Incretin-based therapies for the treatment of obesity-related diseases

Abstract Obesity-related disability-adjusted life years (DALYs) are expected to increase by approximately 40% from 2020 to 2030. DALYs and mortality related to obesity are the consequence of multiple comorbidities such as cardiovascular (i.e., heart failure) and metabolic diseases (i.e. type 2 diabe...

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Main Authors: Irene Caruso, Angelo Cignarelli, Gian Pio Sorice, Sebastio Perrini, Francesco Giorgino
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:npj Metabolic Health and Disease
Online Access:https://doi.org/10.1038/s44324-024-00030-5
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author Irene Caruso
Angelo Cignarelli
Gian Pio Sorice
Sebastio Perrini
Francesco Giorgino
author_facet Irene Caruso
Angelo Cignarelli
Gian Pio Sorice
Sebastio Perrini
Francesco Giorgino
author_sort Irene Caruso
collection DOAJ
description Abstract Obesity-related disability-adjusted life years (DALYs) are expected to increase by approximately 40% from 2020 to 2030. DALYs and mortality related to obesity are the consequence of multiple comorbidities such as cardiovascular (i.e., heart failure) and metabolic diseases (i.e. type 2 diabetes [T2D], metabolic dysfunction-associated steatotic liver disease [MASLD]). Lifestyle interventions represent the foundation of obesity treatment, yet an escalation to pharmacological and/or surgical interventions is often needed. Liraglutide, semaglutide and tirzepatide are incretin-based therapies currently approved by FDA for the management of obesity, while triple GIPR/GCGR/GLP-1R agonist retatrutide (LY3437943), the cagrilintide/semaglutide (CagriSema) 2.4 mg combination, high-dose oral semaglutide, and oral orforglipron are in advanced stages of development. Incretin-based therapies have been associated with a body weight (BW) reduction of ≥5% in at least half of patients in most randomized controlled trials (RCT) and real-world studies (RWS). Semaglutide and tirzepatide have also displayed a mean 60–69% 10-years relative risk reduction of T2D development. In line with evidence accrued in patients with T2D, incretin-based therapies produced a favorable effect on traditional cardiovascular risk factors, such as lipids and blood pressure, and even reduced the risk of major cardiovascular events and heart failure-related events in individuals with obesity, as recently demonstrated for the first time in the SELECT trial with semaglutide 2.4 mg once-weekly. Moreover, incretin-based therapies have also been proven beneficial on obesity-related comorbidities, such as knee osteoarthritis (KOA), obstructive sleep apnea (OSA) syndrome, and MASLD. Further research is needed to improve our understanding of their effects on obesity-related comorbidities and the underlying mechanism, whether involving direct effects on target tissues or mediated by improvement in BW, glucose levels and other CV risk factors.
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spelling doaj-art-d1f4ab30aaa242b8bee0b4447d64d0752024-11-10T12:06:27ZengNature Portfolionpj Metabolic Health and Disease2948-28282024-11-012111410.1038/s44324-024-00030-5Incretin-based therapies for the treatment of obesity-related diseasesIrene Caruso0Angelo Cignarelli1Gian Pio Sorice2Sebastio Perrini3Francesco Giorgino4Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo MoroDepartment of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo MoroDepartment of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo MoroDepartment of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo MoroDepartment of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo MoroAbstract Obesity-related disability-adjusted life years (DALYs) are expected to increase by approximately 40% from 2020 to 2030. DALYs and mortality related to obesity are the consequence of multiple comorbidities such as cardiovascular (i.e., heart failure) and metabolic diseases (i.e. type 2 diabetes [T2D], metabolic dysfunction-associated steatotic liver disease [MASLD]). Lifestyle interventions represent the foundation of obesity treatment, yet an escalation to pharmacological and/or surgical interventions is often needed. Liraglutide, semaglutide and tirzepatide are incretin-based therapies currently approved by FDA for the management of obesity, while triple GIPR/GCGR/GLP-1R agonist retatrutide (LY3437943), the cagrilintide/semaglutide (CagriSema) 2.4 mg combination, high-dose oral semaglutide, and oral orforglipron are in advanced stages of development. Incretin-based therapies have been associated with a body weight (BW) reduction of ≥5% in at least half of patients in most randomized controlled trials (RCT) and real-world studies (RWS). Semaglutide and tirzepatide have also displayed a mean 60–69% 10-years relative risk reduction of T2D development. In line with evidence accrued in patients with T2D, incretin-based therapies produced a favorable effect on traditional cardiovascular risk factors, such as lipids and blood pressure, and even reduced the risk of major cardiovascular events and heart failure-related events in individuals with obesity, as recently demonstrated for the first time in the SELECT trial with semaglutide 2.4 mg once-weekly. Moreover, incretin-based therapies have also been proven beneficial on obesity-related comorbidities, such as knee osteoarthritis (KOA), obstructive sleep apnea (OSA) syndrome, and MASLD. Further research is needed to improve our understanding of their effects on obesity-related comorbidities and the underlying mechanism, whether involving direct effects on target tissues or mediated by improvement in BW, glucose levels and other CV risk factors.https://doi.org/10.1038/s44324-024-00030-5
spellingShingle Irene Caruso
Angelo Cignarelli
Gian Pio Sorice
Sebastio Perrini
Francesco Giorgino
Incretin-based therapies for the treatment of obesity-related diseases
npj Metabolic Health and Disease
title Incretin-based therapies for the treatment of obesity-related diseases
title_full Incretin-based therapies for the treatment of obesity-related diseases
title_fullStr Incretin-based therapies for the treatment of obesity-related diseases
title_full_unstemmed Incretin-based therapies for the treatment of obesity-related diseases
title_short Incretin-based therapies for the treatment of obesity-related diseases
title_sort incretin based therapies for the treatment of obesity related diseases
url https://doi.org/10.1038/s44324-024-00030-5
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