المؤلفون: Scheen, André

المصدر: Médecine des Maladies Métaboliques, 15 (8), 734 - 743 (2021)

مصطلحات موضوعية: Anorectic drugs, Gastrointestinal peptides, Glucagon-like peptide-1, Obesity, Pharmacotherapy, Safety, antiobesity agent, gastrointestinal hormone, glucagon like peptide 1 receptor agonist, glucagon receptor agonist, hormone receptor stimulating agent, liraglutide, semaglutide, body weight loss, chronic disease, drug safety, drug tolerance, human, hypertension, non insulin dependent diabetes mellitus, obesity, Short Survey, Human health sciences, Pharmacy, pharmacology & toxicology, Sciences de la santé humaine, Pharmacie, pharmacologie & toxicologie

الوصف: Both physicians and patients dream of an efficacious and safe pharmacological approach to treat obesity. Unfortunately, most anti-obesity drugs prescribed since the fifties have been associated with an unfavourable risk profile that led to numerous withdrawals during the last 25 years. Medications from pharmaco-chemistry that mainly target brain amines to reduce appetite have been abandoned because of potential cardiovascular and neuropsychiatric toxicities. More recently, biological medications emerged, in particular the glucagon-like peptide-1 (GLP-1) receptor agonist alone, such as those already on the market (liraglutide, semaglutide) or as co-agonists, combined with agonists of receptors of glucose-dependent insulinotropic polypeptide (GIP) and/or glucagon, currently in development. Whatever the drug considered, it must meet three main criteria: to support but not to replace life-style measures, to allow sufficient weight loss and to maintain this beneficial weight loss over the long term, and to be able to be administered as a safe and sustainable therapy, if obesity is considered to be a chronic disease. Because of the complexity of the pathophysiology of obesity, various combined therapies with complementary mechanisms of action would most probably be necessary to obtain a sufficient efficacy, as in type 2 diabetes and arterial hypertension. However, their tolerance and safety profile will still have to be acceptable! © 2021 Elsevier Masson SAS

العلاقة: urn:issn:1957-2557; urn:issn:2214-8477

الوصول الحر: https://orbi.uliege.be/handle/2268/300339Test

المؤلفون: Scheen, André

المصدر: Médecine des Maladies Métaboliques, 16 (4), 336 - 342 (2022)

مصطلحات موضوعية: Amputation, DPP-4 inhibitor, Gliflozin, GLP-1, Peripheral arteriopathy, Type 2 diabetes, dipeptidyl peptidase IV inhibitor, glucagon like peptide 1 receptor agonist, placebo, sodium glucose cotransporter 2 inhibitor, Article, drug safety, fear, human, leg amputation, non insulin dependent diabetes mellitus, pharmacovigilance, randomized controlled trial (topic), risk, risk reduction, Human health sciences, Endocrinology, metabolism & nutrition, Pharmacy, pharmacology & toxicology, Sciences de la santé humaine, Endocrinologie, métabolisme & nutrition, Pharmacie, pharmacologie & toxicologie

الوصف: For the last five years, a potential increased risk of lower-limb amputation (LLA) among patients with type 2 diabetes treated with sodium-glucose cotransporter type 2 inhibitors (SGLT2is) has been a matter of debate. The present article traces the history of this controversy since the landmark publication of CANVAS until the last observational studies in real life. Despite the warnings that emerged from pharmacovigilance reports, neither prospective randomized placebo-controlled trials nor large cohort retrospective observational studies vs. dipeptidyl peptidase-4 inhibitors were able to demonstrate a significant increased risk of LLA among new SGLT2i users. The higher incidence of LLA when compared to glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which is commonly interpreted as an increased risk associated with SGLT2is, might rather reflect a reduction of the risk of LLA with GLP-1 ARs. Overall, available data regarding the risk of LLA with SGLT2is should reassure clinicians, even if some circumstances should call for caution. © 2022 Elsevier Masson SAS

العلاقة: urn:issn:1957-2557; urn:issn:2214-8477

الوصول الحر: https://orbi.uliege.be/handle/2268/300354Test

المؤلفون: Scheen, André

المصدر: Médecine des Maladies Métaboliques, 16 (3), 264 - 270 (2022)

مصطلحات موضوعية: DPP-4 inhibitor, Elderly, Gliflozin, Gliptin, SGLT2 inhibitor, Type 2 diabetes, dipeptidyl peptidase IV inhibitor, glucose, sodium glucose cotransporter 2 inhibitor, Article, cardiovascular risk, chronic kidney failure, diabetes control, drug choice, drug safety, drug tolerability, glycemic control, human, major adverse cardiac event, non insulin dependent diabetes mellitus, risk reduction, Human health sciences, Endocrinology, metabolism & nutrition, Pharmacy, pharmacology & toxicology, Sciences de la santé humaine, Endocrinologie, métabolisme & nutrition, Pharmacie, pharmacologie & toxicologie

الوصف: After failure of metformin monotherapy, both dipeptidyl peptidase-4 inhibitors (gliptins) and sodium-glucose cotransporter type 2 inhibitors (gliflozins) offer a valuable alternative to sulfonylureas, especially in older patients at risk of hypoglycemia. The choice may be guided by the different properties of the two pharmacological classes, as well as by the individual patient's characteristics. Gliptins have an excellent tolerance/safety profile, a major advantage among older fragile patients, including those with advanced renal disease. However, they do not offer other benefits besides improving glucose control. On the contrary, gliflozins target different risk factors beyond correction of hyperglycemia. Furthermore, they have proven their ability to reduce major adverse cardiovascular events, especially heart failure, as well as the progression of chronic kidney disease. However, gliflozins have a less favourable tolerance/safety profile compared to that of gliptins. Obviously, the therapy of patients with type 2 diabetes should be personalized, especially in older people. © 2021 Elsevier Masson SAS

العلاقة: urn:issn:1957-2557; urn:issn:2214-8477

الوصول الحر: https://orbi.uliege.be/handle/2268/300347Test