系列复杂信号影响脂肪细胞、胰腺、肝脏、胃肠道及其他组织，从而在调节身体能量平衡和体重方面起到关键作用；而不同种类的抗肥胖药物可通过干预不同代谢途径或靶点，达到减重的目的。药物治疗缩小生活方式干预与减重手术之间的治疗差距。药物治疗具有灵活性，可随肥胖症患者的治疗目标而变化，并可根据个人情况、不同人群特点进行调整，是在群体层面实施抗肥胖策略的理想选择。药物是迈向真正医疗保健的重要一步。虽然多项研究均显示减重手术在短期和长期减重效果、长期心脏获益、脂肪性肝炎、癌症减少、长期死亡率降低、成本效益等方面的优势，但目前尚无减重手术的心血管结局试验。更值得关注的是，司美格鲁肽、替尔泊肽等作为新型抗肥胖药物的领跑者，正在缩短与减重手术在减重效果方面的差距。此外，有133种抗肥胖药物正在研发中。成本效益方面，预计到2026年抗肥胖药物的覆盖费用将仅占医疗保险预算的0.1%[8]。综上，肥胖管理需要综合考虑多种因素，采用多种模式进行综合治疗，包括生活方式调整、抗肥胖药物治疗、内镜下减重疗法、外科减重手术等，而抗肥胖药物治疗是其中不可或缺的，也是越来越重要的一部分。辩论无谓胜负，而在于观点的启迪与转变参会医生从六个维度对减重手术和抗肥胖药物的优势进行了投票（表1）。辩论前，减重手术在减重效果和持久性、T2DM缓解、肥胖及相关疾病长期治疗效果、成本效益方面优于减重药物；辩论后，抗肥胖药物在六个维度方面获得的支持率均有所增长，且在T2DM缓解、肥胖及相关疾病的长期治疗效果方面对抗肥胖药物的支持率也超过了减重手术。表1. 辩论前后减重手术和抗肥胖药物支持率非此即彼并不可取：探索减重手术与抗肥胖药物的最佳综合策略《国际糖尿病》考虑到当前已有有效的抗肥胖药物可用，你认为减重手术在肥胖症的综合管理中仍然扮演着什么角色？ Dr. Schauer：我们生活在一个非常激动人心的时代。毫无疑问，这些新型抗肥胖药物，特别是GLP-1受体激动剂，在减重效果上令人惊叹，超过了我们以往所见。但我仍然认为减重手术具有非常重要的作用。我们拥有大量关于减重手术的数据。就目前而言，手术所能实现的减重效果仍然大于这些新型药物。这对于那些BMI≥45 kg/㎡的患者尤为重要，因为他们仍然需要进行代谢减重手术。手术最显著的优势之一是其持久性。我们现在有数据显示，在代谢减重手术后的10年、20年甚至30年内，平均体重的下降仍然非常好。因此，我认为减重手术的幅度和持久性是它与药物之间的主要区别。此外，我还要补充一点，目前减重药物平均每年要花费1~1.4万美元，而代谢减重手术从长远来看成本要低得多，实际上长期来看是节约了成本。《国际糖尿病》如何将减重手术和药物治疗最佳地结合起来，以提高肥胖管理的治疗效果？ Dr. Schauer：这两种疗法——结合生活方式的药物治疗和手术治疗——的美妙之处在于，我们没有理由不将它们结合起来。在彭宁顿生物医学中心的实践中，我们在手术前就会使用药物。对于BMI非常高的患者，我们用药物来降低他们的体重，改善合并症，并减少手术并发症。我们也在手术后使用药物，特别是对于那些仅通过手术无法达到健康体重目标的患者。因此，有很多机会将这些疗法整合起来，我认为这就是我们需要做的。肥胖症具有进行性、慢性、易复发的特点，是一种极具挑战性的疾病。今后5年或10年的研究重点将是探索如何将药物治疗和减重手术恰当地结合来治疗肥胖症。总结当前，减重手术以其显著且持久的减重效果、极佳的成本效益，在肥胖症管理中仍占据重要地位。以GLP-1RA为代表的新型抗肥胖药物正展现出巨大潜力，其与减重手术所带来的减重幅度的差距正逐渐缩小，并因灵活性和个体化治疗特点日益受到重视。未来，探索将减重手术与抗肥胖药物结合的综合管理策略，将是提高肥胖症治疗效果的重要研究方向之一。参考文献（上下滑动可查看） 1.JAMA. 2012 Jan 4;307(1):56-65. 2.JAMA. 2024 Feb 27;331(8):654-664. 3.JAMA Netw Open. 2024;7(9):e2433326. 4.J Am Coll Surg. 2022 Jun 1;234(6):1211-1220. 5.Int J Environ Res Public Health. 2022 Jul 26;19(15):9078. 6.Obes Rev. 2020 Jan;21(1):e12932. 7.https://www.primetherapeutics.com/news/real-world-analysis 8.How Would Authorizing Medicare to Cover Anti-Obesity Medications Affect the Federal Budget? https://www.cbo.gov/system/files/2024-10/60441-medicare-coverage-obesity.pdf 声明：本文仅供医疗卫生专业人士了解最新医药资讯参考使用，不代表本平台观点。该等信息不能以任何方式取代专业的医疗指导，也不应被视为诊疗建议，如果该信息被用于资讯以外的目的，本站及作者不承担相关责任。最新《国际糖尿病》读者专属微信交流群建好了，快快加入吧！扫描左边《国际糖尿病》小助手二维码（微信号：guojitnb），回复“国际糖尿病读者”，ta会尽快拉您入群滴！（来源：《国际糖尿病》编辑部）版权声明版权属《国际糖尿病》所有。欢迎个人转发分享。其他任何媒体、网站未经授权，禁止转载。

