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vrijdag 5 oktober 2018

The Lancet: [Comment] Twice the benefits with twincretins?

[Comment] Twice the benefits with twincretins?
Rising global numbers of patients with obesity and diabetes and a scarcity of approved medical therapeutics with curative potential are major challenges for physicians, biomedical researchers, and health-care systems worldwide. Scientific breakthroughs such as discovering gut hormone-based polyagonists with preclinical efficacy and action profiles similar to gastric bypass surgery suggest that transformative medicines for obesity and type 2 diabetes might be within reach.1 Remaining uncertainties are the inclusion of glucagon receptor agonism as a driving factor in the promotion of energy expenditure and weight loss in some of the leading candidates for unimolecular coagonism targeting obesity and type 2 diabetes, because this action requires substantial buffering by incretin action to prevent detrimental effects on glucose metabolism.
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[Articles] Effect of lorcaserin on prevention and remission of type 2 diabetes in overweight and obese patients (CAMELLIA-TIMI 61): a randomised, placebo-controlled trial
Lorcaserin decreases risk for incident diabetes, induces remission of hyperglycaemia, and reduces the risk of microvascular complications in obese and overweight patients, supporting the role of lorcaserin as an adjunct to lifestyle modification for chronic management of weight and metabolic health.
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[Comment] Lorcaserin: balancing efficacy with potential risks
Obesity remains among the most difficult diseases to treat, with lifestyle changes not always leading to sufficient weight loss or sustained long-term results.1 The history of weight-loss medications has been challenging because of adverse effects restricting their application.2 Given the worldwide obesity and diabetes twin epidemics,3 demands for effective treatments both from patients and physicians are high.
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[Articles] Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials
In this individual-patient data meta-analysis of statin-treated patients, elevated baseline and on-statin lipoprotein(a) showed an independent approximately linear relation with cardiovascular disease risk. This study provides a rationale for testing the lipoprotein(a) lowering hypothesis in cardiovascular disease outcomes trials.
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[Comment] Lipoprotein(a): lodestar for future clinical trials
Lipoprotein(a) is an LDL-like particle with a covalently bound, unique glycoprotein called apolipoprotein(a).1 Concentrations of lipoprotein(a) in plasma are under tight genetic control, and in the population these amounts can be skewed positively in distribution, with one in four individuals inheriting levels that increase their lifetime risk of atherosclerotic cardiovascular disease by more than 50%.2 Interest in lipoprotein(a) has been rekindled by findings of large epidemiological3 and Mendelian randomisation4 studies that confirm the causal role of lipoprotein(a) in the development of atherosclerotic cardiovascular disease and calcific aortic valve disease.
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