Semaglutide once-weekly: improved efficacy with a new safety warning

Coon, Scott A.; Crannage, Erica F.; Kerwin, Lara C.; Guyton, Justinne

doi:10.1080/17512433.2018.1534201

Cited by 9 publications

(5 citation statements)

References 42 publications

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“…These reported deteriorations may, however, be related to early worsening of DR with rapid improvement of HbA1c [10], imbalance in baseline DR or short followup [11]. Hence further studies are needed to confirm the effects of GLP-1 agonists on retinopathy [12], in particular, if this is a group effect or related to semaglutide alone. A recent network meta-analysis found GLP-1 agonists appear to reduce the incidence and progression of nephropathy and to have no specific effect on retinopathy-with the notable exception of semaglutide, which may negatively impact the retina [13].…”

Section: Relationship With Retinopathymentioning

confidence: 99%

New anti-hyperglycaemic agents for type 2 diabetes and their effects on diabetic retinopathy

Saw

Wong

et al. 2019

Eye

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There has been an increase in the range of non-insulin anti-hyperglycaemic agents used to treat type 2 diabetes. With the globally rising rates of type 2 diabetes and complications such as diabetic retinopathy, it is important for ophthalmologists to be aware of these new agents and their impacts on diabetic retinopathy and diabetic macular oedema. We conducted a review of the literature to determine if there were any beneficial or harmful effects of the currently used anti-hyperglycaemic agents on diabetic retinopathy or diabetic macular oedema. Our review of the current literature found that apart from thiazolidinediones, anti-hyperglycaemic agents have been reported to have beneficial or neutral effects on diabetic eye complications. Thiazolidinediones (pioglitazone is the only one currently available) have been linked to incident or worsening diabetic macular oedema, although the rate is believed to be low. Glucagon-like peptide 1 (GLP1) agonists (incretins) in general are beneficial except semaglutide which is associated with increased rates of diabetic retinopathy complications. These results have implications for selection of anti-hyperglycaemic agents for patients with diabetic retinopathy or macular oedema. Further studies need to be conducted to identify if reported beneficial effects are independent of the impact of glycaemic control. Early worsening of retinopathy with tight glycaemic control should also be noted in interpretation of future studies.

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Section: Relationship With Retinopathymentioning

confidence: 99%

New anti-hyperglycaemic agents for type 2 diabetes and their effects on diabetic retinopathy

Saw

Wong

et al. 2019

Eye

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“…[113][114][115][116] Most recently, once-weekly semaglutide has been associated with an increased risk of diabetic retinopathy complications. 119 Nevertheless, patients on GLP-1 RAs should be monitored for these side effects if the clinical scenario fits. Although GLP-1 RAs do not cause hypoglycemia, all clinicians should reduce or discontinue concomitant sulphonylurea or insulin to avoid hypoglycemia.…”

Section: Effects On Skinmentioning

confidence: 99%

Effects of glucagon-like peptide 1 receptor agonists on comorbidities in older patients with diabetes mellitus

Onoviran

Smith

et al. 2019

Therapeutic Advances in Chronic Disease

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Elderly patients with diabetes are at high risk of polypharmacy because of multiple coexisting diseases and syndromes. Polypharmacy increases the risk of drug–drug and drug–disease interactions in these patients, who may already have age-related sensory and cognitive deficits; such deficits may delay timely communication of early symptoms of adverse drug events. Several glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been approved for diabetes: liraglutide, exenatide, lixisenatide, dulagluatide, semaglutide, and albiglutide. Some are also approved for treatment of obesity. The current review of literature along with clinical case discussion provides evidence supporting GLP-1 RAs as diabetes medications for polypharmacy reduction in older diabetes patients because of their multiple pleiotropic effects on comorbidities (e.g. hyperlipidemia, hypertension, and fatty liver) and syndromes (e.g. osteoporosis and sleep apnea) that commonly co-occur with diabetes. Using one medication (in this case, GLP-1 RAs) to address multiple conditions may help reduce costs, medication burden, adverse drug events, and medication nonadherence.

