Taw qhia
Liraglutide belongs rau cov chav kawm ntawm cov tshuaj hu ua glucagon-zoo li peptide-1 (GLP-1) receptor agonists. Nws yog ib qho kev tsim kho ntawm cov tshuaj GLP -1, uas tau taug qab hauv qhov xwm txheej thiab tswj kev tshaib plab, lub cev hnyav, thiab qib qabzib. Vim tias nws cov ntawv thov sib txawv, tshwj xeeb tshaj yog nyob rau hauv kev kho mob ntshav qab zib hom 2 thiab stoutness, ligarglutide tau txais kev txiav txim siab tsis ntev los no. Hauv qhov kev nkag blog no, peb yuav tshawb xyuas cov hom phiaj sib txawv ntawm Liraglutide, zeroing ntawm nws qhov txaus rau kev txo qhov hnyav, nws txoj hauv kev saib xyuas hom 2 mob ntshav qab zib, thiab nws qhov tseeb muaj peev xwm siv tsis tau.
Liraglutide zoo li cas rau kev poob phaus?
Liraglutide, uas yog muag raws li lub npe lag luam Saxenda, tau txais kev pom zoo los ntawm Food and Drug Administration (FDA) rau kev tswj qhov hnyav mus sij hawm ntev hauv cov neeg rog lossis rog rog uas tseem muaj tsawg kawg ib qho kev hnyav hnyav, xws li kub siab, hom. 2 mob ntshav qab zib, lossis dyslipidemia. Qhov kev pom zoo tau ua raws li cov txiaj ntsig ntawm SCALE (Satiety and Clinical Adiposity - Liraglutide Evidence) kev sim tshuaj ntsuam xyuas, uas pom tau tias qhov hnyav poob thiab kev txhim kho hauv kev pheej hmoo ntawm cardiometabolic nrog kev kho liraglutide.
Nyob rau hauv SCALE Heftiness thiab Prediabetes ua ntej, uas suav nrog 3,731 cov tswv cuab nrog corpulence lossis rog dhau, cov neeg uas tau txais Liraglutide 3. % nrog kev kho mob cuav tom qab 56 lub lis piam ntawm kev kho mob. Tsis tas li ntawd, 63.2% ntawm cov tswv cuab hauv pawg Liraglutide tau ua tiav kev kho qhov hnyav ntawm qhov hnyav dua los yog sib npaug li 5%, thiab 33.1% ua tiav qhov hnyav ntawm ntau dua lossis sib npaug rau 10%, sib piv nrog 27.1% thiab 10.6%, cais, hauv cov fake kho pawg.
Qhov hnyav txo qhov cuam tshuam ntawmLiraglutidefeem ntau cuam tshuam los ntawm nws cov dej num ntawm GLP-1 receptors nyob rau hauv lub paj hlwb, tshwj xeeb tshaj yog nyob rau hauv lub paj hlwb, uas coj kev ntshaw thiab lub zog sib npaug. Los ntawm kev pib cov receptors no, Liraglutide ua rau cov kev xav ntawm satiety, txo qis kev ntshaw, thiab nce kev siv zog, ua rau lub zog tsis zoo thiab ua kom hnyav dua.
Ntxiv rau nws cov kev cuam tshuam ncaj qha rau qhov hnyav, raglutide tau pom los txhim kho ntau yam kab mob plawv uas cuam tshuam nrog kev rog. Hauv SCALE ua ntej, kev kho mob Liraglutide ua rau muaj kev txo qis hauv nruab nrab ntawm lub voj voog, cov kab mob hauv lub cev, thiab cov cim hluav taws xob, nrog rau kev hloov kho hauv lipid profile thiab kev paub txog insulin. Cov txiaj ntsig zoo ntawm kev noj qab haus huv cardiometabolic tseem ceeb tshwj xeeb vim tias kev rog rog yog qhov tseem ceeb rau cov kab mob plawv, ntshav qab zib hom 2, thiab lwm yam mob ntev.
