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Updated: Jun 29, 2025

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Published on: November 14, 2020
在患有与肥胖有关的心力衰竭和2型糖尿病的患者中使用塞马格卢提德
Mikhail N Kosiborod1, Mark C Petrie1, Barry A Borlaug1
1From the Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine, Kansas City (M.N.K.); the School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow (M.C.P.), the Diabetes Research Centre, University of Leicester, and the NIHR Leicester Biomedical Research Centre, Leicester (M.J.D.), and the Division of Cardiovascular Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester (F.Z.A.) - all in the United Kingdom; the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (B.A.B.); the Baylor Scott and White Research Institute, Dallas (J.B.); the Department of Medicine, University of Mississippi, Jackson (J.B.); Novo Nordisk, Søborg (G.K.H., D.V.M., M.B.T., T.J.J., K.L., M.L.L.), and the Department of Cardiology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev (M. Schou) - both in Denmark; the Department of Cardiovascular Medicine and Section on Geriatrics and Gerontology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); the Division of Cardiac Surgery, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto (S.V.), and the University of Alberta, Edmonton (J.A.E.) - both in Canada; the College of Health and Medicine, Australian National University, Canberra, ACT, Australia (W.A.); the Heart Failure Unit, Cardiology Department, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (T.B.-G.); Max Super Speciality Hospital, Saket, New Delhi, India (V.C.); the Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital-Östra, Gothenburg, Sweden (M.F.); the Department of General Internal Medicine 3, Kawasaki Medical School, Okayama, Japan (H.I.); the Department of Noninvasive Cardiology, Medical University of Lodz, Lodz, Poland (M.L.); the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (V.M.); the Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Hospital Clínico Universitario de Valencia, INCLIVA, Universidad de Valencia, and CIBER (Centro de Investigación Biomédica en Red) Cardiovascular - both in Valencia, Spain (J.N.); Instituto de Cardiologia J.F. Cabral, Corrientes, Argentina (E.P.); ASST (Azienda Socio Sanitaria Territoriale) Papa Giovanni XXIII, Bergamo, Italy (M. Senni); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore (K.S.); the Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (P.M.); the Medical University of Graz, Graz, Austria (D.V.L.); Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany (D.W.); and the Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago (S.J.S.).
在肥胖患者,2型糖尿病患者和心力衰竭患者中,塞马格卢提德显著改善了症状,减轻了体重. 这为这种复杂的患者群体提供了新的治疗选择.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
背景情况:
- 肥胖和2型糖尿病在心力衰竭中很常见,具有保存的喷射分数 (HFpEF),增加了症状负担.
- 目前,没有批准的疗法专门针对2型糖尿病患者的肥胖相关HFpEF.
研究的目的:
- 评估在患有HFpEF,肥胖和2型糖尿病的患者中塞马格卢提德的疗效.
- 评估赛马格卢提德对HFpEF症状,体重和其他相关临床结果的影响.
主要方法:
- 一项为期52周的随机试验分配了616名HFpEF,BMI≥30,2型糖尿病患者每周接受塞马格卢提德 (2.4毫克) 或安慰剂.
- 主要终点包括堪萨斯城心肌病问卷临床总结得分 (KCCQ-CSS) 和体重的变化.
- 二级终点包括6分钟步行距离的变化,主要心血管不良事件的复合和C反应性蛋白 (CRP) 水平.
主要成果:
- 与安慰剂相比,塞马格卢提德显著改善了KCCQ-CSS (13.7比6.4分) 和降低了体重 (-9.8%比-3.4%).
- 在6分钟的步行距离,层次复合终点和CRP水平方面也观察到改善,有利于semaglutide.
- 严重的不良事件在塞马格卢提德组 (17.7%) 的频率低于安慰剂组 (28.8%).
结论:
- 在肥胖和2型糖尿病患者中,塞马格卢提德在减少与HFpEF相关的症状和身体限制方面表现出显著的益处.
- 与安慰剂相比,在52周的时间内,西马格卢提德可以实现更大的体重减轻.
- 塞马格卢提德代表了一种有前途的治疗选择,用于管理2型糖尿病患者与肥胖相关的HFpEF.
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