Kana wanzwa nezve retatrutida Uye kana iwe uchinetseka kana zvichinyatso batsira nekudzikira uremu, heino dhairekitori rakazara rekuita kuti iwe ukurumidze. Uyu mushonga wekuedza kubva kuna Eli Lilly uri mukutarisisa kwayo chiito chine simba Ichi chidzidzo chinotarisa panzira nhatu dzehomoni dzekuda kudya uye metabolism, uye pane data rekuyedza rinoratidza misiyano ichienzaniswa nemishonga iripo. Mumitsetse inotevera, tichakuudza kuti chii, chinoshanda sei, zvayakaratidza, uye chii chaunofanira kufunga usati wanyanya kufara. Iwe uchawanawo kuenzanisa ne semaglutide uye tirzepatide uye tsanangudzo yakajeka yemamiriro ayo ekutonga. Zvose izvi zvinoratidzwa nenzira inoshanda uye muchiSpanish chakajeka, saka hapana chaunopotsa.
Chokutanga uye chakakosha, zvakakosha kujekesa kutanga: retatrutide haisati yabvumirwa nemasangano ekutonga uye inogona kushandiswa chete mumakiriniki ekuedzwa. Zvakadaro, iyo data yakaburitswa uye yakaunzwa pamisangano iri kushamisa, nekurasikirwa nehuremu kunosvika 24% mukati isingasviki gore mune vanhu vakuru vakafutisa vasina chirwere cheshuga. Izvi zvinogoneka zvinotsanangurwa ne "katatu" maitiro ekuita uye nekuwedzera metabolic mhedzisiro inowedzera kupfuura uremu. Chero zvazvingava, tiri kutaura nezve mushonga une simba unoda ... kutarisira kwechiremba uye zvishoma nezvishoma dosing zano rekuvandudza kushivirira, nekuti gastrointestinal yakashata mhedzisiro iripo uye inoenderana nedosi, kunyangwe mazhinji ari akapfava kana pakati nepakati mukusimba.
Chii chinonzi retatrutide uye chinoshanda sei?
Retatrutide (LY-3437943) i "katatu" agonist yakagadzirirwa panguva imwe chete kumisa GLP-1, GIP, uye glucagon receptors. Kusanganiswa uku hakusi netsaona: kutevedzera aya emudumbu uye pancreatic mahormone anovavarira ku... kuderedza kudya, kunonoka kupera kwegastric, uye kuwedzera kushandiswa kwesimbaIyi katatu-chiito fomula inogona kuturikira muhuremu hwakawanda uye ine hutano cardiometabolic profile. Yakagadzirwa naEli Lilly, iyo morekuru ine chinangwa chekubatanidza akanakisa epasirese matatu atinotoziva zvakasiyana nemishonga imwechete- kana mbiri-yakanangana.
The physiological logic inonzwika. GLP-1 analogs inodzora shuga yeropa uye inosimudzira satiety; GIP agonism inoratidzika kuwedzera imwe metabolic chikamu; uye glucagon receptor stimulation inogona kukurudzira thermogenesis uye substrate mobilization. Pamwe chete, mhedzisiro idzi dzinotsvaga idya zvishoma, iva nenzara shoma uye "shandisa" zvakanyanyaSaka hazvishamisi kuti Phase 2 zvidzidzo zvakagadzira misoro.
Miedzo yemakiriniki: huwandu huremu hwakarasika uye chii chinoitika kune hutano hwemetabolism
Muchiyedzo cheChikamu chechipiri muvanhu vakuru vakafuta kana vakafutisa vasina chirwere cheshuga, muyero wepamusoro wakaongororwa (12 mg) wakawana. avhareji kurasikirwa uremu pedyo ne24% pamavhiki makumi mana nemasereUkuru uye kumhanya zvakashamisa kunyange vatsvakurudzi, avo vakacherechedza kuti vatori vechikamu vazhinji vakanga vasati vasvika kune uremu pakupera kwechidzidzo, zvichiratidza kuti sirin'i yekubudirira inogona kunge yakakwirira zvishoma nenguva yakareba yekurapa.
