Izindlela zokwelapha ezisekelwe ku-GLP-1 Zokunciphisa Isisindo: Izindlela, Ukusebenza kahle, kanye Nentuthuko Yocwaningo

Isidakamizwa	Inkomba Eyinhloko	Ukuphatha	Ukuncipha Kwesisindo Okumaphakathi
I-Liraglutide	Thayipha isifo sikashukela sohlobo 2, ukukhuluphala	Umjovo wansuku zonke	5–8%
I-Semaglutide	Thayipha isifo sikashukela sohlobo 2, ukukhuluphala	Umjovo wamasonto onke / ngomlomo	10–15%
I-Tirzepatide	Thayipha isifo sikashukela sohlobo 2, ukukhuluphala	Umjovo wamasonto onke	15–22%
I-Retatrutide (ezilingo)	Ukukhuluphala ngokweqile (okungezona isifo sikashukela)	Umjovo wamasonto onke	Kufika ku-24%

Okuthrendayo:Ukuvela kwezidakamizwa kuqhubeka kusuka kuma-agonists e-GLP-1 receptor → ama-agonists amabili e-GIP/GLP-1 → ama-agonists amathathu (GIP/GLP-1/GCGR).

3. Izilingo Ezinkulu Zemitholampilo Nemiphumela

I-Semaglutide - IZINYATHELO Izilingo

• ISINYATHELO 1 (NEJM, 2021)

  • Abahlanganyeli: Abantu abadala abanokukhuluphala ngokweqile, abangenaso isifo sikashukela

  • Umthamo: 2.4 mg ngeviki (subcutaneous)

  • Imiphumela: Ukunciphisa isisindo somzimba okushoyo14.9%emavikini angama-68 vs. 2.4% nge-placebo

  • ~33% wabahlanganyeli bathole ≥20% ukuncipha kwesisindo.

• ISINYATHELO 5 (2022)

  • Kuboniswe ukwehla kwesisindo okuqhubekayo eminyakeni emi-2 kanye nokuthuthukiswa kwezinto eziyingozi ze-cardiometabolic.

I-Tirzepatide – SURMOUNT & SURPASS Izinhlelo

• I-SURMOUNT-1 (NEJM, 2022)

  • Abahlanganyeli: Abantu abadala abanokukhuluphala ngokweqile, abangenaso isifo sikashukela

  • Umthamo: 5 mg, 10 mg, 15 mg masonto onke

  • Imiphumela: Kusho ukwehla kwesisindo15–21%ngemuva kwamaviki angama-72 (kuncike kumthamo)

  • Cishe u-40% ufinyelelwe ≥25% wokunciphisa isisindo.

• Izilingo ZE-SURPASS (isibalo sabantu abanesifo sikashukela)

  • Ukwehliswa kwe-HbA1c: kuze kufike2.2%

  • Ukuncipha kwesisindo okumaphakathi okufanayo kwe10–15%.

4. Izinzuzo Ezengeziwe Zezempilo Ne-Metabolic

• Ukwehliswa kweukushaya kwegazi, I-LDL-cholesterol, futhiama-triglycerides

• Kwehlisiwei-visceralfuthiamafutha esibindi(ukuthuthukiswa kwe-NAFLD)

• Ingozi ephansi yeimicimbi yenhliziyo(isb., MI, unhlangothi)

• Ukuthuthuka okubambezelekile kusuka ku-prediabetes kuya kohlobo 2 sikashukela

5. Iphrofayili Yezokuphepha Nokucatshangelwa

Imiphumela engemihle evamile (imvamisa imnene ukuya komaphakathi):

• Isicanucanu, ukuhlanza, ukuqunjelwa, ukuqunjelwa

• Ukulahlekelwa ukudla

• Ukungakhululeki kwesikhashana kwamathumbu

Izixwayiso / contraindications:

• Umlando we-pancreatitis noma i-medullary thyroid carcinoma

• Ukukhulelwa nokuncelisa

• I-titration yomthamo kancane kancane iyanconywa ukuze kuthuthukiswe ukubekezelelana

6. Iziqondiso Zocwaningo Lwesikhathi esizayo

1. Ama-multi-agonists esizukulwane esilandelayo:

   • Ama-agonists amathathu aqondise i-GIP/GLP-1/GCGR (isb.I-Retatrutide)

2. Amafomula e-Oral GLP-1:

   • I-semaglutide yomlomo we-high-dose (kufika ku-50 mg) ngaphansi kokuhlolwa

3. Imithi yokwelapha eyinhlanganisela:

   • I-GLP-1 + insulin noma i-SGLT2 inhibitors

4. Izinkomba ezibanzi ze-metabolic:

   • Isifo sesibindi esinamafutha e-non-alcoholic (NAFLD), i-polycystic ovary syndrome (PCOS), i-apnea yokulala, ukuvimbela i-cardiovascular

7. Isiphetho

Izidakamizwa ezisekelwe ku-GLP-1 zimelela ukushintshwa kwepharadigm kusuka ekulawulweni kwesifo sikashukela kuya ekulawuleni okuphelele kwe-metabolic nesisindo.
With agents likeI-SemaglutidefuthiI-Tirzepatide, ukuncipha kwesisindo esingahlinzeki esingaphezu kuka-20% sekufinyeleleke.
Ama-agonists wesikhathi esizayo we-multi-receptor kulindeleke ukuthi athuthukise ukusebenza kahle, ukuqina, kanye nezinzuzo ze-cardiometabolic.