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Beyond glycemic control: clinical cardiovascular effects of tirzepatide-a narrative review.
Therapeutic advances in endocrinology and metabolism · Beyond glycemic control: clinical cardiovascular effects of tirzepatide-a narrative review.
tirzepatide 作為首款雙重 GIP/GLP-1 受體促效劑,不僅顯著改善血糖與體重,更透過多重機制降低心血管風險因子,並顯示改善心衰與內皮功能的潛力,是目前最具轉化價值的心代謝藥物。
P2型糖尿病與肥胖患者
Itirzepatide 治療
C安慰劑或標準療療
O血糖控制、體重減少、收縮/舒張血壓下降、血脂改善、內皮功能提升、炎症生物標誌物標誌物下降、心衰症狀改善
Orforglipron for the treatment of moderate-to-severe obstructive sleep apnea in adults with obesity or overweight: Study design and baseline characteristics of ATTAIN-OSA, a phase 3 trial.
Contemporary clinical trials communications · Orforglipron for the treatment of moderate-to-severe obstructive sleep apnea in adults with obesity or overweight: Study design and baseline characteristics of ATTAIN-OSA, a phase 3 trial.
首次評估口服 GLP-1 受體促效劑 orforglipron 在肥胖伴中至重度阻塞性睡眠呼吸中止症患者中的療效,若成功將提供非注射、便利的替代方案,解決 PAP 依從性低的問題。
P肥胖或超重伴中至重度 OSA 成人
Ionce-daily oral orforglipron (12, 24, 或 36 mg)
C安慰劑
OWeek 52 時 AHI 變化、睡眠相關 hypoxic burden、患者報告結果、hs-CRP、體重變化
Cost-effectiveness of tirzepatide versus semaglutide for patients with obesity or overweight in the US: evidence from the SURMOUNT-5 head-to-head phase-3 trial.
Journal of medical economics · Cost-effectiveness of tirzepatide versus semaglutide for patients with obesity or overweight in the US: evidence from the SURMOUNT-5 head-to-head phase-3 trial.
基於頭對頭第 III 期 SURMOUNT-5 試驗數據的模型顯示,tirzepatide 在美國社會視角下比 semaglutide 更具成本效益,每位患者可節省 $41,688 並獲得額外 0.506 QALY。
P肥胖或超重伴 ≥1 種肥胖相關併發症成人(無 2型糖尿病)
Itirzepatide (MTD) + 食療與運動
Csemaglutide (MTD) + 食療與運動
O增量成本效益比 (ICER)、每位患者成本節省、QALY 得增、2型糖尿病與心血管疾病發生率降低
Effect of Medications for Type 2 Diabetes on Cardiovascular Events and Mortality: A Comprehensive Pairwise and Network Meta-Analysis.
Diabetes, obesity & metabolism · Effect of Medications for Type 2 Diabetes on Cardiovascular Events and Mortality: A Comprehensive Pairwise and Network Meta-Analysis.
網羅 93 項 RCT 的網狀分析證實,GLP-1 受體促效劑、SGLT2 抑制劑與 tirzepatide 顯著降低 MACE 與全因死亡率,其中 tirzepatide 對 mortality 的獲益尤為顯著 (OR 0.72)。
P2型糖尿病患者
IGLP-1 RA、SGLT2i、tirzepatide 等降血糖藥物
C安慰劑或有效對照藥物
O主要不良心血管事件 (MACE)、全因死亡率
Tirzepatide and SGLT2 Inhibitors for Heart Failure With Preserved Ejection Fraction and Obesity: Entering a New Cardiometabolic Therapeutic Era.
Endocrinology, diabetes & metabolism · Tirzepatide and SGLT2 Inhibitors for Heart Failure With Preserved Ejection Fraction and Obesity: Entering a New Cardiometabolic Therapeutic Era.
tirzepatide 在 SUMMIT 試驗中顯著減重 >20%、減少心臟周圍脂肪組織並改善生活品質評分,與 SGLT2i 互補作用於心腎腫軸,提示其在肥胖相關 HFpEF 中的巨大潛力。
P肥併伴 HFpEF 患者
Itirzepatide 與 SGLT2 抑制劑
C標準療療或安慰劑
O體重變化、心臟周圍/心外脂肪組織減少、KCCQ 評分改善、心衰住院率
📚其他值得關注的文獻
Outpatient Dispensing Patterns and Changes in Tirzepatide Strength Mix in Japan: A Study Using the National Open Claims Data.
Cureus
日本門診 tirzeparatide 使用量快速成長,86.2% 為門診外配藥,顯示其在真實世界中的廣泛採用與給藥模式穩定擴散。
Glucagon-like peptide-1 receptor agonists in pediatrics: The pancreatology perspective.
