endocrine:glp1:liraglutide
Liraglutide
Liraglutide is a once-daily GLP-1 receptor agonist used for Type 2 Diabetes, obesity, and cardiovascular risk reduction.
Brand names:
- Victoza (Type 2 Diabetes)
- Saxenda (Obesity)
Mechanism of Action
Liraglutide activates the GLP-1 receptor.
Effects:
- Increases glucose-dependent insulin secretion
- Decreases glucagon secretion
- Slows gastric emptying
- Increases satiety
- Promotes weight loss
Net clinical effects:
- Decreases HbA1c
- Reduces body weight
- Reduces major adverse cardiovascular events
Low hypoglycemia risk unless combined with insulin or sulfonylureas.
Indications
Type 2 Diabetes Mellitus
- Glycemic control
- Cardiovascular risk reduction
Obesity ★
- Chronic weight management
- Reduces visceral adiposity
- Improves metabolic risk factors
Atherosclerotic Cardiovascular Disease (ASCVD) ★
Major Trial
LEADER Trial:
- Reduced cardiovascular death
- Reduced major adverse cardiovascular events
- Demonstrated mortality benefit in high-risk patients
Dosing
- Once-daily subcutaneous injection
- Titrate gradually to minimize GI side effects
No oral formulation.
Adverse Effects
Common:
- Nausea
- Vomiting
- Diarrhea
- Early satiety
Serious (rare):
- Pancreatitis
- Gallbladder disease
- Theoretical risk of medullary thyroid carcinoma
Contraindications
- Personal or family history of medullary thyroid carcinoma
- MEN2 syndrome
- Severe gastrointestinal disease
Use caution in:
- History of pancreatitis
Liraglutide vs Other GLP-1 Agents
- Shorter-acting options available
- Less robust ASCVD data
- Weekly injection
- Strong primary prevention data
- Greater weight loss
- Oral formulation available
- Strong ASCVD data
Liraglutide:
- First GLP-1 to show mortality reduction
- Daily dosing
GLP-1 vs SGLT2
Liraglutide:
- Strong ASCVD reduction
- Modest weight loss
- Minimal heart failure benefit
- Strong heart failure benefit
- Strong renal protection
Clinical Pearls
- First GLP-1 with proven CV mortality reduction
- Daily injection
- Useful in obesity and diabetes
- Not a primary heart failure therapy
Related
endocrine/glp1/liraglutide.txt · Last modified: by andrew2393cns
