胰高糖素样肽-1受体激动剂治疗:从单药起始到联合用药

Strategy on Glucagon Like Peptide-1 Receptor Agonist:from Initiation Monotherapy to Combination with Anti-hyperglycemic Drugs

胰高糖素样肽-1受体激动剂(glucagon like peptide-1 receptor antagonist,GLP-1 RA)是继胰岛素后的新一代注射降糖制剂,其优越的降糖作用和安全性得到了肯定。但是何时单用GLP-1 RA,如何联用口服药还有存在争议。近年来大量循证医学证据提供了新的答案。本文将从GLP-1 RA单用、与二甲双胍为基础的二联或三联治疗,与基础胰岛素、钠-葡萄糖转运蛋白2抑制剂(sodium-glucose co-transporter-2 inhibitor,SGLT-2i)联用的循证医学证据做一综述,以帮助临床更好地使用该类药物。

Glucagon like peptide-1 receptor antagonist(GLP-1 RA)is a new generation of injection preparation after insulin.The overwhelming antihyperglycemic effect of GLP-1 RA has been widely confirmed by patients and clinicians.However,there is controversial issue about when to use GLP-1 RA alone and how to combine oral anti-hyperglycmic drugs.This review summarized the indication of initiation monotherapy,combination with metformin,other two oral anti-hyperglycemic drugs,basal insulin,sodium-glucose co-transporter-2 inhibitor.It will believably contribute to better clinical application of GLP-1 RA for patients and clinicians.