Journal of pediatric gastroenterology and nutrition
探討 GLP-1 受體促效劑在兒童中的應用,聚焦胰腺相關風險與代謝益處,但缺乏摘要限制深度解析。
Early changes in renal function do not appear to mediate cardiovascular risk with dapagliflozin plus semaglutide: a real-world observational hypothesis-generating cohort study.
Expert review of cardiovascular therapy
真實世界數據顯示,dapagliflozin 加 semaglutide 的早期 eGFR 變化不介導其對心衰/心肌梗塞的影響,提示雙藥物心腎獲益可能經獨立路徑發揮作用。
The emerging role of glucagon-like peptide-1 receptor agonists in idiopathic intracranial hypertension: Therapeutic potential and challenges.
Indian journal of ophthalmology
GLP-1 受體促效劑透過顯著減重降低顱內壓,並可能直接影響腦脊髓液生成,為特發性腦內高壓提供新療法選項,但成本與長期數據尚待確認。
Investigating the Incremental Cost and Utilization Burden of Obstructive Sleep Apnea in Overweight to Severely Obese Patients.
Diabetes, obesity & metabolism
合併 OSA 的肥胖患者額外醫療成本顯著增加,即使長期使用 GLP-1 RA 也不免此負擔,顯示需同時治療基礎疾病與共病。
Weekly Glucagon-Like Peptide-1 Receptor Agonists in Type 1 Diabetes: What We Know So Far and Future Trials.
Endocrinology and metabolism clinics of North America
週一次 GLP-1 受體促效劑作為 1型糖尿病的輔助療法,雖未獲核准,但顯示潛在益處於血糖控制與體重管理,需更多試驗證實。
Oral GLP-1RA TERN-601 for Adults With Obesity/Overweight: Placebo-Controlled, Multiple-Ascending-Dose, Phase 1 and 2 Studies.
Obesity (Silver Spring, Md.)
口服小分子 GLP-1 受體促效劑 TERN-601 顯示劑量依賴減重,但肝毒性訊號導致臨床開發終止,提醒口服製劑開發需兼顧疗效與安全。
Nutritional considerations for glucagon-like peptide-based therapies: An Asian Indian consensus recommendation.
Obesity pillars
為亞洲印度人使用 GLP-based 療法提供結構化營養支援共識,強調早期評估、均衡飲食與肌肉維持,以預防營養不良與代謝彈回。
Bivalent gambogic acid-functionalized curcumin nanoparticles with insulin modulate the gut-liver-kidney network in type 2 diabetes.
Journal of controlled release : official journal of the Controlled Release Society
納米藥物結合胰島素調節腸-肝-腎網路,改善葡萄糖穩定性與內分泌訊號,同時抑制炎症與腎纖維化,提供雙性別微生物修復的新機制。
Enhancing economic modelling in obesity: integrating novel type 2 diabetes progression & obstructive sleep apnea remission - a UK case study.
Journal of medical economics
更新英國肥胖健經模型,納入 SURMOUNT 試驗證據與 OSA 緩解模型,顯著改善成本效益估計與模型效率,支持 tirzepatide 的長期價值。
SURPASS-CVOT and the Emerging Biology of Cardiometabolic Benefit.
Diabetes, obesity & metabolism
探討 SURPASS-CVOT 試驗設計與 tirzepatide 心代謝獲益的新興生物學基礎,但缺乏摘要限制資訊密度。
Design of a metabolically-stable peptide therapeutic with triple-hormone-receptor agonist activity.
Journal of computer-aided molecular design
利用計算機輔助設計穩定的三重激肽(GLP-1、GIP、GCG)受體促效劑,預示未來口服低劑量製劑與減少胃腸副作用的可能。
Cost-effectiveness of tirzepatide versus semaglutide for patients with obesity or overweight in the US: evidence from the SURMOUNT-5 head-to-head phase-3 trial.
Journal of medical economics
基於頭對頭第 III 期 SURMOUNT-5 試驗數據的模型顯示,tirzepatide 在美國社會視角下比 semaglutide 更具成本效益,每位患者可節省 $41,688 並獲得額外 0.506 QALY。
Cardio-Protective Effect of GLP-1 Agonists in OSA Patients: A Study of Cardiovascular Risk.
Laryngoscope investigative otolaryngology
GLP-1 受體促效劑在未使用 CPAP 的 OSA 患者中顯著降低心肌梗塞、心衰、心跳停止等心血管風險,顯示其獨特心血管保護潛力,超越傳統呼吸治療。
40-Week Repeat-Dose Toxicity, Toxicokinetics, and Immunogenicity of Efsubaglutide Alfa Following Subcutaneous Administration in Cynomolgus Monkeys.
