Pharmacotherapy for chronic obesity management: a look into the future

Intern Emerg Med. 2023 Jun;18(4):1019-1030. doi: 10.1007/s11739-023-03237-4. Epub 2023 May 30.

Abstract

Substantial leaps have been made in the drug discovery front in tackling the growing pandemic of obesity and its metabolic co-morbidities. Greater mechanistic insight and understanding of the gut-brain molecular pathways at play have enabled the pursuit of novel therapeutic agents that possess increasingly efficacious weight-lowering potential whilst remaining safe and tolerable for clinical use. In the wake of glucagon-like peptide 1 (GLP-1) based therapy, we look at recent advances in gut hormone biology that have fermented the development of next generation pharmacotherapy in diabesity that harness synergistic potential. In this paper, we review the latest data from the SURPASS and SURMOUNT clinical trials for the novel 'twincretin', known as Tirzepatide, which has demonstrated sizeable body weight reduction as well as glycaemic efficacy. We also provide an overview of amylin-based combination strategies and other emerging therapies in the pipeline that are similarly providing great promise for the future of chronic management of obesity.

Keywords: Amylin; Glucagon dependent insulinotropic polypeptide; Glucagon-like peptide 1; Obesity; Tirzepatide; Type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucagon-Like Peptide 1 / metabolism
  • Glucagon-Like Peptide 1 / therapeutic use
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Obesity* / drug therapy

Substances

  • Glucagon-Like Peptide 1
  • Hypoglycemic Agents