Liraglutide yuav tsum tau siv ua ke nrog kev noj zaub mov kom tsawg thiab ua kom lub cev muaj zog ntxiv rau kev pom kev poob phaus thiab kev saib xyuas. Cov tshuaj tsis yog ib qho kev sib pauv rau txoj kev hloov ntawm lub neej tab sis yog ib qho cuab yeej sib txuas los pab tib neeg nrog kev kov yeej lub cev nqaij daim tawv kom txo qhov hnyav.
Kev nyab xeeb thiab kev zam ntawm Liraglutide rau kev tswj qhov hnyav tau raug soj ntsuam hauv kev sim tshuaj. Cov teebmeem thib ob uas paub zoo tshaj plaws suav nrog kev mob, lub plab zom mov, nres, thiab hnyav, uas feem ntau maj mam coj mus rau qhov hnyav thiab feem ntau yuav txo qis rau lub sijhawm ntev. Tsis tshua muaj tab sis muaj kev phiv loj heev, xws li kab mob pancreatitis thiab kab mob gallbladder, tau tshaj tawm, thiab cov tib neeg uas muaj keeb kwm ntawm cov mob no yuav tsum tau siv Liraglutide nrog ceev faj.
Hauv cov ntsiab lus, Liraglutide yog ib qho tshuaj zoo rau kev poob phaus hauv cov tib neeg uas muaj rog lossis rog, tshwj xeeb tshaj yog thaum siv nrog kev hloov pauv hauv kev ua neej. Nws cov txheej txheem tshwj xeeb ntawm kev ua, tsom rau GLP-1 receptors hauv lub hlwb, txhawb kev satiety thiab txo qis qab los noj mov, ua rau poob ceeb thawj thiab txhim kho kev noj qab haus huv cardiometabolic. Txawm li cas los xij, zoo li txhua yam tshuaj, cov txiaj ntsig thiab kev pheej hmoo ntawm Liraglutide yuav tsum tau ua tib zoo txiav txim siab ntawm tus kheej, thiab nws yuav tsum tau saib xyuas los ntawm tus kws kho mob.
Liraglutide puas tuaj yeem siv los kho mob ntshav qab zib hom 2?
Liraglutide, txwv tsis pub hu ua Victoza, feem ntau tau siv los kho hom 2 mob ntshav qab zib mellitus txij li nws tau pom zoo los ntawm FDA xyoo 2010. Hom 2 mob ntshav qab zib yog ib qho teeb meem tsis tu ncua uas tau piav qhia los ntawm qib qabzib siab los ntawm vim yog kev tawm tsam insulin thiab nruab nrab beta-cell tawg. . Liraglutide yog ib qho kev kho mob zoo rau cov teeb meem mob ntshav qab zib mellitus thiab kev tswj glycemic vim nws hais txog ntau yam tseem ceeb ntawm cov kab mob ntshav qab zib hom 2.
Los ntawm nws cov teebmeem ntawm insulin thiab glucagon secretion, Liraglutide txhim kho glycemic tswj hauv txoj hauv kev tseem ceeb. Los ntawm kev ua kom lub GLP-1 receptors, ligarglutide nce cov piam thaj-dependent insulin secretion ntawm pancreatic beta hlwb, txo cov ntshav qab zib.Liraglutidesmothers lub emission ntawm glucagon, ib yam tshuaj uas txhawb kev loj hlob ntawm lub siab qabzib, nyob rau tib lub sij hawm, ntxiv txhim kho glycemic tswj.
Txawm hais tias nws cuam tshuam rau cov tshuaj insulin thiab glucagon emissions, Liraglutide ncua lub plab zom mov, txo qis tus nqi ntawm cov tshuaj, tshwj xeeb tshaj yog cov piam thaj, khaws cia los ntawm lub plab zom mov mus rau hauv cov hlab ntsha. Cov qib qabzib tom qab prandial nce txhua qhov qeeb qeeb vim qhov kev cuam tshuam hauv plab hnyuv, txo qis qhov tshwm sim ntawm hyperglycemia thiab qabzib tawm.