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“…Mindazonáltal, az óvatos adagolás inzulinnal kezelt, illetve retinopathiában szenvedő személyek esetében fokozott körültekintést és gyakoribb ellenőrzést igényel, e körülményre az amerikai Élelmiszer-és Gyógyszerellenőrzési Hivatal (FDA) a figyelmet külön is felhívta. 38,39 Áttekintésünk az egyes készítmények árával nem foglalkozik, a hangsúly kifejezetten a szakmai szempontok összefoglalása. A beadás kényelme, egyszerűsége azonban az alkalmazás tekintetében kiemelt jelentőségű.…”

Section: Táblázat a Hosszú Hatású Glp-1-ra-kkal Végzett Keringési Véunclassified

A hosszú hatású GLP-1-receptoragonisták helye a 2-es típusú diabetes kezelésében – a jelen hazai lehetőségek

Winkler¹

2019

Diabetologia Hungarica

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Az inkretin hatásmechanizmusú vércukorcsökkentők, azon belül is a glukagonszerű peptid (GLP)-1-receptoragonisták mind fontosabb szerepet töltenek be a 2-es típusú diabetes kezelésében. Hosszú hatású változataik megjelenése tovább szélesíti a terápiás eszköztárat, ugyanakkor növeli a kezelés kényelmét, s javíthatja a kezelés elfogadását. Hazai forgalmazásban ez idő szerint a napi egyszer adagolandó liraglutid, a heti egyszeri beadást igénylő exenatid heti egyszer és a dulaglutid, valamint a szemaglutid érhető el. A közlemény áttekinti e származékok főbb farmakokinetikai jellemzőit, hatékonyságuk és biztonságosságuk adatait, kitérve a kardiovaszkuláris végpontú vizsgálatokra is. Glykaemiás hatékonyságuk mellett előnyük testsúlycsökkenést elősegítő természetük, kedvező kardiovaszkuláris és renális hatásuk. Mellékhatásaik túlnyomó részben gastrointestinalis természetűek, átmenetiek és enyhék, egy vizsgálatban, néhány esetben azonban, bázisinzulint is kapó személyeken, feltehetően a gyors anyagcserejavulással összefüggésben a retinopathia progresszióját észlelték. E tekintetben további megfigyelések szükségesek. ■ Kulcsszavak: nem-prandialis hatású GLP-1-receptoragonisták, exenatid heti egyszer, albiglutid, dulaglutid, szemaglutid, hatékonyság, biztonságosság The place of long acting GLP-1 receptor agonists in the therapy of type 2 diabetes-the present possibilities in Hungary Summary: Drugs with incretin mechanism, first of all the glucagon-like peptide (GLP)-1 receptor agonists have an outstanding role in the present blood glucose lowering therapy in type 2 diabetes. Their compounds with long acting effect not only broadened the therapeutic possibilities, but also increased the convenience of treatment and could improve the seizure of parenteral therapy. At present the liraglutide, requiring daily dosage and three preparations with weekly one injection are available on the Hungarian market, the exenatide quaque weekly, the dulaglutide and the semaglutide. Main data of their pharmacokinetics, efficiency and safety are overviewd in the article, with a special focus on studies with cardiovascular endpoints. It is stressed out, that beside of the powerful glycemic efficacy their special advantage is the weight loss promoting nature and the favourable cardiorenal effects. Their adverse effects are mostly of gastrointestinal origin, in the majority mild and transitoric. In one study-likely to be associated with too fast metabolic improvement-at patients, getting also basal insulin the progression of retinopathy was observed. This needs further long-term observations.

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Semaglutide once-weekly: improved efficacy with a new safety warning

Cited by 9 publications

References 42 publications

New anti-hyperglycaemic agents for type 2 diabetes and their effects on diabetic retinopathy

New anti-hyperglycaemic agents for type 2 diabetes and their effects on diabetic retinopathy

Effects of glucagon-like peptide 1 receptor agonists on comorbidities in older patients with diabetes mellitus

A hosszú hatású GLP-1-receptoragonisták helye a 2-es típusú diabetes kezelésében – a jelen hazai lehetőségek

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