Risultati per: Efficacia e sicurezza dei farmaci GLP-1 per il diabete di tipo 2 e l’obesità

Stroke, Volume 56, Issue Suppl_1, Page ATMP104-ATMP104, February 1, 2025. Background and Purpose:Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM). We aimed to evaluate the association of GLP-1RA use with clinical outcomes in diabetic patients admitted for acute ischemic stroke (AIS).Methods:This single-center retrospective study included diabetic patients aged ≥18 years admitted for AIS from 2015-2023. GLP-1RA use was defined as a history of taking GLP-1RA at admission or being prescribed GLP-1RA at discharge. The primary outcome was the incidence of new ischemic stroke within 1 year. Secondary outcomes included functional independence (modified Rankin Scale score 0-2) and mortality at 90 days. Propensity score weighting was used to balance covariates between groups. Logistic regression was used to estimate log odds ratios (LORs) for outcomes.Results:Of 123 patients, 35 (28%) used GLP-1RA. The GLP-1RA group had lower incidence of new ischemic stroke at 1 year (2.9% vs 6.8%; adjusted LOR -1.13, 95% CI -3.21-0.95, p=0.28) and higher rates of functional independence at 90 days (67% vs 40%; adjusted LOR 2.38, 95% CI -0.12-4.87, p=0.06) compared to the non-GLP-1RA group, but these differences were not statistically significant. Mortality at 90 days was similar between groups (25% vs 26%; adjusted LOR 0.078, 95% CI -1.51-1.67, p=0.92).Conclusions:In this cohort of diabetic patients admitted for AIS, GLP-1RA use showed trends toward reduced incidence of recurrent stroke and improved functional outcomes, although not statistically significant. Larger prospective studies are needed to further evaluate the potential neuroprotective effects of GLP-1RAs in ischemic stroke.

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Objectives
The response to glucagon-like peptide-1 (GLP-1) analogues for weight loss varies significantly. We investigated the anthropometric, demographic and clinical characteristics associated with total body weight loss (TBWL) from subcutaneous GLP-1 analogue therapy in patients with obesity in a real-world setting.

Design
Retrospective cohort analysis.

Setting
An urban, multidisciplinary obesity community clinic in Vancouver, Canada, from November 2018 to April 2021.

Participants
483 adults with a body mass index (BMI) of greater double equals30 kg/m2 who had filled a new prescription for subcutaneous semaglutide or liraglutide, with at least 6-month follow-up, were included (mean follow-up: 17.3 months). Individuals with prior bariatric surgery were excluded.

Outcomes
The primary outcome was the %TBWL over a mean follow-up period of 520 days. Participant’s TWBL was categorised as non-response (15% TBWL).

Results
The average %TBWL in the cohort was 12.2%. Among the participants, 17.8% had a non-response, 48.4% had a moderate response and 33.8% had a hyper-response. In the multivariable regression analysis, being a woman was associated with hyper-response (adjusted OR 1.92, CI 1.01 to 3.65, p=0.048). Age, diabetes status, baseline BMI, being sedentary, anxiety and depression were not independently associated with TBWL in response to GLP-1 analogue therapy.

Conclusions
In a real-world setting, female sex was found to be associated with a hyper-response to GLP-1 analogue therapy for obesity management. Other clinical factors evaluated, including diabetes status, were not associated with the response. Future research should assess additional variables and support the development of novel biomarkers that are associated with weight loss response.

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Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Volume 178, Issue 2, February 2025.