Qhov txaus ntawm Liraglutide hauv kev kho mob ntawm hom 2 mob ntshav qab zib mellitus tau pom dav dav hauv kev kho mob ua ntej. Hauv qhov chaw thib ib (Liraglutide Impact thiab Activity in Diabetes) qhov kev pab cuam, uas suav nrog rau 6 qhov kev tswj xyuas ua ntej, Liraglutide tau qhia txog kev hloov pauv tseem ceeb hauv kev tswj glycemic, raws li kev kwv yees los ntawm kev txo qis hauv HbA1c (glycated hemoglobin), yoo ntshav ntshav qabzib, thiab tom qab cov piam thaj. qib. Cov kev txhim kho no tau txhawb nqa lub sijhawm ntev, nrog qee qhov kev tshawb fawb qhia tau txiaj ntsig txog li 52 lub lis piam.
Qhov tseem ceeb, nws tau pom tias Liraglutide muaj qee yam uas tsis yog cov txiaj ntsig tswj glycemic rau cov neeg mob ntshav qab zib hom 2. Hauv Pioneer (Liraglutide Impact thiab Activity in Diabetes: Assessment of Cardiovascular Results) ua ntej, uas suav nrog 9,340 tus tswvcuab uas muaj ntshav qab zib hom 2 thiab kev twv txiaj hauv plawv siab, Liraglutide tag nrho txo qis qhov kev twv txiaj ntawm qhov tsis zoo ntawm cov hlab plawv tsis zoo, suav nrog cov xwm txheej tsis zoo ntawm cov hlab plawv. myocardial localized necrosis, thiab tsis yog mob stroke, sib piv nrog kev kho mob cuav.
Cov txiaj ntsig ntawm cov hlab plawv ntawm Liraglutide ntseeg tau tias muaj kev cuam tshuam los ntawm cov kab ke sib txawv, nco txog kev hloov kho rau endothelial muaj peev xwm, txo qis hauv cov cim hluav taws xob, thiab muaj kev cuam tshuam zoo rau lipid profile thiab mem tes. Cov kev tshawb pom no qhia txog qhov muaj peev xwm ntawm Liraglutide tsis yog rau kev tswj glycemic nkaus xwb tab sis kuj txo qis tag nrho cov hlab plawv hauv cov neeg mob ntshav qab zib hom 2.
LiraglutideFeem ntau yog ua tau zoo rau cov tib neeg uas muaj ntshav qab zib hom 2, nrog rau cov kev mob tshwm sim feem ntau yog mob plab, xws li xeev siab, raws plab, thiab ntuav. Cov kev mob tshwm sim no feem ntau yog ib ntus thiab tuaj yeem tswj tau los ntawm kev siv tshuaj maj mam titration thiab kev tswj hwm nrog zaub mov. Tsis tshua muaj tab sis muaj kev phiv loj heev, xws li mob pancreatitis thiab medullary thyroid carcinoma, tau tshaj tawm, thiab cov neeg uas muaj keeb kwm ntawm cov mob no yuav tsum tau siv Liraglutide nrog ceev faj.
Hauv kev xaus, Liraglutide yog qhov kev kho mob zoo thiab tsim tau zoo rau hom 2 mob ntshav qab zib mellitus, muab kev txhim kho tseem ceeb hauv kev tswj glycemic, txo qis kev pheej hmoo ntawm cov hlab plawv, thiab cov txiaj ntsig poob phaus. Nws cov txheej txheem tshwj xeeb ntawm kev nqis tes ua, tsom ntau yam ntawm cov ntshav qab zib pathophysiology, ua rau nws yog ib qho tseem ceeb hauv kev tswj tus mob no. Txawm li cas los xij, ib yam li txhua yam tshuaj, kev siv Liraglutide yuav tsum yog tus kheej raws li tus neeg mob tus yam ntxwv, comorbidities, thiab cov hom phiaj kho mob, thiab nws cov txiaj ntsig thiab kev pheej hmoo yuav tsum tau ua tib zoo xav hauv kev koom tes nrog tus kws kho mob.
