GLP-1 RECEPTOR AGONISTS: BENEFITS AND RISKS

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are actively used for the treatment of type 2 diabetes mellitus and obesity. Since they effectively reduce glycemia, contribute to weight loss and improve the quality of life of patients. Despite the undeniable advantages and expansion of indications for the use of GLP-1 RA, in particular in obese patients without diabetes, there is a growing need for in-depth study of their safety profile.

Purpose: to establish the advantages and disadvantages of glucagon-like peptide-1 receptor agonists using based on the analysis of scientific literature.

Materials and methods. An analysis of studies in various databases was conducted, in particular Scopus, Web of Science, Google Scholar, PubMed, SpringerLink, reprotox, Medline, Cochrane Library for 2016-2026. The results of randomized clinical trials, meta-analyses and recommendations of leading diabetes associations that evaluated the effects of GLP-1 RA in patients with type 2 diabetes and obesity were analyzed.

Results. GLP-1 RA have a high clinical efficacy, combining good glycemic control and significant weight loss, along with proven cardio- and renoprotective effects. Accordingly, these pharmacodynamic effects confirm the extraordinary value of GLP-1 RA in the treatment of common metabolic disorders. However, their use should be based on an individual assessment of the benefits and risks, taking into account comorbidities and individual characteristics of patients. For example, despite the metabolic benefits of obesity and type 2 diabetes pharmacotherapy, long-term use of semaglutide may have a side effect in the form of muscle loss, especially in patients with initial signs of sarcopenia and elderly people. Despite the clinical efficacy of GLP-1 RA, their effect on the exocrine function of the pancreas and a possible association with acute pancreatitis are of concern. Establishing cause-and-effect relationships is critical for patient safety, especially with risk factors.

Conclusion. A comprehensive assessment of the balance of benefits and risks of long-term use of glucagon-like peptide-1 receptor agonists, establishing cause-and-effect relationships, and optimizing therapeutic approaches, especially in patients with concomitant risk factors, is critically important for improving patient safety and ensuring maximum benefit from this group of drugs.