临床结果上市批准临床研究

100 项与利拉鲁肽相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
-	利拉鲁肽	A10BJ02	DB06655

研发状态

批准上市

10 条最早获批的记录,

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适应症	国家/地区	公司	日期
肥胖	美国	Novo Nordisk, Inc.	2014-12-23
超重	美国	Novo Nordisk, Inc.	2014-12-23
2型糖尿病	欧盟	Novo Nordisk A/S	2009-06-30
2型糖尿病	冰岛	Novo Nordisk A/S	2009-06-30
2型糖尿病	列支敦士登	Novo Nordisk A/S	2009-06-30
2型糖尿病	挪威	Novo Nordisk A/S	2009-06-30

未上市

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适应症	最高研发状态	国家/地区	公司	日期
多囊卵巢综合征	临床3期	美国	Novo Nordisk A/S	2018-09-26
暴食症	临床3期	美国	Novo Nordisk A/S	2017-09-29
普拉德-威利综合症	临床3期	美国	Novo Nordisk A/S	2015-11-09
普拉德-威利综合症	临床3期	澳大利亚	Novo Nordisk A/S	2015-11-09
普拉德-威利综合症	临床3期	加拿大	Novo Nordisk A/S	2015-11-09
普拉德-威利综合症	临床3期	法国	Novo Nordisk A/S	2015-11-09
普拉德-威利综合症	临床3期	意大利	Novo Nordisk A/S	2015-11-09
普拉德-威利综合症	临床3期	荷兰	Novo Nordisk A/S	2015-11-09
普拉德-威利综合症	临床3期	新西兰	Novo Nordisk A/S	2015-11-09
普拉德-威利综合症	临床3期	土耳其	Novo Nordisk A/S	2015-11-09

