Skip to main content
Erschienen in: MMW - Fortschritte der Medizin 5/2023

10.03.2023 | Orale Antidiabetika | FB_CME

Nutzen von SGLT2-Inhibitoren und GLP-1-Rezeptoragonisten bei Menschen ohne Diabetes

Indikationen von Antidiabetika jenseits der Glukosekontrolle

verfasst von: Dr. med. Niels-Ulrik Korbinian Hartmann, Prof. Dr. med. Michael Lehrke

Erschienen in: MMW - Fortschritte der Medizin | Ausgabe 5/2023

Einloggen, um Zugang zu erhalten

Auszug

Mit den SGLT2-Inhibitoren und den GLP-1-Rezeptoragonisten sind zwei Substanzklassen aus der Diabetestherapie hervorgegangen, von denen auch Menschen ohne Diabetes profitieren. Sie haben die Therapie von Herzinsuffizienz, chronischer Niereninsuffizienz und Adipositas nachhaltig verändert. Durch die unterschiedlichen Wirkmechanismen ergeben sich spezifische Ansatzpunkte für metabolische und kardiovaskuläre Interventionen, die Hausärztinnen und Hausärzte bei der Verordnung berücksichtigen sollten.
Literatur
1.
Zurück zum Zitat Skyler JS et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol 2009; 53: 298-304 Skyler JS et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol 2009; 53: 298-304
2.
Zurück zum Zitat DeFronzo RA et al. Renal, metabolic and cardiovascular considerations of SGLT2 inhibition. Nat Rev Nephrol 2017; 13: 11-26 DeFronzo RA et al. Renal, metabolic and cardiovascular considerations of SGLT2 inhibition. Nat Rev Nephrol 2017; 13: 11-26
3.
Zurück zum Zitat Baker WL et al. Effects of sodium-glucose co-transporter 2 inhibitors on blood pressure: a systematic review and meta-analysis. J Am Soc Hypertens 2014; 8: 262-275 Baker WL et al. Effects of sodium-glucose co-transporter 2 inhibitors on blood pressure: a systematic review and meta-analysis. J Am Soc Hypertens 2014; 8: 262-275
4.
Zurück zum Zitat Packer M. SGLT2 Inhibitors Produce Cardiorenal Benefits by Promoting Adaptive Cellular Reprogramming to Induce a State of Fasting Mimicry: A Paradigm Shift in Understanding Their Mechanism of Action. Diabetes Care 2020; 43: 508-511 Packer M. SGLT2 Inhibitors Produce Cardiorenal Benefits by Promoting Adaptive Cellular Reprogramming to Induce a State of Fasting Mimicry: A Paradigm Shift in Understanding Their Mechanism of Action. Diabetes Care 2020; 43: 508-511
5.
Zurück zum Zitat Zinman B et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373: 2117-2128 Zinman B et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373: 2117-2128
6.
Zurück zum Zitat McGuire DK et al. Association of SGLT2 Inhibitors With Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes: A Meta-analysis. JAMA Cardiol 2021; 6: 148-158 McGuire DK et al. Association of SGLT2 Inhibitors With Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes: A Meta-analysis. JAMA Cardiol 2021; 6: 148-158
7.
Zurück zum Zitat Wanner C et al. Empagliflozin and Clinical Outcomes in Patients With Type 2 Diabetes Mellitus, Established Cardiovascular Disease, and Chronic Kidney Disease. Circulation 2018; 137: 119-129 Wanner C et al. Empagliflozin and Clinical Outcomes in Patients With Type 2 Diabetes Mellitus, Established Cardiovascular Disease, and Chronic Kidney Disease. Circulation 2018; 137: 119-129
8.
Zurück zum Zitat McDonagh TA et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021; 42: 3599-3726 McDonagh TA et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021; 42: 3599-3726
9.
Zurück zum Zitat McMurray JJV et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019; 381: 1995-2008 McMurray JJV et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019; 381: 1995-2008
10.
Zurück zum Zitat Packer M et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383: 1413-1424 Packer M et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383: 1413-1424
11.
Zurück zum Zitat Anker SD et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med 2021; 385: 1451-1461 Anker SD et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med 2021; 385: 1451-1461
12.
Zurück zum Zitat Solomon SD et al. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med 2022; 387: 1089-1098 Solomon SD et al. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med 2022; 387: 1089-1098
