Преимущества агонистов глюкагоноподобного пептида в свете профилактики сердечно-сосудистых и почечных осложнений

Агонисты рецепторов глюкагоноподобного пептида-1 (арГПП-1) доказали свои преимущества в стойком снижении гликемии и HbA1c и достижении целевого контроля у пациентов с сахарным диабетом 2 типа (СД2) как монотерапия или в комбинации с другими лекарственными препаратами. Эти препараты также проявляют высокую эффективность в снижении массы тела как для пациентов с СД2, так и без него.

Результаты исследований говорят о потенциале арГПП-1 в снижении сердечно-сосудистых событий, особенно у пациентов с ранее имевшими атеросклеротическими заболеваниями. Хотя при низком риске сердечно-сосудистых заболеваний подобные эффекты могут быть менее очевидны.

Наличие побочных эффектов, особенно со стороны желудочно-кишечного тракта (ЖКТ), высокая стоимость и низкая доступность препаратов могут быть ограничением для их использования. Кроме того, преимущества в отношение возможной профилактики поздних осложнений СД2 внутри группы неоднородны, при наличии у пациента факторов риска преимущества могут иметь препараты с доказанным влиянием на сердечно-сосудистые и почечные исходы. Таким образом, в некоторых случаях пациентам может понадобиться смена препарата внутри данного класса. При этом важно осуществлять плавный переход между препаратами для оптимизации лечения сахарного диабета и минимизации побочных эффектов.

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