Oleh Admin Kalbe Medical pada February 13, 2017 07:30

Semaglutide Menjanjikan sebagai Terapi DM tipe 2

Dalam dekade terakhir ini, dengan dipasarkannya obat diabetes dari golongan glucagon-like peptide-1 (GLP-1) receptor agonist membuat semakin bertambahnya pilihan terapi bagi pasien diabetes melitus tipe 2. Mekanisme kerja obat ini menyerupai GLP-1 yang asli atau yang terdapat dalam tubuh kita, yaitu meningkatkan sekresi insulin dan menghambat sekresi glukagon (yang tergantung kadar glukosa), dan memperlambat pengosongan lambung serta meningkatkan rasa kenyang melalui efek sentral pada hipotalamus di otak.
   
Dalam jurnal The Lancet Diabetes & Endocrinology, Christopher Sorli dan kolega melaporkan hasil studi SUSTAIN1, yaitu studi skala besar pertama fase 3 obat semaglutide, suatu obat diabetes GLP-1 receptor agonist yang hanya diberikan seminggu sekali, pada DM tipe 2. Studi SUSTAIN1, melibatkan 388 pasien yang dibagi secara acak untuk diberikan semaglutide injeksi subkutan (0,5 mg atau 1,0 mg) atau plasebo. Rerata HbA1c basal mereka adalah 8,05% dan rerata BB mereka adalah 91,93 kg. Studi dilakukan pada pasien yang belum pernah diberikan terapi farmakologis sebelumnya, dan hanya diberikan intervensi diet dan olahraga sekurang-kurangnya 30 hari sebelum dilakukan intervensi.

   
Pada minggu ke-30 terjadi penurunan HbA1c secara signifikan sebesar 1,45% pada kelompok semaglutide 0,5 mg dan 1,55% pada semaglutide 1,0 mg. Sedangkan hanya terjadi penurunan HbA1c sebesar 0,02% pada kelompok plasebo (tidak signifikan). Selain itu, terjadi penurunan BB secara signifikan sebesar 3,73 kg pada kelompok semaglutide 0,5 mg dan 4,53 kg dengan semaglutide 1,0 mg. Tidak terjadi penurunan BB yang signifikan dengan plasebo (0,98 kg). Dari profil keamanan, kejadian yang paling sering adalah keluhan pada saluran cerna. Mual dilaporkan oleh 20% kelompok semaglutide 0,5 mg, 24% pada semaglutide 1,0 mg, dan 8% pada plasebo. Kasus diare terjadi sekitar 13%, 11%, dan 2% pada masing-masing kelompok.

   
Saat ini studi head-to-head perbandingan antara semaglutide dan empagliflozin, sitagliptin dan liraglutide masih dilakukan. Hasil studi tersebut tentu saja sangat ditunggu-tunggu untuk membandingkan efikasi dan keamanan dari obat baru ini. Studi skala besar semaglutide yang lain (SUSTAIN-6) menunjukkan bahwa pemberian semaglutide 0,5 dan 1,0 mg menyebabkan terjadinya penurunan risiko keluaran komposit primer yang signifikan sebesar 26% dari kejadian pertama kematian kardiovaskular, infark miokardium non-fatal atau stroke non-fatal di atas 2 tahun dibandingkan dengan mereka yang hanya diberikan plasebo. (PMD)


Image : Ilustrasi
Referensi:
1.Scheen AJ. Semaglutide: A promising new glucagon-like peptide-1 receptor agonist. The Lancet Diabetes & Endocrinology. 2017. DOI: http://dx.doi.org/10.1016/S2213-8587(17)30012-8.
2.Douglas D. Semaglutide shows promise in type 2 diabetes [Internet]. 2017 [cited 2017 Jan 30]. Available from : http://www.medscape.com/viewarticle/874985.

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