摘要
背景:在肠促胰岛素系统中,胰高血糖素样肽-1 (GLP-1) 是一种抑制胰高血糖素释放并调节葡萄糖依赖性胰岛素分泌的激素。在 2 型糖尿病中,使用 GLP-1 激动剂纠正受损的肠促胰岛素系统是一种明确的治疗策略。目的:这篇综述文章旨在讨论索马鲁肽与二线抗糖尿病药物的作用机制、关键调控事件、血糖控制的临床试验以及比较分析。 描述:Semaglutide 是一种胰高血糖素样肽 1 (GLP-1) 受体激动剂,可增强糖尿病患者的血糖控制。 2019 年,美国食品和药物管理局批准了第一种口服 GLP-1 受体激动剂索马鲁肽,以每日一次的片剂形式给药。此外,最近的研究强调了索马鲁肽改善体重减轻的肥胖患者血糖控制的能力。尽管如此,在临床实践中,在 2 型 DM 治疗范式中,口服索马鲁肽的影响仍未确定。这篇综述文章讨论了有关血糖控制的作用机制、药效学、关键调节事件和临床试验。 结论:该评价通过强调其益处和不良事件,突出了索马鲁肽与现有二线药物治疗 2 型糖尿病的比较分析。
关键词: 口服 Semaglutide,GLP-1 受体激动剂,作用机制,2 型糖尿病,血糖控制,肠促胰岛素系统
图形摘要
[http://dx.doi.org/10.1016/S2213-8587(13)70112-8] [PMID: 24622669]
[http://dx.doi.org/10.2337/dc16-0273] [PMID: 27222545]
[http://dx.doi.org/10.1016/S0140-6736(13)62219-9] [PMID: 24315621]
[http://dx.doi.org/10.1016/j.mpmed.2014.09.007] [PMID: 25568613]
[http://dx.doi.org/10.1152/ajpendo.00326.2004] [PMID: 16219666]
[http://dx.doi.org/10.1089/dia.2019.0185] [PMID: 31436480]
[http://dx.doi.org/10.1002/jcph.443] [PMID: 25475122]
[http://dx.doi.org/10.2337/db13-1087] [PMID: 24608440]
[http://dx.doi.org/10.2337/dc14-2441] [PMID: 25538310]
[http://dx.doi.org/10.3389/fendo.2019.00155] [PMID: 31031702]
[http://dx.doi.org/10.1021/jm9909645] [PMID: 10794683]
[http://dx.doi.org/10.1080/14656566.2018.1552258] [PMID: 30499733]
[http://dx.doi.org/10.1152/physrev.00034.2006] [PMID: 17928588]
[http://dx.doi.org/10.1053/j.gastro.2007.03.054] [PMID: 17498508]
[http://dx.doi.org/10.1113/jphysiol.2008.164012] [PMID: 19001044]
[http://dx.doi.org/10.1210/en.2009-1178] [PMID: 19933397]
[http://dx.doi.org/10.1111/1753-0407.12439] [PMID: 27287542]
[http://dx.doi.org/10.2337/diabetes.52.5.1147] [PMID: 12716745]
[http://dx.doi.org/10.2337/db11-1029] [PMID: 22124465]
[http://dx.doi.org/10.2337/diabetes.51.9.2757] [PMID: 12196469]
[http://dx.doi.org/10.1016/j.cmet.2008.11.002] [PMID: 19041768]
[http://dx.doi.org/10.1111/bph.12689] [PMID: 24628305]
[http://dx.doi.org/10.1124/pr.55.1.6] [PMID: 12615957]
[http://dx.doi.org/10.1016/j.pharmthera.2006.11.007] [PMID: 17306374]
[http://dx.doi.org/10.1016/j.biopha.2018.08.088] [PMID: 30372907]
[http://dx.doi.org/10.3390/pharmaceutics11020078]
[http://dx.doi.org/10.1126/scitranslmed.aar7047] [PMID: 30429357]
[http://dx.doi.org/10.1016/j.ejps.2005.03.003] [PMID: 15911227]
[http://dx.doi.org/10.1002/jcph.1131] [PMID: 29693715]
[http://dx.doi.org/10.1016/j.jdiacomp.2019.107520] [PMID: 31952996]
[http://dx.doi.org/10.1007/s40262-019-00756-2] [PMID: 30945118]
[http://dx.doi.org/10.2337/dc17-0417] [PMID: 29246950]
[http://dx.doi.org/10.1210/jc.2018-00070] [PMID: 29688502]
[http://dx.doi.org/10.1001/jama.2019.2942] [PMID: 30903796]
[http://dx.doi.org/10.1001/jama.289.1.76] [PMID: 12503980]
[http://dx.doi.org/10.1016/j.nut.2009.07.008] [PMID: 20152707]
[http://dx.doi.org/10.1016/j.neuropharm.2011.12.022] [PMID: 22227019]
[http://dx.doi.org/10.1210/en.2014-1675] [PMID: 25380238]
[http://dx.doi.org/10.1016/j.physbeh.2010.02.029] [PMID: 20226203]
[http://dx.doi.org/10.1152/ajpregu.00520.2015] [PMID: 27030669]
[http://dx.doi.org/10.1111/dom.12932] [PMID: 28266779]
