GLP-1 receptor agonist—application and safety of semaglutide

doi:10.3877/cma.j.issn.2095-9605.2024.02.003

Abstract

Abstract:

Current treatments for obesity include lifestyle interventions, pharmacotherapy, and bariatric metabolic surgery. However, non-surgical strategies often fail to sustain weight loss for most patients. The emerging glucagon-like peptide 1 receptor agonists (GLP-1RAs), semaglutide, has been proven effective in treating obesity and diseases such as diabetes. It works by activating GLP-1 receptors in the hypothalamus, regulating appetite, and delaying gastric emptying. However, adverse effects such as hypoglycemia, cholelithiasis, acute pancreatitis, and increased risks of self-harm and suicide have been reported. Future research should include more diverse populations and conduct large-scale randomized controlled trials targeting the Chinese population to better refine clinical applications. This review summarizes the mechanisms, weight loss efficacy, and safety of semaglutide in chronic weight management for obesity.

Key words: Obesity, Glucagon-like peptide 1 receptor agonists, Semaglutide, Efficacy, Safety

Youtong Yan, Rui Zhao, Qianyi Wan, Guixiang Zhang, Hongyi Shen, Zhong Cheng, Yi Chen. GLP-1 receptor agonist—application and safety of semaglutide[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2024, 10(02): 88-93.

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References 38

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临床研究	受试者人数	目标人群	试验药物	试验周期	主要终点	文献
STEP 1扩展	327	肥胖但无糖尿病	试验组：司美格鲁肽2.4 mg；对照组：安慰剂	STEP 1试验第68周至120周	第0周至第120周体重减轻（kg）	Diabetes, Obesity & Metabolism, 2022, 24(8): 1553-1564.
STEP 2	1210	肥胖合并糖尿病	试验组：司美格鲁肽2.4 mg；司美格鲁肽1.0 mg；对照组：安慰剂	68周	体重变化百分比、体重减轻至少5%的受试者比例	Lancet. 2021 Mar 13;397(10278):971-984.
STEP 3	611	肥胖但无糖尿病	试验组：司美格鲁肽2.4 mg；对照组：安慰剂	68周	体重变化百分比、体重减轻至少5%的受试者比例	JAMA. 2021 Apr 13;325(14):1403-1413.
STEP 4	803	肥胖但无糖尿病	试验组：司美格鲁肽2.4mg 68周；对照组：20周司美格鲁肽+48周安慰剂	68周	体重从第20周到第68周变化的百分比	JAMA. 2021 Apr 13;325(14):1414-1425.
STEP 6	401（日本/韩国）	肥胖有/无糖尿病	试验组：司美格鲁肽2.4 mg 司美格鲁肽1.7 mg；对照组：安慰剂	68周	体重变化百分比、体重减轻至少5%的受试者比例	Lancet Diabetes Endocrinol. 2022 Mar;10(3):193-206.
STEP 7	375（中国、巴西、韩国）	肥胖有/无糖尿病	试验组：司美格鲁肽2.4 mg 司美格鲁肽1.7 mg；对照组：安慰剂	44周	体重变化百分比、体重减轻至少5%的受试者比例	Lancet Diabetes Endocrinol. 2022 Mar;10(3):193-206.

临床研究	受试者人数	目标人群	试验药物	试验周期	主要终点	文献
STEP 1扩展	327	肥胖但无糖尿病	试验组：司美格鲁肽2.4 mg；对照组：安慰剂	STEP 1试验第68周至120周	第0周至第120周体重减轻（kg）	Diabetes, Obesity & Metabolism, 2022, 24(8): 1553-1564.
STEP 2	1210	肥胖合并糖尿病	试验组：司美格鲁肽2.4 mg；司美格鲁肽1.0 mg；对照组：安慰剂	68周	体重变化百分比、体重减轻至少5%的受试者比例	Lancet. 2021 Mar 13;397(10278):971-984.
STEP 3	611	肥胖但无糖尿病	试验组：司美格鲁肽2.4 mg；对照组：安慰剂	68周	体重变化百分比、体重减轻至少5%的受试者比例	JAMA. 2021 Apr 13;325(14):1403-1413.
STEP 4	803	肥胖但无糖尿病	试验组：司美格鲁肽2.4mg 68周；对照组：20周司美格鲁肽+48周安慰剂	68周	体重从第20周到第68周变化的百分比	JAMA. 2021 Apr 13;325(14):1414-1425.
STEP 6	401（日本/韩国）	肥胖有/无糖尿病	试验组：司美格鲁肽2.4 mg 司美格鲁肽1.7 mg；对照组：安慰剂	68周	体重变化百分比、体重减轻至少5%的受试者比例	Lancet Diabetes Endocrinol. 2022 Mar;10(3):193-206.
STEP 7	375（中国、巴西、韩国）	肥胖有/无糖尿病	试验组：司美格鲁肽2.4 mg 司美格鲁肽1.7 mg；对照组：安慰剂	44周	体重变化百分比、体重减轻至少5%的受试者比例	Lancet Diabetes Endocrinol. 2022 Mar;10(3):193-206.

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