Yuav ua li cas yog lub peev xwm off-label siv ntawm Liraglutide?
Thaum Liraglutide feem ntau qhia rau kev kho mob ntshav qab zib hom 2 thiab kev tswj qhov hnyav hnyav, tau muaj kev txaus siab rau nws cov peev txheej siv tsis tau. Kev siv off-label yog hais txog kev coj noj coj ua ntawm kev sau tshuaj rau lub hom phiaj, pej xeem, lossis ntau npaum li cas uas tsis tau pom zoo los ntawm cov koom haum tswj hwm. Nyob rau hauv rooj plaub ntawm Liraglutide, ntau qhov chaw ntawm kev tshawb fawb tau tshwm sim, tshawb nrhiav nws cov peev xwm kho mob hauv ntau yam mob dhau qhov nws pom zoo qhia.
Ib qho ntawm Liraglutide qhov kev cia siab tshaj plaws ntawm daim ntawv lo siv yog rau kev kho mob uas tsis yog-alcoholic steatohepatitis (NASH) thiab cov kab mob uas tsis yog-alcoholic fatty siab (NAFLD). NAFLD yog ib qho mob ua rau lub siab tsis tu ncua uas tau piav qhia los ntawm kev sib sau ntawm cov rog hauv daim siab, uas tuaj yeem ua rau NASH, hom mob hnyav dua uas cuam tshuam nrog kev khaus thiab fibrosis. NAFLD thiab NASH muaj feem cuam tshuam nrog kev rog rog, insulin tsis kam, thiab ntshav qab zib hom 2, ua rau Liraglutide ib qho kev xaiv kho kom zoo nkauj.
Qee qhov kev kuaj mob ua ntej thiab kuaj mob tau tshawb fawb txog qhov cuam tshuam ntawm Liraglutide ntawm NAFLD thiab NASH. Liraglutide tau pom tias txo qis cov kab mob siab thiab fibrosis, nce insulin rhiab heev, thiab txo cov roj siab hauv cov qauv tsiaj. Cov kev tshawb pom no tau raug txhawb nqa los ntawm tib neeg kev kuaj mob, uas tau nthuav tawm qhov tseem ceeb ntawm kev txo qis hauv daim siab rog, txhim kho hauv siab cov protein ntau, thiab kev hloov pauv loj hauv thaj tsam histological nrog kev kho Liraglutide.
Kev txhim kho hauv cov tshuaj insulin, txo qis hauv lub cev qhov hnyav thiab qhov kev xav ntawm adiposity, thiab muaj kev cuam tshuam ncaj qha rau ntawm lub siab lipid zom thiab ua rau hnyav dua yog cov khoom muaj peev xwm uas Liraglutide pab NAFLD thiab NASH. Txawm hais tias qhov kev kho mob loj dua thiab ntev ntev yuav tsum tau ua tiav tag nrho cov kev muaj peev xwm thiab kev ruaj ntseg ntawm Liraglutide hauv NAFLD thiab NASH, cov ntaub ntawv pov thawj siv tau hais tias nws tuaj yeem yog qhov kev xaiv kho kom zoo rau cov xwm txheej no.
Lwm daim ntawv thov muaj peev xwm rau Liraglutide sab nraum daim ntawv lo yog kev kho mob ntawm polycystic zes qe menyuam syndrome (PCOS). PCOS yog ib qho teeb meem ntawm endocrine uas cuam tshuam rau cov poj niam ntawm lub hnub nyoog conceptive thiab yog portrayed los ntawm polycystic zes qe menyuam morphology, ovulatory tawg, thiab hyperandrogenism. PCOS feem ntau txuas nrog kev rog thiab insulin tsis kam, uas ua rau nws cov metabolic thiab kev ua me nyuam tshwm sim.