Pamusoro pekurasikirwa nehuremu, paive nekukanganisa kunoshamisa pamakasi e cardiometabolic: a triglyceride kuderedza kusvika ku40%kuderera kweapoC-III yeinenge 38%, kuderedzwa kwemafuta echiropa, kuvandudzwa kweropa, uye zviratidzo zvekuwedzera insulin senitivity. Mune kumwe kuongorora, vakadzi vakabudirira kuderedza uremu kusvika ku29%, chimiro chinokatyamadza chinosimbisa pfungwa yekuti kuita katatu kunogona kupa imwe bhenefiti mune mamwe maprofile.
Iyo data haina kugumira kune vanhu vasina chirwere cheshuga. Muchidzidzo chevarwere vane Type 2 chirwere cheshuga, vatori vechikamu vanobatwa neretatrutide vakarasika [chimwe chikamu che] 17% yehuremu hwemuviri mumwedzi mipfumbamweuye chinenge chikamu chimwe muzvitatu chakagadzirisa mazinga eglucose muropa panguva yekurapa. Iyi poindi yakakosha nekuti murudzi rwe2 chirwere cheshuga, kuwana uremu hwakafanana kuderedzwa kunowanzo kuoma. Muboka re placebo, nenzira, kurasikirwa kwehuremu kwaive kwakapoteredza 2,1%, iyo inosimbisa musiyano pakati pekupindira kwekushanda uye boka rekutonga.
Pakupedzisira, nhamba yemhinduro imwechete inofanirwa kutaurwa: kusvika a 83% yeavo vakagamuchira iyo yepamusoro dosi vakawana kurasikirwa ≥15% yehuremu hwekutanga. Aya makiriniki akakosha zvikumbaridzo zvinoenderana nekuvandudzwa kwakakodzera munjodzi ye cardiometabolic.
Dosage uye nhungamiro: sei kutanga kuderera uye kuwedzera zvishoma nezvishoma
Muchikamu chechipiri, vhiki dzevhiki dze1, 4, 8, uye 12 mg dzakaedzwa, asi vazhinji vatori vechikamu havana kutanga zvakananga nechinangwa chechinangwa. Nzira yakasiyana yakasarudzwa. kutanga zano pa 2 mg / vhiki nekukwira zvishoma nezvishoma kukurudzira kushivirira, kunyanya maererano nemigumisiro yegumbo. Iyi "zvishoma nezvishoma" maitiro akadzikisa mwero wekurega uye akavandudza kutevedzera.
Izvi zvinoshandura sei mukuita? Mukushaikwa kweiyo yepamutemo tekinoroji data sheet (nekuti haisati yatenderwa), zvirongwa zvine musoro zvakafanana nemuenzaniso uyu: mavhiki 1-4 kusvika 2 mg5-8 mavhiki pa 4 mg; ipapo gadzirisa ku8 kana 12 mg zvichienderana nekushivirira uye mhinduro. Muzvidzidzo, kuwedzera kwedosi kwakabatanidzwa nehuwandu hwepamusoro hwemigumisiro yakaipa yemimba, saka chiyero chetitration chinofanira kuva chega.
Yakakosha nuance nezve frequency: mazhinji ezvinyorwa uye kuburitswa kwenhau zvakatsanangurwa vhiki nevhiki kutongaZvisinei, zvimwe zvinyorwa zvenhau zvakataura purogiramu yevhiki mbiri. Sezvo maprotocol akaburitswa achitsanangura marejisheni evhiki, zvinoita sekunge ichi chichava chiyero, kunyangwe isu tichizomirira iyo yakazara Phase 3 mhedzisiro uye sarudzo yekutonga kuti tizive iyo yekupedzisira dosi.
Kuchengeteka uye kwakashata mhedzisiro: izvo zvinotozivikanwa
Iyo yakazara yekuchengetedza mbiri ye retatrutide, yakavakirwa paChikamu 2 data, inofananidzwa neiyo yemishonga ine hukama. Zviitiko zvinowanzoitika zvave kuda kurutsa, kurutsa, manyoka, uye kurutsaIzvi zvinowanzoitika zvekirasi iyi yemishonga uye zvinowanzoitika nepamusoro-soro kana panguva yekukwira kwedosi. Musoro wemusoro, kuneta, uye zvimwe mhedzisiro zvakaonekwa zvakare. kukwidziridzwa kwechiropa enzymes, kazhinji yehunyoro kusvika pakati nepakati.
