Adverse effects of GLP-1 receptor agonists: difference between revisions
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| 27 | Discontinuation for adverse events ran at about 7% in [[STEP trial programme|STEP 1]] and 16.6% in [[SELECT trial|SELECT]], where treatment continued for over three years. Longer exposure produces more cumulative discontinuation even where per-period tolerability is similar.{{r|lincoff2023}} | 27 | Discontinuation for adverse events ran at about 7% in [[STEP trial programme|STEP 1]] and 16.6% in [[SELECT trial|SELECT]], where treatment continued for over three years. Longer exposure produces more cumulative discontinuation even where per-period tolerability is similar.{{r|lincoff2023}} |
| 28 | 28 | ||
| + | 29 | == Less common but significant == | |
| + | 30 | Gallbladder disease — cholelithiasis and cholecystitis — occurs more often than on placebo. Rapid weight loss by any means increases biliary cholesterol saturation and reduces gallbladder motility, so the effect is at least partly attributable to the weight change rather than to the drug directly.{{r|wilding2021}} | |
| + | 31 | ||
| + | 32 | Acute pancreatitis has been reported and is uncommon. Trial data have not established a causal relationship, and the background rate in populations with obesity and type 2 diabetes is itself elevated, which makes a modest excess hard to detect.{{r|nauck2016}} | |
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| 29 | == References == | 34 | == References == |
| 30 | {{reflist}} | 35 | {{reflist}} |
| 31 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> | 36 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> |
| 32 | <ref name="wilding2021">Wilding JPH, Batterham RL, Calanna S, et al. "Once-weekly semaglutide in adults with overweight or obesity." ''New England Journal of Medicine'' 384(11):989–1002 (2021). PMID 33567185.</ref> | 37 | <ref name="wilding2021">Wilding JPH, Batterham RL, Calanna S, et al. "Once-weekly semaglutide in adults with overweight or obesity." ''New England Journal of Medicine'' 384(11):989–1002 (2021). PMID 33567185.</ref> |
| + | 38 | <ref name="nauck2016">Nauck MA, Meier JJ. "The incretin effect in healthy individuals and those with type 2 diabetes." ''The Lancet Diabetes & Endocrinology'' 4(6):525–536 (2016). PMID 26876794.</ref> | |
| 33 | <ref name="lincoff2023">Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. "Semaglutide and cardiovascular outcomes in obesity without diabetes." ''New England Journal of Medicine'' 389(24):2221–2232 (2023). PMID 37952131.</ref> | 39 | <ref name="lincoff2023">Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. "Semaglutide and cardiovascular outcomes in obesity without diabetes." ''New England Journal of Medicine'' 389(24):2221–2232 (2023). PMID 37952131.</ref> |
| + | 40 | ||
| + | 41 | == See also == | |
| + | 42 | * [[GLP-1 receptor agonist]] | |
| + | 43 | * [[Dose escalation schedule]] | |
| + | 44 | * [[Gastric emptying]] | |
| + | 45 | * [[Aspiration risk under anaesthesia]] | |
| 34 | 46 | ||
| 35 | {{DEFAULTSORT:Adverse effects of GLP-1 receptor agonists}} | 47 | {{DEFAULTSORT:Adverse effects of GLP-1 receptor agonists}} |