[http://dx.doi.org/10.1007/s40265-014-0298-1] [PMID: 25274537]
[http://dx.doi.org/10.1007/s40265-018-0937-z] [PMID: 29946963]
[http://dx.doi.org/10.1210/jc.2017-01838] [PMID: 29342295]
[http://dx.doi.org/10.1111/dom.12244] [PMID: 24320621]
[http://dx.doi.org/10.1172/JCI76184]
[http://dx.doi.org/10.3389/fimmu.2015.00386] [PMID: 25657648]
[http://dx.doi.org/10.4103/2230-8210.111625] [PMID: 23869296]
[http://dx.doi.org/10.18773/austprescr.2008.059]
[http://dx.doi.org/10.1089/dia.2011.0050] [PMID: 21751887]
[http://dx.doi.org/10.2147/VHRM.S10952] [PMID: 20730070]
[http://dx.doi.org/10.1007/s40265-019-1057-0] [PMID: 30701480]
[http://dx.doi.org/10.1080/00325481.2017.1342509] [PMID: 28657399]
[http://dx.doi.org/10.2337/db15-1356] [PMID: 26861783]
[http://dx.doi.org/10.7326/AITC201903050] [PMID: 30831593]
[http://dx.doi.org/10.1111/dom.12670] [PMID: 27059700]
[http://dx.doi.org/10.2337/dc19-0883] [PMID: 31530666]
[http://dx.doi.org/10.1016/S0140-6736(19)31271-1] [PMID: 31186120]
[http://dx.doi.org/10.2337/dc19-0749] [PMID: 31186300]
[http://dx.doi.org/10.1016/S2213-8587(17)30013-X] [PMID: 28110911]
[http://dx.doi.org/10.1016/S2213-8587(19)30192-5] [PMID: 31189517]
[http://dx.doi.org/10.1186/s12933-018-0728-6] [PMID: 29301528]
[http://dx.doi.org/10.1056/NEJMoa1607141] [PMID: 27633186]
[http://dx.doi.org/10.2147/DMSO.S229802] [PMID: 31819577]
[http://dx.doi.org/10.1056/NEJMoa1901118] [PMID: 31185157]
[http://dx.doi.org/10.1111/obr.12839] [PMID: 30768766]
[http://dx.doi.org/10.1016/S0140-6736(18)33195-7] [PMID: 31591979]
[http://dx.doi.org/10.1136/bmj.k1767]
[http://dx.doi.org/10.7326/0003-4819-153-7-201010050-00006] [PMID: 20921542]
[http://dx.doi.org/10.1016/S0140-6736(19)31904-X] [PMID: 31591978]
[http://dx.doi.org/10.1016/S0140-6736(18)31773-2] [PMID: 30122305]
[http://dx.doi.org/10.1002/oby.22794] [PMID: 32441473]
[http://dx.doi.org/10.1016/j.neuropharm.2018.01.040] [PMID: 29402504]
[http://dx.doi.org/10.3233/JAD-2006-9102] [PMID: 16627931]
[http://dx.doi.org/10.1016/j.neurobiolaging.2008.04.002] [PMID: 18479783]
[http://dx.doi.org/10.1172/JCI59903] [PMID: 22476197]
[http://dx.doi.org/10.3233/JAD-2005-7107] [PMID: 15750215]
[http://dx.doi.org/10.1016/j.expneurol.2011.06.005] [PMID: 21703262]
[http://dx.doi.org/10.1016/j.brainres.2008.08.089] [PMID: 18805403]
[http://dx.doi.org/10.1111/ene.12137] [PMID: 23551560]
[http://dx.doi.org/10.1016/j.parkreldis.2013.11.005] [PMID: 24280021]
[http://dx.doi.org/10.1093/brain/aws009] [PMID: 22344583]
[http://dx.doi.org/10.2337/dbi18-0045] [PMID: 30573675]
[http://dx.doi.org/10.3233/JPD-181503] [PMID: 30741689]
[http://dx.doi.org/10.1186/s13063-019-3259-x] [PMID: 30606236]
[http://dx.doi.org/10.1016/j.cmet.2018.03.001] [PMID: 29617641]
[http://dx.doi.org/10.1016/j.clinre.2019.01.009] [PMID: 30833185]
[http://dx.doi.org/10.1016/j.cmet.2006.01.004] [PMID: 16517403]
[http://dx.doi.org/10.1210/er.2011-1052] [PMID: 22323472]
[http://dx.doi.org/10.1210/en.2009-1272] [PMID: 20203154]
[http://dx.doi.org/10.1155/2019/1534365] [PMID: 31396537]