Glucagon-Like Peptide 1 Receptor Agonist Usage in Type 2 Diabetes in Primary Care for the UK and Beyond: A Narrative Review

Fernando, Kevin; Bain, Stephen C.; Holmes, Patrick; Jones, Philip Newland; Patel, Dipesh

doi:10.1007/s13300-021-01116-9

Cited by 9 publications

(4 citation statements)

References 79 publications

(141 reference statements)

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“…The benefits of glucose control and reduction of CV risk with GLP-1 RAs have also been proven in non-obese patients with T2D [ 16 , 21 , 37 ]. However, although the limitation by the Spanish National Health Service could affect the use of GLP-1 RAs, it may not be the major reason for the majority of patients, as other countries without the BMI limitation have similar prescription rates as Spain [ 26 , 38 , 39 ].…”

Section: Potential Reasons That Limit the Use Of Glp-1 Ras Based On T...mentioning

confidence: 99%

GLP-1 RAs in Spain: A Short Narrative Review of Their Use in Real Clinical Practice

et al. 2023

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Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are a class of drugs with potent glucoselowering activity. Additionally, some GLP-1 RAs have demonstrated cardiovascular and renal benefits. Current guidelines recommend their use in patients with type 2 diabetes (T2D) at high risk of or with established cardiovascular disease (CVD), regardless of glycaemic control, with lifestyle modification and metformin. However, several studies have recently highlighted the limited number of patients with T2D benefiting from these medications worldwide. Given the huge burden of CVD among patients with T2D, efforts should be made to bring clinical practice closer to expert guidelines. This review describes the current situation of GLP-1 RA use in Spain and the reasons behind the gap between guidelines and realworld practice and suggests possible solutions.

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Section: Potential Reasons That Limit the Use Of Glp-1 Ras Based On T...mentioning

confidence: 99%

GLP-1 RAs in Spain: A Short Narrative Review of Their Use in Real Clinical Practice

et al. 2023

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“…Glucagon-like peptide-1 (GLP-1) receptor agonists, exenatide, lixisenatide, liraglutide, dulaglutide and semaglutide, are among the recent subcutaneous treatment options that provide better glycemic improvement and weight loss in patients with type 2 diabetes according to the current guidelines (1,2).…”

Section: Introductionmentioning

confidence: 99%

The First Successful Desensitization Protocol in Exenatide Allergy: A Case Report

Yeğit

Sarıbeyliler

Karadağ

et al. 2022

Preprint

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Background: Glucagon-like peptide-1 (GLP-1) receptor agonists are important treatment options in obese patients with type 2 diabetes. To date, few immediate allergic reactions due to GLP1 analogues were reported. One report revealed that a patient with an immediate hypersensitivity reaction due to exenatide was able to tolerate liraglutide, the alternative GLP-1 receptor agonist. Since exenatide is the only available GLP-1 receptor agonist covered by insurance in our country, a drug desensitization protocol, the only therapeutic method in hypersensitivity reactions used in case of absence of an alternative drug, was considered. Here we report a successful desensitization protocol for the first time in two obese diabetic patients with an immediate hypersensitivity to exenatide. Case presentation: The first patient was a 47-year-old female. She was referred to our outpatient allergy clinic because of a generalized urticaria developed within minutes in the first week of an exenatide BID 5 mcg/20 mcl treatment. The second patient was a 46-year-old female. She had a large local immediate injection site reaction appeared in 15 minutes following an exenatide BID 5 mcg/20 mcl injection for a month. We applied desensitization with exenatide to two patients who need GLP-1 receptor agonist treatment. Protocol was completed in 7 steps in approximately 3 hours, with the aim of reaching the daily dosage of exenatide. Throughout this process, we observed that both cases tolerated the protocol without any complaints or complications. Conclusions: We present the first successful desensitization protocol to exenatide in both local and/or systemic immediate hypersensitivity reactions and indicate the importance of desensitization in patients who do not have alternative therapies.

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“…Although GLP-1RA shows advantages in reducing glucose and weight ( 12 ), adverse reactions can not be ignored. Studies have shown that the most common side effects of GLP-1RA are from the gastrointestinal tract, including nausea, vomiting, diarrhea, and constipation ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Can glucagon-like peptide-1 receptor agonists cause acute kidney injury? An analytical study based on post-marketing approval pharmacovigilance data

Dong

Sun

2022

Front. Endocrinol.

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Clinical studies after marketing have shown that the use of glucagon-like peptide-1 receptor agonist(GLP-1RA) may lead to acute kidney injury(AKI). However, few epidemiological studies have investigated the risk, clinical features, and outcomes of AKI caused by different GLP-1RA. In this study, Adverse Event Reporting System (FAERS) data were used to compare the association between different GLP-1RA and AKI in the real world.MethodsFAERS data from January 2004 to December 2021 were mined using disproportionality analysis and Bayesian analysis to determine the correlation between different GLP-1RA and AKI, and the onset time, mortality, and hospitalization rate of different GLP-1RA were analyzed.ResultsWe identified 2670 cases of AKI events associated with GLP-1RA, of which liraglutide was the most commonly reported (34.98%). The patients with AKI were mainly males (47.94%), and the age group was mainly 45-84 years old (73.15%). obese patients with weight more than 99kg (24.42%) were more likely to have AKI. According to different signal mining methods, reporting odds ratio (ROR) (1.50, 95% confidence interval =1.41-1.60) and Bayesian confidence Propagation neural network (0.57, 95% confidence interval =0.54), liraglutide was more strongly associated with AKI than other GLP-1RA. The median time to onset of AKI was 63 days [quartile range (IQR): 15-458.5 days]. In addition, the hospitalization rate and fatality rate of patients with GLP-1RA-related AKI were 45.28% and 4.23% respectively.ConclusionsBased on the data in the FAERS database, we analyzed the risk, onset time, and adverse reaction outcomes of GLP-1RA-induced AKI in detail. The results showed that liraglutide had the highest risk of AKI. From the early stage of treatment, we need to monitor patients’ renal function regularly, especially for patients with high kidney risks such as obesity and age.

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Glucagon-Like Peptide 1 Receptor Agonist Usage in Type 2 Diabetes in Primary Care for the UK and Beyond: A Narrative Review

Cited by 9 publications

References 79 publications

GLP-1 RAs in Spain: A Short Narrative Review of Their Use in Real Clinical Practice

GLP-1 RAs in Spain: A Short Narrative Review of Their Use in Real Clinical Practice

The First Successful Desensitization Protocol in Exenatide Allergy: A Case Report

Can glucagon-like peptide-1 receptor agonists cause acute kidney injury? An analytical study based on post-marketing approval pharmacovigilance data

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