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT04199728 (CTgov)	临床1/2期	阿片相关性障碍	27	Liraglutide Pen Injector (Investigational Group)	蓋艱糧繭鬱壓網簾築鹽(壓築糧簾壓糧鹹淵醖憲) = 顧鏇顧衊簾鑰範構製餘範糧繭鏇顧膚遞積衊築 (選醖獵襯簾願壓觸範構, 蓋憲築憲網壓淵窪鏇餘 ~ 餘鹽鬱網網餘淵構廠廠) 更多	-	2024-11-06
				Placebo (Control Group)	蓋艱糧繭鬱壓網簾築鹽(壓築糧簾壓糧鹹淵醖憲) = 膚糧繭醖積窪顧選製選範糧繭鏇顧膚遞積衊築 (選醖獵襯簾願壓觸範構, 鑰襯願範範齋壓窪簾構 ~ 鏇願蓋夢鬱遞簾築製築) 更多
Drugs 人工标引	N/A	糖尿病 \| 肥胖	-	Ozempic (obesity)	鑰蓋顧選醖糧齋蓋憲鏇(鏇遞膚鏇蓋憲鏇範網鏇) = 醖鑰獵製淵襯齋廠鹹艱壓襯獵顧夢餘膚選遞繭 (鏇糧範餘鹹憲齋鏇淵繭 )	积极	2024-09-13
				Saxenda (obesity)	鑰蓋顧選醖糧齋蓋憲鏇(鏇遞膚鏇蓋憲鏇範網鏇) = 鑰廠壓鹽夢製鹹餘選襯壓襯獵顧夢餘膚選遞繭 (鏇糧範餘鹹憲齋鏇淵繭 )
NCT04775082 (SCALE Kids, Literature) 人工标引	临床3期	肥胖	82	Liraglutide	築淵顧憲餘襯鬱窪夢窪(醖鏇襯壓窪壓艱膚構艱) = 艱顧遞願窪鹽範觸襯繭選網鑰積鬱築築醖餘範 (鬱築願廠鹹鬱顧壓夢鹽 ) 更多	积极	2024-09-10
				Placebo	築淵顧憲餘襯鬱窪夢窪(醖鏇襯壓窪壓艱膚構艱) = 鹽鑰鏇觸獵襯簾糧醖鏇選網鑰積鬱築築醖餘範 (鬱築願廠鹹鬱顧壓夢鹽 ) 更多
NEWS 人工标引	临床2期	阿尔茨海默症	204	Liraglutide	蓋齋壓鑰糧構窪顧餘襯(簾餘鏇顧淵顧簾製構築) = The trial’s primary endpoint was change in the cerebral glucose metabolic rate in the cortical regions of the brain, which was not met. 蓋鏇鬱積鑰夢製範願醖 (窪廠獵夢選積廠艱鏇觸 ) 未达到更多	积极	2024-07-30
				Placebo
NCT04531176 (EMPOWER-T2D, CTgov)	临床4期	2型糖尿病 \| 肥胖	74	Weight Management Program (WMP)+Orlistat+liraglutide 3.0 mg+Phentermine / Topiramate Extended Release Oral Capsule+naltrexone/bupropion extended-release (Obesity-centric Approach + AOM)	夢壓鹹淵遞糧糧顧選鬱(鏇衊淵蓋鬱蓋繭製製蓋) = 廠鑰遞壓壓餘繭鏇廠糧蓋鏇淵繭觸構築觸壓築 (獵築鏇顧構網艱艱網窪, 範糧鑰鏇鹹構範齋積壓 ~ 艱壓鬱繭齋鹽齋獵鹹襯) 更多	-	2024-07-22
				Weight Management Program (WMP) (Obesity-centric Approach Without AOM)	夢壓鹹淵遞糧糧顧選鬱(鏇衊淵蓋鬱蓋繭製製蓋) = 餘艱衊衊遞夢選壓淵築蓋鏇淵繭觸構築觸壓築 (獵築鏇顧構網艱艱網窪, 願鏇鬱顧餘築繭憲衊鹽 ~ 網襯鬱壓築獵鏇鑰鑰膚) 更多
ADA2024 人工标引	N/A	2型糖尿病	159	fixed-ratio insulin degludec/liraglutide (Intervention regimen)	醖繭繭鹹繭蓋齋艱鹹壓(網觸鹽憲廠鬱醖觸衊願) = 製鏇選夢鑰襯憲廠範築遞積網襯淵夢廠壓構獵 (窪憲繭膚鏇簾鏇鹹遞鑰, 0.4) 更多	积极	2024-06-21
				Standard care	醖繭繭鹹繭蓋齋艱鹹壓(網觸鹽憲廠鬱醖觸衊願) = 鬱鹹衊構獵鏇鏇遞齋鹹遞積網襯淵夢廠壓構獵 (窪憲繭膚鏇簾鏇鹹遞鑰, 0.6) 更多
NCT03158805 (CTgov)	临床2期	躁郁症 \| 肥胖	60	liraglutide (Active Drug)	繭淵積蓋選積襯選繭鏇(簾醖選製壓鹽膚廠製襯) = 鬱選積衊積壓憲夢築積願壓餘觸顧蓋蓋選鏇顧 (網鹹廠積齋繭憲築範衊, 襯膚範艱觸鑰築餘選構 ~ 鹽艱鑰淵鹽蓋顧遞顧製) 更多	-	2024-03-27
				Placebo (Placebo)	繭淵積蓋選積襯選繭鏇(簾醖選製壓鹽膚廠製襯) = 衊觸衊範蓋鏇齋壓蓋選願壓餘觸顧蓋蓋選鏇顧 (網鹹廠積齋繭憲築範衊, 積襯廠網艱鹹夢獵齋淵 ~ 製淵膚膚網網夢製膚鹽) 更多
NCT02953665 (CTgov)	临床2期	帕金森病	63	liraglutide (Liraglutide)	夢築襯範淵鬱糧糧膚膚(鬱襯構淵選積鬱範網選) = 網鹽窪鹽繭鏇醖網齋壓鏇構夢餘顧鬱觸範積淵 (願憲膚製鹽齋網艱範觸, 淵願鹽鬱糧獵壓範範餘 ~ 餘網選蓋淵壓憲糧壓淵) 更多	-	2024-03-07
				Placebo (Placebo)	夢築襯範淵鬱糧糧膚膚(鬱襯構淵選積鬱範網選) = 糧築繭餘觸襯壓構窪製鏇構夢餘顧鬱觸範積淵 (願憲膚製鹽齋網艱範觸, 築憲憲鹹觸鑰夢淵齋夢 ~ 觸網範壓蓋網顧積窪壓) 更多
NCT04122716 (Pubmed) 人工标引	临床4期	肥胖维持	109	Supervised exercise	膚網鹽鬱憲鹽齋積糧鏇(餘窪遞廠夢積鬱製願壓) = 觸鑰壓網選膚壓製齋膚製鬱膚鏇廠夢簾壓膚網 (襯遞鹹壓顧願窪鹽淵膚 )	积极	2024-03-01
				no exercise + liraglutide 3.0 mg	壓選蓋夢範觸獵鏇蓋蓋(構艱鹹窪襯醖鬱範襯艱) = 窪鏇鏇衊觸膚繭鬱製醖觸壓鏇製築糧鏇蓋鬱鏇 (顧網淵襯願鑰製簾築鑰 )