Regulatory toxicology and pharmacology : RTP
新長效 GLP-1 受體促效劑 efsubaglutide alfa 在食盧猴中顯示良好安全性與代謝穩定性,無嚴重毒性,支持其進入臨床開發階段。
GLP-1 agonists for smoking cessation and post-cessation weight management: A systematic review and meta-analysis of randomized trials.
Tobacco induced diseases
GLP-1 受體促效劑對戒煙成功率無顯著影響,但可顯著減少戒煙後體重增加 (平均減 4.14 kg),提示其在體重管理中的輔助價值。
Tirzepatide and SGLT2 Inhibitors for Heart Failure With Preserved Ejection Fraction and Obesity: Entering a New Cardiometabolic Therapeutic Era.
Endocrinology, diabetes & metabolism
tirzepatide 在 SUMMIT 試驗中顯著減重 >20%、減少心臟周圍脂肪組織並改善生活品質評分,與 SGLT2i 互補作用於心腎腫軸,提示其在肥胖相關 HFpEF 中的巨大潛力。
First-in-Human Study of a Long-Acting GLP-1 Receptor Agonist (TE-8105) in Overweight or Obese Adults Without Type 2 Diabetes Mellitus.
Journal of clinical pharmacology
長效 GLP-1 受體促效劑 TE-8105 在超重/肥胖無糖尿病成人中顯示可接受安全性與適度減重 (平均 2.06%),半長約 120 小時,支持低頻給藥潛力。
Prescription Sequence Symmetry Analysis of Glucagon-Like Peptide-1 Receptor Agonists and Neuropsychiatric Conditions.
Clinical pharmacology and therapeutics
真實世界處方序列分析發現 GLP-1 RA 使用與後續抗憂鬱藥物及物質使用障礙藥物啟用呈負相關,提示其可能具備穩定情緒的間接益處。
Efficacy and safety of once-weekly subcutaneous zenagamtide, a novel unimolecular GLP-1 and amylin receptor agonist, in type 2 diabetes: a multicentre, randomised, parallel, double-blind, placebo-controlled, dose-finding, phase 2 trial.
Lancet (London, England)
雙週給藥的 zenagamtide (GLP-1/amylin/calcitonin 三受體激肽) 在 2型糖尿病中顯示劑量依賴降 HbA1c 與減重潛力,為新一代週用注射藥物提供早期證據。
Sodium-Glucose Cotransporter-Inhibitors, Incretin Receptor Agonists (Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists), and Finerenone for Kidney Protection in Type 1 Diabetes.
Endocrinology and metabolism clinics of North America
探討 SGLT2 抑制劑、GLP-1 受體促效劑與 finerenone 在 1型糖尿病腎保護中的聯合潛力,強調多靶點介入對抗糖尿病腎病的必要性。
Cardiovascular Effects of Glucagon Receptor Signaling Alone and Combined With Glucagon-Like Peptide-1 Receptor Signaling in Multiagonists: A Narrative Review With a Translational Focus.
Journal of the American Heart Association
雙重激肽藥物(如 mazduitide、survodutide)透過同時激活 glucagon 與 GLP-1 受體,可能改善血糖與血壓,但需警惕心律與 QT 延長風險,未來試驗有待澄清淨獲益。
Real-World Effectiveness and Safety of Finerenone in People With Type 2 Diabetes and Chronic Kidney Disease: A Spanish Multicentre Retrospective Observational Study (MEDFINE-RWD).
Diabetes, obesity & metabolism
在真實世界中,finerenone 在 2型糖尿病與 CKD 患者中尿蛋白減少 34.5%,高依附率與良好安全性支持其在併用 SGLT2i/GLP-1 RA 基礎上的腎保護價值。
Therapeutic potential of GLP-1 receptor agonists and SGLT2 inhibitors in diabetic neuropathy: a critical appraisal.
Diabetology & metabolic syndrome
儘管前臨床證據支持 GLP-1 RA 與 SGLT2i 對糖尿病神經病變的潛在療效,但臨床試驗資料仍缺乏,真實世界應用亦見高非反應率,需更多長期 RCT 證實其病 modificatory 作用。
Spending and Affordability of Glucagon-Like Peptide-1 Receptor Agonists and Other Incretin Mimetics in the United States, 2013-2023.
Journal of general internal medicine
美國 GLP-1 藥物總支出近十年增近 15 倍,高自付費負擔集中於無保險與低收入群體,凸顯 affordability 為長期使用的關鍵障礙。