Mimwe mishumo yekuedza yakaratidza kuwedzera kwe kurova kwemoyo uye conduction abnormalities zvisingaonekwi zvakakomba. Sezvakaita chero incretin agonism, kiyi iri mukugadziriswa zvishoma nezvishoma uye kuongororwa kwekiriniki, kugadzirisa chiyero chekuwedzera uye nhanho dzekudya kudzikamisa zviratidzo zvekugaya.
Zvakakosha kuisa izvi muchirevo nevanoenzanisa. Semaglutide, semuenzaniso, inogovera akawanda emhedzisiro iyi, uye zviremera zvakanyeverawo nezvazvo zvisingawanzoitiki zviitiko zve-non-arteritic anterior ischemic optic neuropathyZvakare, tiri kutaura pamusoro pezviitiko zvisingawanzoitiki, asi zvinoratidza kuti nei kutarisa uye ruzivo rwemurwere zvakakosha mukurapa uremu husingaperi.
Kuwanikwa, mamiriro ekutonga uye nguva dzinotarisirwa
Kubva nhasi - nereferensi yeruzivo kubva munaChikunguru 2025 - iyo retatrutida Hazvina mvumo Kana iyo FDA kana masangano eEurope akazvibvumira. Nokudaro, kushandiswa kwayo kunongogumira kune inodzorwa miedzo yekiriniki, iyo iri pamutemo uye yakaenzana. Iyo kambani yakaratidza Phase 2 ongororo pamusangano weADA wa2023 (Chikumi 23-26) uye ine zvirongwa zvinoenderera mberi zvekusimbisa kushanda uye kuchengetedzeka muhuwandu hwevanhu.
Ringasvika riini? Mafungiro eruzhinji anosiyana: mamwe masosi anofungidzira nawo kunonoka 2025 kana kutanga kwa2026nepo vamwe vachiisa muono pakati 2026 uye 2027Kusvikira Phase 3 miedzo yapera uye bhenefiti-yengozi yaongororwa, haitenderwe. Kana mumwe munhu achida "kuiwana" kunze kwekiriniki kuyedza, ngwarira: haina mvumo yekutengesa.
Retatrutide versus semaglutide uye tirzepatide
Semaglutide ndeye GLP-1 receptor agonist ine nhoroondo refu. Yakatenderwa muna 2017 yechirwere cheshuga uye kubvira 2021 yakaratidzwa [inotevera]. chisingaperi kudzora uremuMuvanhu vakuru vasina chirwere cheshuga, iwe unogona kuwana zvakapoteredza imwe 15% kurasikirwa uremu mumavhiki makumi matanhatu nemasereMigumisiro yaro yakawanda yakashata ndeyemimba (kusvotwa, kurutsa, manyoka) uye zviitiko zvakadai sepancreatitis kana gastroparesis zvakatsanangurwa, kuwedzera kune nyevero yeNAION yatotaurwa.
Tirzepatide inosanganisa GLP-1 uye GIP agonism. Iine mvumo muUnited States neEurope (pakutanga yechirwere cheshuga; gare gare, yekufutisa seZepbound). Miedzo yakaita seSURPASS yakaratidza... kurasikirwa kusvika ku20% mumavhiki makumi manomwe nemaviriUye kunyangwe chimiro chayo chekushivirira chakafanana neicho cheGLP-1, pamadosi akakwira akawanda anodonha akaonekwa (semuenzaniso, ne15 mg), ruzivo rwekufunga mukuita kwekiriniki.
Kubva pane iripo yekutanga data, retatrutide ndiyo inonyanya kushanda paavhareji kurasikirwa uremu, inoteverwa netirzepatide uyezve semaglutide. Uyezve, pane zviratidzo kuti inopa yakafara metabolic mabhenefiti (lipids, mafuta echiropa, insulin senitivity). Zvisinei, zvakakosha kuyeuka kuti retatrutide ichiri muchikamu chekusimbisa uye haigoni kufananidzwa "musoro-ku-musoro" kusvikira pane miedzo yemusoro-kune-musoro kana meta-analys yakasimba ine homogeneous maitiro.
Ndiani angabatsirike uye makiriniki anotarisira chii?
