References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2021-7-18-30

medsovet-6137

Research Article

САХАРНЫЙ ДИАБЕТ

DIABETES MELLITUS

Эффективность дулаглутида в свете доказательной медицины: расширение показаний

Efficacy of dulaglutide: an evidence-based review of its potential indications

https://orcid.org/0000-0001-9007-4123

Бирюкова

Е. В.

Biryukova

E. V.

Бирюкова Елена Валерьевна - доктор медицинских наук, профессор.

127473, Москва, ул. Делегатская, д. 20, стр. 1.

Elena V. Biryukova - Dr. Sci. (Med.), Professor, Yevdokimov Moscow State University of Medicine and Dentistry.

20, Bldg. 1, Delegatskaya St., Moscow, 127473.

lena@obsudim.ru

https://orcid.org/0000-0002-2125-622X

Соловьева

И. В.

Solovyeva

I. V.

Соловьева Инна Владимировна - ассистент кафедры эндокринологии и диабетологии.

127473, Москва, ул. Делегатская, д. 20, стр. 1.

Inna V. Solovyeva - Assistant, of the Department of Endocrinology and Diabetology, Yevdokimov Moscow State University of Medicine and Dentistry.

20, Bldg. 1, Delegatskaya St., Moscow, 127473.

Московский государственный медико-стоматологический университет имени А.И. ЕвдокимоваРоссияYevdokimov Moscow State University of Medicine and DentistryRussian Federation

2021

12052021

071830

2021

Бирюкова Е.В., Соловьева И.В.

Biryukova E.V., Solovyeva I.V.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/6137

Сахарный диабет (СД) является величайшей в истории человечества неинфекционной эпидемией. Данный обзор посвящен актуальной проблеме современного здравоохранения - лечению сахарного диабета 2-го типа (СД2). Ключевое внимание уделяется профилактике развития и прогрессирования осложнений СД2, и освещается необходимость коррекции факторов риска сердечно-сосудистых заболеваний (ССЗ), которые являются ведущей причиной высоких показателей смертности у лиц с СД2. Благодаря клиническим исследованиям (КИ) последних десятилетий сформировалась серьезная доказательная база о влиянии различных сахароснижающих препаратов на развитие диабетических осложнений и исходы у больных СД2. Также с появлением инновационных классов сахароснижающих препаратов существенно расширились возможности терапии СД2. Агонисты рецепторов глюкагоноподобного пептида-1 (арГПП-1) - класс сахароснижающих препаратов, действующих на многие патогенетические механизмы СД2 и обладающих высоким профилем безопасности. Важным шагом в лечении СД2 является создание пролонгированных форм арГПП-1. В России дулаглутид (Трулисити) стал первым зарегистрированным арГПП-1 для лечения СД2 (2016), который можно применять 1 р/нед независимо от приема пищи, что способствует высокой приверженности лечению. Доказательная база по эффективности и безопасности дулаглутида постоянно расширяется. Авторами уделено внимание вопросам сердечно-сосудистой безопасности применения дулаглутида, рассмотрены основные результаты исследования REWIND, поднимается вопрос о целесообразности более раннего начала первичной профилактики кардиоваскулярных событий у больных СД2. Благодаря результатам исследования REWIND рекомендуется включение арГПП-1 в состав терапии у пациентов с СД2 и сердечно-сосудистыми факторами риска с целью получения дополнительных преимуществ в отношении жизненного прогноза.

Diabetes mellitus (DM) is the biggest noncontagious epidemic in human history. This review is addressing an urgent challenge of modern healthcare - the treatment of type 2 diabetes mellitus (DM2). Key attention is paid to the prevention of the development and progression of type 2 diabetes complications and the need to manage risk factors for cardiovascular diseases (CVD), which are the leading cause of high mortality rates in people with type 2 diabetes. The clinical trials (CT) of recent decades contributed to the build-up of a solid evidence base on the effect of various antihyperglycemic drugs on the development of diabetic complications and outcomes in patients with T2DM. Also, the emergence of innovative classes of antihyperglycemic drugs have significantly expanded the potential of T2DM therapy. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of glucose-lowering drugs that affect many pathogenetic mechanisms of T2DM and have a high safety profile. Creation of extended-release forms of GLP-1 RAs is an important step in the treatment of T2DM. Dulaglutide (Trulicity) has become the first GLP-1 RA for the treatment of T2DM (2016) authorized in Russia that can be used once weekly without regard to timing of food ingestion, which contributes to high compliance with treatment. The evidence base on the efficacy and safety of dulaglutide is continuously expanding. The authors paid attention to the issues of cardiovascular safety of the administration of dulaglutide, discussed the main results of REWIND study, and brought up a problem about the expediency of an earlier initiation of primary prevention of cardiovascular events in patients with type 2 diabetes. The results of the REWIND study made it possible to recommend the inclusion of GLP-1 RAs into the therapy of patients with type 2 diabetes and cardiovascular risk factors with a view to get additional advantages in terms of life prognosis.

сахарный диабет 2-го типасердечно-сосудистые заболеванияфакторы рискасахароснижающая терапиядулаглутидисследование REWIND

type 2 diabetes mellituscardiovascular diseasesrisk factorsglucose-lowering therapydulaglutideREWIND study

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The authors declare that there are no conflicts of interest present.