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Glucagon-like peptide-1 receptor agonist

  (Redirected from GLP-1 agonist)

Glucagon-like peptide-1 receptor agonists also known as GLP-1 receptor agonists or incretin mimetics are agonists of the GLP-1 receptor. This class of drugs is used for the treatment of type 2 diabetes.[1][2] One of their advantages over older insulin secretagogues, such as sulfonylureas or meglitinides, is that they have a lower risk of causing hypoglycemia.[3]

There is some dispute over the safety profile of these drugs due to proliferative effects in the pancreas.[citation needed] Diabetes is associated with both acute pancreatitis and pancreatic cancer. While some recent studies have not found that these drugs can cause either pancreatitis or cancer,[4] a 2017 study found that recent prescription of incretins was associated with an increased risk of pancreatic cancer over non-insulin anti diabetic drugs (NIADs).[5]

Approved GLP-1 agonists:

Under investigation:[1]

These agents work by activating the GLP-1R rather than inhibiting the breakdown of GLP-1 in the case of DPP-4 inhibitors, and are generally considered more potent.[11]

As of 2017 it was unclear if they affect a person's risk of death.[12]

A JAMA article meta-analysis in 2018 (covering studies concerning GLP-1 agonists, DPP-4 inhibitors, and SGLT-2 inhibitors) showed GLP-1 agonists were associated with lower stroke risk than controls.[13]

ReferencesEdit

  1. ^ a b Baggio LL (2008). "Glucagon-like Peptide-1 Analogs Other Than Exenatide". Medscape Diabetes & Endocrinology. 
  2. ^ Ali ES, Hua J, Wilson CH, Tallis GA, Zhou FH, Rychkov GY, Barritt GJ (2016). "The glucagon-like peptide-1 analogue exendin-4 reverses impaired intracellular Ca2+ signalling in steatotic hepatocytes". BBA − Molecular Cell Research. 1863 (9): 2135–46. doi:10.1016/j.bbamcr.2016.05.006. PMID 27178543. 
  3. ^ "Standards of medical care in diabetes—2012". Diabetes Care. 35 Suppl 1: S11–63. 2012. doi:10.2337/dc12-s011. PMC 3632172 . PMID 22187469. 
  4. ^ Forsmark, CE (2016). "Incretins, Diabetes, Pancreatitis and Pancreatic Cancer: What the GI specialist needs to know". Pancreatology. 16 (1): 10–3. doi:10.1016/j.pan.2015.11.009. PMID 26795258. 
  5. ^ Schroeder, C. "Incretin Meds Like Januvia and Victoza Again Linked to Pancreatic Cancer". DrugNews. Retrieved 24 February 2018. 
  6. ^ "FDA Approves New Treatment for Type 2 Diabetes". 
  7. ^ "FDA approves Adlyxin to treat type 2 diabetes". 
  8. ^ "FDA Approves Weekly Injectable Diabetes Drug: Albiglutide". 
  9. ^ "FDA Approves Weekly Injectable Diabetes Drug: Dulaglutide". 
  10. ^ Longer Acting GLP-1 Receptor Agonists and the Potential for Improved Cardiovascular Outcomes. 2013
  11. ^ "GLP-1 Receptor Agonists vs. DPP-4 Inhibitors for Type 2 Diabetes". 
  12. ^ Liu, J; Li, L; Deng, K; Xu, C; Busse, JW; Vandvik, PO; Li, S; Guyatt, GH; Sun, X (8 June 2017). "Incretin based treatments and mortality in patients with type 2 diabetes: systematic review and meta-analysis". BMJ (Clinical research ed.). 357: j2499. doi:10.1136/bmj.j2499. PMC 5463186 . PMID 28596247. 
  13. ^ Zheng, Sean L.; Roddick, Alistair J.; Aghar-Jaffar, Rochan; Shun-Shin, Matthew J.; Francis, Darrel; Oliver, Nick; Meeran, Karim (2018-04-17). "Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes". JAMA. 319 (15). doi:10.1001/jama.2018.3024. ISSN 0098-7484.