13.
Zurück zum Zitat Heerspink HJL et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 2020; 383: 1436-1446 Heerspink HJL et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 2020; 383: 1436-1446
14.
Zurück zum Zitat EMPA-KIDNEY Collaborative Group. Empagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 2023; 388: 117-127 EMPA-KIDNEY Collaborative Group. Empagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 2023; 388: 117-127
15.
Zurück zum Zitat Thiele K et al. Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure. ESC Heart Fail 2022; 9: 2233-2238 Thiele K et al. Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure. ESC Heart Fail 2022; 9: 2233-2238
16.
Zurück zum Zitat Thiele K et al. Effects of empagliflozin on erythropoiesis in patients with type 2 diabetes: Data from a randomized, placebo-controlled study. Diabetes Obes Metab 2021; 23: 2814-2818 Thiele K et al. Effects of empagliflozin on erythropoiesis in patients with type 2 diabetes: Data from a randomized, placebo-controlled study. Diabetes Obes Metab 2021; 23: 2814-2818
17.
Zurück zum Zitat Voors AA et al. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial. Nat Med 2022; 28: 568-574 Voors AA et al. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial. Nat Med 2022; 28: 568-574
18.
Zurück zum Zitat Mann PA, Lehrke M. Cardiac substrate utilization in heart failure: Where is the relevance of SGLT2 inhibition? J Thorac Cardiovasc Surg 2022; 164: 895-899 Mann PA, Lehrke M. Cardiac substrate utilization in heart failure: Where is the relevance of SGLT2 inhibition? J Thorac Cardiovasc Surg 2022; 164: 895-899
19.
Zurück zum Zitat Muller TD et al. Glucagon-like peptide 1 (GLP-1). Mol Metab 2019; 30: 72-130 Muller TD et al. Glucagon-like peptide 1 (GLP-1). Mol Metab 2019; 30: 72-130
20.
Zurück zum Zitat Cosentino F et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2020; 41: 255-323 Cosentino F et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2020; 41: 255-323
21.
Zurück zum Zitat Sattar N et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. Lancet Diabetes Endocrinol 2021; 9: 653-662 Sattar N et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. Lancet Diabetes Endocrinol 2021; 9: 653-662
22.
Zurück zum Zitat Shi Q et al. Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis of randomised controlled trials. Lancet 2022; 399: 259-269 Shi Q et al. Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis of randomised controlled trials. Lancet 2022; 399: 259-269
23.
Zurück zum Zitat Pi-Sunyer X et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med 2015; 373: 11-22 Pi-Sunyer X et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med 2015; 373: 11-22
24.
Zurück zum Zitat Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med 2021; 384: 989-1002 Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med 2021; 384: 989-1002
25.
Zurück zum Zitat Wadden TA et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA 2021; 325: 1403-1413 Wadden TA et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA 2021; 325: 1403-1413
26.
Zurück zum Zitat Rubino D et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA 2021; 325: 1414-1425 Rubino D et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA 2021; 325: 1414-1425
27.
Zurück zum Zitat Rubino DM et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA 2022; 327: 138-150 Rubino DM et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA 2022; 327: 138-150
28.
Zurück zum Zitat Ryan DH et al. Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) rationale and design. Am Heart J 2020; 229: 61-69 Ryan DH et al. Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) rationale and design. Am Heart J 2020; 229: 61-69
Metadaten
Titel
Nutzen von SGLT2-Inhibitoren und GLP-1-Rezeptoragonisten bei Menschen ohne Diabetes
Indikationen von Antidiabetika jenseits der Glukosekontrolle
verfasst von
Dr. med. Niels-Ulrik Korbinian Hartmann
Prof. Dr. med. Michael Lehrke
Publikationsdatum
10.03.2023

Weitere Artikel der Ausgabe 5/2023

MMW - Fortschritte der Medizin 5/2023 Zur Ausgabe