Umjovo we-Tirzepatide Wesifo Sikashukela kanye Nokuncipha Kwesisindo

I-Tirzepatide iyinoveli ye-insulinotropic polypeptide (GIP) encike ku-glucose ekabili ethuthukisiwe kanye ne-glucagon-like peptide-1 (GLP-1) agonist receptor. Indlela yayo embaxambili ihlose ukuthuthukisa ukukhiqizwa kwe-insulin, ukucindezela ukukhululwa kweglucagon, ukubambezeleka ukuphuma kwesisu, nokwenza ngcono ukusutha, inikeze indlela yokwelapha ebanzi yohlobo 2 lwesifo sikashukela i-mellitus (T2DM) nokukhuluphala.

Okutholakele Okubalulekile Ezifundweni Zomtholampilo

1. Ukulawula I-Glycemic

Ngaphakathi kokuningiIDLULAisigaba sesi-3 sokuhlolwa komtholampilo, i-tirzepatide ibonisiweukulawulwa kwe-glycemic ephezuluuma kuqhathaniswa nama-antidiabetic agents akhona, kufaka phakathi i-semaglutide ne-insulin degludec.

• Kusho ukunciphisa kwe-HbA1c: kuze kufike−2.4%kusukela ekuqaleni ngemva kwamasonto angu-40-52.

• Ingxenye ephezulu yabahlanganyeli ezuziweI-HbA1c <6.5%, ukuhlangabezana noma ukweqa okuhlosiwe kwe-ADA.

• Ukuthuthukiswa okuphawulekayo ekuzileni kwe-plasma glucose kanye namazinga e-postprandial glucose abonwa.

2. Ukunciphisa Isisindo

I-Tirzepatide ikhiqizwa ngokuqhubekayoukuncipha kwesisindo okunenjongo ngokomtholampilo futhi kuncike kumthamokokubili kubantu abanesifo sikashukela nabangenaso isifo sikashukela.

• Ezigulini ze-T2DM: isilinganiso sokuncipha kwesisindo somzimba sisukela ku-7-12 kg.

• Kubantu abangenaso isifo sikashukela (isilingo se-SURMOUNT-1):

  • Imithamo engu-10 mg kanye ne-15 mg iholele ekutheniI-15-22% isho ukwehla kwesisindo somzimba, uma kuqhathaniswa noma kudlule imikhawulo yokuhlinzwa kwe-bariatric.

• Iningi labahlanganyeli lizuze okungenani5–10%ukunciphisa isisindo.

3. Ukuthuthukiswa Kwe-Cardiometabolic

Ukwelashwa kwe-Tirzepatide kubuye kwathuthukisa imingcele ebanzi ye-metabolic:

• Ukuncishiswaku-triglycerides, LDL-C, kanye ne-cholesterol ephelele.

• Iyakhulaku-HDL-C.

• Okubalulekileukwehla komfutho wegazi we-systolic ne-diastolic.

• Ukuthuthukiswa kokuzwela kwe-insulin nokusebenza kwe-β-cell.

4. Ukuphepha Nokubekezeleleka

Iphrofayili yokuphepha ibihambisana nezinye izindlela zokwelapha ezisuselwa ku-incretin:

• Izimo ezingezinhle ezivame kakhulu: izimpawu ze-gastrointestinal ezimaphakathi kuya kwezimaphakathi (isicanucanu, ukuhlanza, isifo sohudo).

• Izehlakalo eziphansi ze-hypoglycemia, ikakhulukazi lapho kusetshenziswa i-insulin noma i-sulfonylureas.

• Akukho ukukhathazeka okukhulu kokuphepha okuphawulwe emiphumeleni yenhliziyo nemithambo yegazi.

5. Ukuqonda Kwemishini

I-Tirzepatide ihlukilei-agonism yama-receptor amabiliikhulisa zombili izindlela ze-GIP ne-GLP-1:

• GIP ukusebenzaithuthukisa ukukhiqizwa kwe-insulin ethembele ku-glucose futhi ingathuthukisa i-adipose tissue metabolism.

• Ukusebenza kwe-GLP-1ikhuthaza ukucindezelwa kokudla futhi ibambezele ukuphuma kwesisu.

• Yaboumphumela we-synergistickuholela ekulawulweni kwe-glucose okuthuthukisiwe ngokunciphisa isisindo okuthuthukisiwe uma kuqhathaniswa nama-ejenti wendlela eyodwa.

Isiphetho

I-Tirzepatide imele i-aukuthuthuka kwe-metabolic therapy, ukuhlinzekaukusebenza okungakaze kubonwe kukho kokubili ukulawulwa kwe-glycemic kanye nokunciphisa isisindokubantu abanesifo sikashukela sohlobo 2 kanye nokukhuluphala ngokweqile.
Indlela yayo ekabili ye-incretin ihlinzeka ngendlela edidiyelwe yokubhekana nezimbangela zokungasebenzi kahle kwe-metabolic - i-hyperglycemia, ukumelana ne-insulin, nesisindo somzimba eseqile.
Uma kubhekwa ukusebenza kwayo okuqinile kanye nephrofayili yokuphepha elawulekayo, i-tirzepatide ingase ichaze kabusha ipharadigm yokwelapha yesifo sikashukela nokuphathwa kokukhuluphala kule minyaka eyishumi ezayo.

Izithenjwa

• UFrias JP et al.,I-New England Journal of Medicine, 2021.

• Jastreboff AM et al.,I-New England Journal of Medicine, 2022 (SURMOUNT-1).

• Ludvik B et al.,I-Lancet, 2021.

• I-Eli Lilly Clinical Data, Izilingo EZINGAPHEZULU 1-5.