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肠促胰素类药物在减重中的临床应用及新药研究进展OA

Clinical application of incretin-based drugs in weight reduction and research progress of novel agents

中文摘要英文摘要

肠促胰素类药物通过模拟或增强内源性肠促胰素信号,在体重管理和代谢疾病治疗中展现出重要临床价值.该类药物主要靶向胰高血糖素样肽-1受体、葡萄糖依赖性促胰岛素释放多肽受体及胰高血糖素受体等,经由中枢摄食调控、胃肠功能调节及外周代谢调节等多重机制发挥减重作用,并进一步改善血糖、血脂、脂肪肝及心肾代谢.本文以肠促胰素类药物为研究核心,重点梳理国内已上市及在研候选药物在减重领域的临床应用要点与相关研究进展.现有证据表明,司美格鲁肽、替尔泊肽减重幅度显著,兼具多重代谢获益;以玛仕度肽、埃诺格鲁肽等为代表的国产创新药物亦展现出良好的减重效果与安全性.在安全性方面,该类药物整体耐受性良好,常见不良反应主要为轻中度胃肠道反应,需关注胆囊事件、胰腺炎及情绪变化等潜在风险.儿童和青少年、老年人及妊娠期妇女等特殊人群用药需个体化评估.未来研究应聚焦于疗效预测生物标志物的筛选、长效口服制剂的开发及长期安全性随访数据的积累.

Incretin-based drugs have demonstrated significant clinical value in weight management and the treatment of metabolic diseases by mimicking or enhancing endogenous incretin signaling.These agents primarily target multiple receptors including glucagon-like peptide-1,glucose-dependent insulinotropic polypeptide,and glucagon,exerting weight-reducing effects through multiple mechanisms such as central appetite regulation,gastrointestinal function modulation,and peripheral metabolic improvement,while further ameliorating blood glucose,blood lipids,fatty liver,and cardiorenal metabolic risks.This review focuses on incretin-based drugs,systematically summarizing the key clinical application points and relevant research progress of domestically marketed and investigational candidate drugs in the field of weight reduction.Available evidence indicates that semaglutide and tirzepatide demonstrate substantial weight reduction with multiple metabolic benefits;domestic innovative drugs represented by mazdutide and ecnoglutide also exhibit favorable weight-reducing effects and safety profiles.Regarding safety,these agents are generally well-tolerated,with the most common adverse reactions being mild-to-moderate gastrointestinal events,while potential risks including gallbladder events,pancreatitis,and mood changes require attention.In special populations,individualized assessment is warranted for use in children,elderly people,and pregnant women.Future research should focus on the screening of predictive biomarkers for efficacy,the development of long-acting oral formulations,and the accumulation of long-term safety follow-up data.

罗成思;高蕊;朱艳娇;吴希超;何帅;宋智颖;李安安;周芃霖;李妍

山东第一医科大学第一附属医院(山东省千佛山医院)药学部/山东省儿童药物临床评价与研发工程技术研究中心/山东省医药卫生临床药学重点实验室,济南 250014山东第一医科大学第一附属医院(山东省千佛山医院)药学部/山东省儿童药物临床评价与研发工程技术研究中心/山东省医药卫生临床药学重点实验室,济南 250014山东第一医科大学第一附属医院(山东省千佛山医院)药学部/山东省儿童药物临床评价与研发工程技术研究中心/山东省医药卫生临床药学重点实验室,济南 250014山东中医药大学药学院,济南 250355山东中医药大学药学院,济南 250355山东中医药大学药学院,济南 250355山东中医药大学药学院,济南 250355山东中医药大学药学院,济南 250355山东第一医科大学第一附属医院(山东省千佛山医院)药学部/山东省儿童药物临床评价与研发工程技术研究中心/山东省医药卫生临床药学重点实验室,济南 250014

医药卫生

肠促胰素类药物减重肥胖症代谢性疾病

incretin-based drugsweight reductionobesitymetabolic diseases

《中国药房》 2026 (16)

2202-2207,6

山东省药品临床综合评价项目(No.2024YZ002)

10.6039/j.issn.1001-0408.2026.16.21

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