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Updated: Sep 9, 2025

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Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
347
統合失調症,糖尿病前症,肥満の抗精神病薬治療患者におけるセマグルチド治療:HISTORIによるランダム化臨床試験
Ashok A Ganeshalingam1,2,3, Nicolai Uhrenholt2,4,5,6, Sidse Arnfred6,7
1Department of Endocrinology, Odense University Hospital, Odense, Denmark.
JAMA psychiatry
|September 3, 2025
まとめ
セマグルチドは,統合失調症と糖尿病前の成人におけるHbA1cと体重を有意に低下させた. 精神的健康に悪影響を及ぼさず 生活の質を向上させ 有望な治療法となりました
科学分野:
- 代謝精神科
- 薬理学的介入
- 統合失調症の治療法
背景:
- 統合失調症の患者は 心血管疾患と2型糖尿病により 寿命が短縮され 2代目の抗精神病薬 (SGA) によって悪化することが多い
- 統合失調症におけるこれらの併発症に対する現在の介入の有効性は限られている.
研究 の 目的:
- 統合失調症,糖尿病前期,SGAで治療された過体重/肥満の成人における,グルカゴン型のペプチド-1受容体アゴニストであるセマグルチドの効果を評価する.
- 血糖コントロール,体重,統合失調症の症状,生活の質の変化を評価する.
主な方法:
- 統合失調症,糖尿病前期,BMI ≥27の成人患者154人を対象とした30週間のプラセボ対照,ダブルブラインドランダム化臨床試験.
- 参加者は,週に1回,皮下セマグルチド (週1. 0mg) またはプラセボを投与された.
- 主なアウトカムは,グリコシル化ヘモグロビンA1c (HbA1c) の変化であり,次要アウトカムは,体重,陽性・陰性症候群スケール (PANSS- 6) のスコア,およびショートフォーム調査 (SF- 36v2) のスコアであった.
主要な成果:
- セマグルチドは,プラセボと比較してHbA1cを0. 46%,体重を9. 21kg大幅に低下させた.
- セマグルチドを投与した患者の81%がHbA1cを5. 7%以下で達成し,プラセボを投与した患者の19% (P < . 001) であった.
- 精神的生活の質や統合失調症の症状の有意な変化は認められなかった. 胃腸の副作用はセマグルチドでより頻繁に見られました.
結論:
- セマグルチドは,統合失調症,糖尿病前期,肥満患者の血糖コントロールを改善し,体重を減らすための安全で効果的な治療法です.
- 精神疾患の症状を悪化させずに 身体的な生活の質の改善が示されました
- セマグルチドは,この患者集団における代謝併発症に対処するための潜在的な治療法です.
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