Muab nws qhov cuam tshuam rau kev ua haujlwm ntawm cov tshuaj insulin thiab txo qhov hnyav,Liraglutidetau tshawb fawb raws li kev xaiv kev kho mob rau PCOS. Hauv ntau qhov kev tshawb fawb me me, Liraglutide tau pom tias txhim kho insulin tsis kam, txo cov qib androgen, thiab txhawb kev poob phaus hauv cov poj niam nrog PCOS. Cov kev txhim kho metabolic thiab hormonal no tau cuam tshuam nrog cov txiaj ntsig zoo ntawm kev coj khaub ncaws tsis tu ncua, ovulation, thiab cov txiaj ntsig fertility.
Cov txheej txheem tseeb uas Liraglutide txhim kho PCOS tshwm sim tsis tau nkag siab tag nrho tab sis tuaj yeem koom nrog kev sib xyaw ntawm nws cov teebmeem ntawm insulin rhiab heev, poob phaus, thiab ncaj qha ua haujlwm ntawm zes qe menyuam. Thaum cov ntaub ntawv pov thawj muaj kev cia siab, kev sim tshuaj loj dua thiab tsim tau zoo yog xav tau los lees paub qhov ua tau zoo thiab kev nyab xeeb ntawm Liraglutide hauv kev tswj hwm PCOS.
Ntxiv nrog rau NAFLD / NASH thiab PCOS, Liraglutide tau tshawb fawb hauv ntau qhov chaw sab nraud, suav nrog kev kho mob pw tsaug zog apnea, kev paub tsis meej, thiab qee yam mob plawv. Thaum cov ntaub ntawv pov thawj rau cov ntawv thov no raug txwv thiab ua ntej, lawv qhia txog qhov muaj peev xwm ntawm Liraglutide thiab xav tau kev tshawb fawb ntxiv kom paub meej nws cov peev xwm kho mob.
Nws yog ib qho tseem ceeb uas yuav tsum tau hais txog tias kev siv cov tshuaj Liraglutide yuav tsum tau ua kom ceev faj thiab raws li kev qhia ntawm tus kws kho mob. Kev nyab xeeb thiab kev ua tau zoo ntawm Liraglutide nyob rau hauv cov ntaub ntawv tawm ntawm cov ntawv no tsis tau tsim kom tiav, thiab qhov sib npaug ntawm cov txiaj ntsig thiab kev pheej hmoo yuav txawv ntawm nws cov lus pom zoo. Cov neeg mob xav txog kev siv cov tshuaj Liraglutide yuav tsum muaj kev sib tham zoo nrog lawv tus kws kho mob txog cov txiaj ntsig, kev pheej hmoo, thiab kev tsis paub tseeb uas cuam tshuam nrog txoj hauv kev no.
Hauv kev xaus, thaum Liraglutide feem ntau yog siv rau kev kho mob ntshav qab zib hom 2 thiab kev tswj qhov hnyav, muaj kev txaus siab ntau ntxiv rau nws cov ntawv thov uas tsis muaj npe. Kev cog lus thaj chaw ntawm kev tshawb fawb suav nrog kev kho NAFLD / NASH thiab PCOS, qhov twg Liraglutide cov teebmeem ntawm insulin rhiab heev, poob phaus, thiab kev noj qab haus huv metabolic tuaj yeem muab cov txiaj ntsig kho. Txawm li cas los xij, nws yog ib qho tseem ceeb kom paub meej tias cov ntaub ntawv pov thawj rau kev siv daim ntawv lo no tseem txwv, thiab xav tau kev tshawb fawb ntxiv los tsim kom muaj kev nyab xeeb thiab ua tau zoo. Ib yam li txhua yam tshuaj, kev txiav txim siab sivLiraglutiderau lub hom phiaj off-label yuav tsum tau ua nyob rau hauv ib tug tib neeg lub hauv paus, hnyav cov txiaj ntsig thiab kev pheej hmoo, thiab nyob rau hauv kev saib xyuas ze ntawm tus kws kho mob.
