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用类似葡萄糖素的-1激动剂治疗2-3类肥胖症:为期2年的现实世界队列研究
Mona Abdel-Bary1, Andrea Brody1, Jenna Schmitt1
1Department of Medicine, Medical Weight Loss Program, Allina Health System, Minneapolis, Minnesota, USA.
Diabetes, obesity & metabolism
|March 19, 2025
概括
葡萄糖类1受体激动剂 (GLP1RA) 的现实世界使用表明,近一半的患者在两年内停止治疗. 那些继续服用GLP1RA的人实现了显著的体重减轻,与那些停止或从未开始服用药物的人不同.
科学领域:
- 药理学和内分泌学 药理学和内分泌学
- 肥胖医学 肥胖医学
- 现实世界 证据研究 实证研究
背景情况:
- 类似葡萄糖类1受体激动剂 (GLP1RA) 在对肥胖的临床试验中显示出高疗效.
- 可访问性和合规性问题对GLP1RA在常规临床实践中的有效性构成重大挑战.
- 了解现实世界减肥结果对于优化肥胖治疗策略至关重要.
研究的目的:
- 量化可访问性和合规性障碍对GLP1RAs长期减肥疗效在现实环境中的影响.
- 为了比较继续,停止或从未开始GLP1RA治疗的患者之间的减肥结果.
- 确定GLP1RA在患有2-3级肥胖症的患者中停药的常见原因.
主要方法:
- 追溯队列研究分析了从2020年1月到2022年11月的数据.
- 在一个大型中西部医疗保健系统中,包括853名为2-3级肥胖症的GLP1RA处方患者.
- 测量的主要结果:两年总体重减轻百分比 (TWL%).
主要成果:
- 在研究期间,GLP1RA的处方量增加了六倍.
- 24.7%的患者从未接受过该药物,35.6%在两年内停止使用.
- 常见的停用原因:失去后续 (26.6%),副作用 (23.7%) 和保险停止 (21.4%).
- 继续服用GLP1RA的患者比停止或从未开始服用的患者减肥显著增加 (3.98%-5.82%的差异).
- 连续使用者的平均两年TWL%为9.22% (SD 9.73%),低于临床试验数据.
结论:
- 在接受GLP1RA治疗的患者中,近一半在两年内停止治疗.
- 停药导致减肥结果类似于从未开始服用药物.
- 持续使用GLP1RA的真实体重减轻比临床试验中先前报告的要低,突出了坚持和获取的影响.
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