Iwo maprofiles anogona kubatsira zvakanyanya kubva kurudzi urwu rwekurapa vanhu vakuru vane kufutisa kana kufutisa necomorbiditiesIzvi ndezvechokwadi kunyanya kune avo vasina kupindura GLP-1 analogues kana maviri maviri agonist. Mune vanhu vane Type 2 chirwere cheshuga, iyo mbiri inokanganisa shuga yeropa uye uremu zvakare yakakosha mukana. Kunyange zvakadaro, chirongwa chacho chinofanira kunge chiri chega: kune misiyano mukushivirira, comorbidities yekufunga nezvayo, uye zvekutanga zvekiriniki (semuenzaniso, mafuta echiropa, hypertension, kana dyslipidemia).
Ndichiri kumirira kubvumidzwa, nzvimbo zhinji dzine hunyanzvi dziri kugadzirira maprotocol ezvekuzoitwa mune remangwana, mamwe kunyange mumaguta makuru eUnited States. MuSpain, uremu manejimendi zvikwata zvakaita se MediQuo Weight Loss Clinic Ivo vanosarudza nzira dzemunhu, dzimwe nguva dzinosanganisira auriculotherapy kuderedza uremuNezvekudya zvinovaka muviri, hunhu, uye zvekurapa zvekutevera, iyi hwaro hwakakosha kuzadzisa chero kurapwa kwemishonga. Kana iwe uchifarira nzira inotungamirwa nehunyanzvi, unogona kuwana rumwe ruzivo pa [link/website kero]. www.mediquo.com/clinica-perdida-de-peso.
Inoshanda mushandisi gwara: akakosha pfungwa usati watanga
Semushonga une simba, retatrutide inoda nzira yehungwaru. Nzira ine musoro, yakavakirwa pane zvakaonekwa mumiedzo, ndeye kutanga pa 2 mg / vhiki uye kuwedzera zvishoma nezvishoma, kutarisa zviratidzo zvekudya, hydration, uye mirayiridzo yezvokudya (kudya zviduku, mafuta mashoma, kuisa mberi kweprotein) panguva yekuwedzera. Kana kuwedzera kunowedzera zvakanyanya kushivirira, iyo yapfuura dose inogona kuchengetwa kwemamwe mavhiki akati wandei usati waedza nhanho inotevera.
Chiyero chinotarirwa (4, 8, kana 12 mg) chinoenderana nekuti unopindura sei uye kuti mangani emhedzisiro aunosangana nawo. Pakupedzisira, iyo "inotapira nzvimbo" ndiyo yakaderera dose yaunokwanisa kushivirira. kuderedza uremu zvine mwero pasina kukanganisa kunaka kwehupenyu. Nehumbowo hwazvino, hapana mapfupi: kuchengetedza shanduko yemararamiro kunoramba kwakakosha kubatanidza mhedzisiro uye kuchengetedza tsandanyama.
Inowanzobvunzwa mibvunzo
Ndeipi yakajairika yekutanga dose? Muchikamu chechipiri, vazhinji vakatanga ne 2 mg vhiki nevhiki uye zvishoma nezvishoma vakawedzera kusvika ku4, 8, kana 12 mg. Iyi yakaderera yekutanga dose inoderedza kuda kurutsa uye mamwe GI mhedzisiro yakabatana nekukurumidza kuwedzera.
Inoitwa kakawanda sei? Mapepa ebvunzo anotsanangura purogiramu yevhiki nevhikiMamwe mabhuku ane mukurumbira akataura nezvekutonga kwevhiki mbiri, asi maprotocol akadzama anga ari vhiki nevhiki; isu tichafanirwa kumirira dosi yakabvumidzwa kuti isimbise izvi.
Yatenderwa here nhasi? Kwete Retatrutida ichiri kuongororwa uye haana mvumo Izvo hazvina kubvumidzwa neFDA kana European agency. Kushandiswa kwayo kunofanira kugumira kumakiriniki ekuedzwa. Mamwe mafungidziro eruzhinji anoisa mvumo inobvira pakati pekupera kwa2025 na2027, chero iyo data yeChikamu 3 ichifarirwa.