Cov ntaub ntawv
1. Armstrong, MJ, Gaunt, P., Aithal, GP, Barton, D., Hull, D., Parker, R., ... & Newsome, PN (2016). Liraglutide kev nyab xeeb thiab kev ua tau zoo nyob rau hauv cov neeg mob uas tsis yog-alcoholic steatohepatitis (LEAN): ib tug multicentre, ob-dig muag, randomised, placebo-tswj theem 2 txoj kev kawm. Lub Lancet, 387(10019), 679-690.
2. Davies, MJ, Aronne, LJ, Caterson, ID, Thomsen, AB, Jacobsen, PB, & Marso, SP (2018). Liraglutide thiab cov txiaj ntsig ntawm cov hlab plawv hauv cov neeg laus uas rog dhau lossis rog: Kev soj ntsuam tom qab hoc los ntawm SCALE randomized tswj kev sim. Mob ntshav qab zib, rog rog thiab Metabolism, 20(3), 734-739.
3. Jensterle, M., Kravos, NA, Goričar, K., & Janez, A. (2017). Kev ua haujlwm luv luv ntawm cov koob tshuaj qis liraglutide ua ke nrog metformin tiv thaiv cov koob tshuaj liraglutide ib leeg hauv kev kho mob rog rog PCOS: randomized sim. BMC Endocrine Disorders, 17(1), 1-8.
4. Marso, SP, Daniels, GH, Brown-Frandsen, K., Kristensen, P., Mann, JF, Nauck, MA, ... & Steinberg, WM (2016). Liraglutide thiab cov txiaj ntsig ntawm cov hlab plawv hauv ntshav qab zib hom 2. New England Journal of Medicine, 375(4), 311-322.
5. Mehta, A., Marso, SP, & Neeland, IJ (2017). Liraglutide rau kev tswj qhov hnyav: kev tshuaj xyuas tseem ceeb ntawm cov pov thawj. Obesity Science & Practice, 3(1), 3-14.
6. Newsome, PN, Buchholtz, K., Cusi, K., Linder, M., Okanoue, T., Ratziu, V., ... & Sejling, AS (2021). Ib qho placebo-tswj sim ntawm subcutaneous semaglutide hauv nonalcoholic steatohepatitis. New England Journal of Medicine, 384(12), 1113-1124.
7. Pi-Sunyer, X., Astrup, A., Fujioka, K., Greenway, F., Halpern, A., Krempf, M., ... & Wilding, JP (2015) . Ib qho randomized, tswj kev sim ntawm 3.0 mg ntawm liraglutide hauv kev tswj qhov hnyav. New England Journal of Medicine, 373(1), 11-22.
8. Pratley, RE, Aroda, VR, Lingvay, I., Lüdemann, J., Andreassen, C., Navarria, A., ... & SUSTAIN 7 Investigators. (2018). Semaglutide piv rau dulaglutide ib zaug ib lub lim tiam hauv cov neeg mob uas muaj ntshav qab zib hom 2 (SUSTAIN 7): ib qho randomised, qhib-label, theem 3b sim. Lancet Diabetes & Endocrinology, 6(4), 275-286.
9. Salameh, TS, Mortazavi, S., Logsdon, AF, Nguyen, PA, Micsak, AL, Zarbock, AJ, ... & Erickson, RG (2021). GLP-1 Receptor Agonists nyob rau hauv Cov Poj Niam nrog PCOS: Kev Ntsuam Xyuas Txheej Txheem thiab Kev Ntsuam Xyuas Meta. Phau ntawv Journal of Clinical Endocrinology & Metabolism.
10. Srivastava, G., Apovian, CM, & Rosenbaum, M. (2019). Pharmacological thiab hnyav-txog cov txiaj ntsig metabolic ntawm kev kho liraglutide hauv cov neeg mob rog rog: kev tshuaj ntsuam meta. Clinical Obesity, 9(6), e12347.