Liraglutide – how to achieve therapeutic goals – month, year or chronic therapy? Review article

Main Article Content

Marta Walczak

Abstract

The basic principle of obesity disease treatment is a comprehensive treatment. The therapy goals should be individually selected for the patient and depend primarily on comorbidities and possible complications. Correspondingly to other chronic diseases, incl. hypertension, type 2 diabetes mellitus, chronic coronary syndromes, the strategy of obesity disease treatment should include non-pharmacological methods, pharmacotherapy and, if unsuccessful, surgery. The recommended duration of pharmacotherapy is at least 12 months. Liraglutide acts centrally on proopiomelanocortin (POMC)/CART neurons to increase satiety and reduce hunger, with a transient effect of reducing gastric emptying and thereby controlling appetite.


Among the many favourable features of liraglutide, documented and particularly important from a clinical point of view, are positive effect on carbohydrate metabolism disorders, cardioprotective effect on the reduction of the risk of cardiovascular death, infarction or non-fatal stroke, and reduction of systolic blood pressure in people with abnormal glycaemia or without it versus placebo.

Article Details

How to Cite
Walczak , M. (2022). Liraglutide – how to achieve therapeutic goals – month, year or chronic therapy?. Medycyna Faktow (J EBM), 15(2(55), 197-204. https://doi.org/10.24292/01.MF.0222.12
Section
Articles

References

1. NCD Risk Factor Collaboration (NCD-RisC) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population- based measurement studies with 19·2 million participants. Lancet. 2016; 387: 1377-96.
2. Beglinger C, Degen L. Gastrointestinal satiety signals in humans – physiologic roles for GLP-1 and PYY? Physiol Behav. 2007; 89(4): 460-4.
3. Wharton S, Lau DCW, Vallis M et al. Obesity in adults: a clinical practice guideline. CMAJ. 2020; 192(31): E875-E891.
4. Chang KT, Chen CH, Chuang HH et al. Which obesity index is the best predictor for high cardiovascular disease risk in middle-aged and elderly population? Arch Gerontol Geriatr. 2018; 78: 165-70.
5. De Lorenzo A, Soldati L, Sarlo F et al. New obesity classification criteria as a tool for bariatric surgery indication. World J Gastroenterol. 2016; 22: 681-703.
6. Bogdański P, Filipiak KJ, Kowalska I et al. Interdyscyplinarne stanowisko w sprawie rozpoznawania i leczenia otyłości. Forum Zaburzeń Metabolicznych. 2020; 11(2): 47-54.
7. Yumuk V, Tsigos C, Fried M et al. European Guidelines for Obesity Management in Adults. Obes Facts. 2015; 8: 402-24.
8. Novo-Nordisk. Product Monograph SAXENDA (access: 14.06.2022).
9. European Association for the Study of Obesity (EASO). Obesity: an underestimated threat: public perceptions of obesity in Europe. May 2015.
10. Pi-Sunyer X; SCALE Obesity and Prediabetes Investigators. Liraglutide in Weight Management. N Engl J Med. 2015; 373(18): 1781-2.
11. Drucker DJ. The biology of incretin hormones. Cell Metab. 2006; 3(3): 153-65.
12. Picciotto MR, Mineur YS. Nicotine, food intake, and activation of POMC neurons. Neuropsychopharmacology. 2013; 38: 245.
13. Secher A, Jelsing J, Baquero AF et al. The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. J Clin Invest. 2014; 124(10): 4473-88.
14. le Roux CW, Astrup A, Fujioka K et al; SCALE Obesity Prediabetes NN8022-1839 Study Group. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017; 389(10077): 1399-409.
15. Jelsing J, Vrang N, Hansen G et al. Liraglutide: short-lived effect on gastric emptying-long lasting effects on body weight. Diabetes Obes Metab. 2012; 14(6): 1-8.
16. Dong Z, Chai W, Wang W et al. Protein kinase A mediates glucagon-like peptide 1-induced nitric oxide production and muscle microvascular recruitment. Am J Physiol Endocrinol Metab. 2013; 304(2): E222-228.
17. Chen WR, Hu SY, Chen YD et al. Effects of liraglutide on left ventricular function in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am Heart J. 2015; 170(5): 845-54.
18. Margulies KB, Hernandez AF, Redfield MM et al; NHLBI Heart Failure Clinical Research Network. Effects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. JAMA. 2016; 316(5): 500-8.
19. Bistola V, Lambadiari V, Dimitriadis G et al. Possible mechanisms of direct cardiovascular impact of GLP-1 agonists and DPP4 inhibitors. Heart Fail Rev. 2018; 23(3): 377-88.
20. Zhao X, Huang K, Zheng M et al. Effect of liraglutide on blood pressure: a meta-analysis of liraglutide randomized controlled trials. BMC Endocr Disord. 2019; 4(19).
21. Pedersen SD, Manjoo P, Wharton S. Canadian Adult Obesity Clinical Practice Guidelines: Pharmacotherapy in Obesity Management (access: 14.06.2022).
22. Heffron SP, Parham JS, Pendse J et al. Treatment of Obesity in Mitigating Metabolic Risk. Circ Res. 2020; 126(11): 1646-65.
23. Drucker DJ. The Cardiovascular Biology of Glucagon-like Peptide-1. Cell Metab. 2016; 24(1): 15-30. http://doi.org/10.1016/j.cmet.2016.06.009.
24. Seferović PM, Coats AJS, Ponikowski P et al. European Society of Cardiology/Heart Failure Association position paper on the role and safety of new glucose-lowering drugs in patients with heart failure. Eur J Heart Fail. 2020; 22(2): 196-213. http://doi.org/10.1002/ejhf.1673.