Zviri nani pane semaglutide? Phase 2 zvidzidzo zvinoratidza kurasikirwa kukuru munguva shoma ichienzaniswa nesemaglutide. Nekudaro, kuenzanisa kwakananga uye data renguva refu neiyo yakatobvumidzwa retatrutide (kana yave kuwanikwa) inoshaikwa kutaura izvi zvakasarudzika.
Uye tichienzanisa ne tirzepatide (Mounjaro/Zepbound)? Tirzepatide inonzi dual-action inhibitor (GLP-1/GIP), nepo retatrutide iri katatu-action inhibitor (GLP-1/GIP/glucagon). Yekutanga data inofarira retatrutide maererano nezana. kuora muviriAsi zvakare, miyedzo yekuenzanisa uye ruzivo rwepasirese rwunozodiwa.
Inoshanda kune "mafuta emudumbu"? Miedzo yakaratidza kuderedzwa kwemuviri wese uye mafuta echiropa, nekurasikirwa kukuru kwehuremu. Kugovera chaiko Kuwanda kwekurasikirwa kwemafuta (dumbu vs. dzimwe nzvimbo) kunogona kusiyana kubva kumunhu kusvika kune munhu, asi kuvandudzwa kwechiuno chechiuno uye zviratidzo zvemagetsi zvinotsigira zvinobatsira mumafuta e-visceral.
Zviri pamutemo here kuzviwana kunze kwemiedzo? Kushandiswa kwayo kuri pamutemo chete mukutsvakurudza kwekiriniki. Chero imwe nzira Kunze kwemhoteredzo iyoyo ine ngozi uye inogona kuita chitsotsi.
Retatrutida yakafanana neMounjaro (tirzepatida)? Kwete. Izvo zvakafanana mukuita paGLP-1 uye GIP, asi retatrutide inowedzera glucagon receptor agonismizvo zvinogona kutsanangura kumwe kushanda kwekuwedzera kunoonekwa.
Zvakanakira uye zvinogumira nhasi
Pakati pezvakanakisa zvakanakira ndeye kuderedza uremu munguva shomaChidzidzo chacho chakaratidzawo zvakawanda zvakasiyana-siyana zvemasabolism (lipids, mafuta echiropa, BP, insulin senitivity) uye zviratidzo zvekuchengetedzwa kwemasisita akawanda kune vamwe vatori vechikamu. Musanganiswa uyu unoratidza nzira yakawandisa yekufutisa iyo inodarika "kuona chiyero chichidzika."
Padivi pekugumira, idrawback iyo HazvibvumirwiNekudaro, data renguva refu rinoshaikwa uye kushivirira kunosiyana, neGI mhedzisiro inogona kuda kunonoka kukwira kwedosi. Uyezve, sekunge kune ese kufutisa pharmacotherapy, kuita kwayo kwakanyanya kunoitika kana Inobatanidza nemaitiro kudya kwakakwana, kuita muviri uye kurara, uye nerutsigiro rwemaitiro.
Kana iwe uri kufunga nezve nzira yekubatsirwa nemishonga, tsvaga zvikwata zvine ruzivo mukurapa kufutisa uye yakajeka yekutevera protocol. Dzese munyika nekunze, kune makiriniki atove ari kugadzirira kushandisa marapirwo matsva kana atenderwa, uye masevhisi ekuderedza uremu seMediQuo anogona kutanga. gadzira hurongwa hwemunhu pasina kurasikirwa nekiriniki helm.
Mufananidzo wakazara wakavezwa nemiedzo une tariro: retatrutide ikozvino inotungamirira muhutano hwakakwana kana ichienzaniswa netirzepatide uye semaglutide kune vanhu vakuru vasina chirwere cheshuga, kuwedzera zvakakosha zvemasabolism; its Achilles 'chitsitsinho chakafanana nekugara mukirasi ino: kushivirira kwekugaya uye kudiwa kwekuyeraKiyi kune chero innovation inoshaikwa: Phase 3 kusimbiswa uye chaiyo-yenyika, maoko-pane ruzivo nehunyanzvi hwekuita. Kusvika panguva iyoyo, kushivirira, pfungwa dzakatsoropodza, uye rutsigiro rwehunyanzvi ndiyo yakanakisa musanganiswa wekufamba iyi inovimbisa asi ichida munda nechivimbo.