Ta de Clinicagem

TdC 357: Análogos de GLP-1 na prática - 4 clinicagens

Marcela Belleza e Ênio Macedo convidam novamente Nathalie Santana para debater clinicagens sobre o uso dos análogos do peptídeo semelhante ao glucagon 1 (GLP-1) na prática. O episódio inicia explicando qual o panorama atual das medicações no Brasil (quais fármacos são comercializados, quebra de patente, como usar as canetas), e partem para as 4 clinicagens: - indicações além do tratamento da obesidade e do diabetes tipo 2 - eventos adversos novos - cuidados em cenários específicos (gestações, perioperatório, idosos) - estratégias para suspensão e redução de custo Referências: ADA Professional Practice Committee for Obesity. Pharmacologic treatment of obesity in adults: Standards of Care in Overweight and Obesity. BMJ Open Diabetes Res Care. 2026. Aronne LJ, et al. Orforglipron for maintenance of body weight reduction (ATTAIN-MAINTAIN). Nat Med. 2026. Batsis JA, et al. Effect of incretin-based and nonpharmacologic weight loss on body composition: a systematic review. Ann Intern Med. 2026. Bliddal H, et al. Once-weekly semaglutide in persons with obesity and knee osteoarthritis (STEP 9). N Engl J Med. 2024. Bonaca MP, et al. Semaglutide and walking capacity in peripheral artery disease and type 2 diabetes (STRIDE). Lancet. 2025. Celletti F, et al. WHO guideline on GLP-1 therapies for obesity in adults. JAMA. 2026. Das SR, et al. 2020 ACC Expert Consensus Decision Pathway on novel therapies for cardiovascular risk reduction in type 2 diabetes. J Am Coll Cardiol. 2020. Marino EC, et al. Perioperative hyperglycemia screening and control: SBD/SBA/ABESO joint position statement. Brazilian Diabetes Society Guideline. 2026. He L, et al. GLP-1 receptor agonists and risk of gallbladder and biliary diseases: a meta-analysis. JAMA Intern Med. 2022. Horn DB, et al. Tirzepatide for maintenance of bodyweight reduction (SURMOUNT-MAINTAIN). Lancet. 2026. Malhotra A, et al. Tirzepatide for obstructive sleep apnea and obesity (SURMOUNT-OSA). N Engl J Med. 2024. Nauck MA, et al. GLP-1 receptor agonists and next-generation incretin-based medications. Lancet. 2026. Perkovic V, et al. Effects of semaglutide on chronic kidney disease in type 2 diabetes (FLOW). N Engl J Med. 2024. Rosen CJ, Ingelfinger JR. GLP-1 receptor agonists. N Engl J Med. 2026. Saraiva JFK, et al. 2025 Brazilian guideline on obesity management and cardiovascular prevention. Arq Bras Cardiol. 2025. Sanyal AJ, et al. Semaglutide in metabolic dysfunction-associated steatohepatitis (ESSENCE). N Engl J Med. 2025. Wyckoff JA, et al. Preexisting diabetes and pregnancy: Endocrine Society/ESE guideline. Eur J Endocrinol. 2025. Brazilian Society of Anesthesiology (SBA). Update on perioperative management of GLP-1 RAs and GLP-1/GIP co-agonists. 2026. Available at: sbahq.org