{"id":61461,"date":"2022-08-13T18:28:43","date_gmt":"2022-08-13T11:28:43","guid":{"rendered":"https:\/\/asprou.com\/?p=61461"},"modified":"2023-04-06T15:46:51","modified_gmt":"2023-04-06T08:46:51","slug":"tirzepatide-thuoc-chu-van-tren-hai-thu-the-gip-va-glp-1","status":"publish","type":"post","link":"https:\/\/asprou.com\/khoa-duoc\/tirzepatide-thuoc-chu-van-tren-hai-thu-the-gip-va-glp-1\/","title":{"rendered":"Tirzepatide – thu\u1ed1c ch\u1ee7 v\u1eadn tr\u00ean hai th\u1ee5 th\u1ec3 GIP v\u00e0 GLP-1 \u0111\u1ea7u ti\u00ean v\u00e0 duy nh\u1ea5t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 \u1edf ng\u01b0\u1eddi l\u1edbn"},"content":{"rendered":"\n
  1. T\u1ed4NG QUAN<\/strong><\/li><\/ol>\n\n\n\n

    B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – d\u1ea1ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng m\u00e3n t\u00ednh v\u00e0 ti\u1ebfn tri\u1ec3n trong \u0111\u00f3 c\u01a1 th\u1ec3 kh\u00f4ng t\u1ea1o ra ho\u1eb7c s\u1eed d\u1ee5ng insulin m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3, d\u1eabn \u0111\u1ebfn l\u01b0\u1ee3ng glucose trong m\u00e1u t\u0103ng cao. M\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nh\u01b0ng nhi\u1ec1u b\u1ec7nh nh\u00e2n v\u1eabn kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau \u0111\u01b0\u1eddng huy\u1ebft khuy\u1ebfn c\u00e1o. C\u00e1c c\u00f4ng ty d\u01b0\u1ee3c ph\u1ea9m v\u1eabn kh\u00f4ng ng\u1eebng nghi\u00ean c\u1ee9u thu\u1ed1c m\u1edbi gi\u00fap ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft v\u00e0 h\u1ea1n ch\u1ebf th\u1ea5p nh\u1ea5t t\u00e1c d\u1ee5ng ph\u1ee5 \u0111\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n\n\n\n

    Ng\u00e0y 13 th\u00e1ng 5 n\u0103m 2022, C\u1ee5c Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 (FDA) \u0111\u00e3 ph\u00ea duy\u1ec7t tirzepatide (Mounjaro\u2122), l\u00e0 ch\u1ea5t ch\u1ee7 v\u1eadn tr\u00ean c\u1ea3 hai th\u1ee5 th\u1ec3 GIP (glucose-dependent insulinotropic polypeptide) v\u00e0 th\u1ee5 th\u1ec3 GLP-1 (glucagon-like peptide-1), \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 c\u1ea3i thi\u1ec7n vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf ng\u01b0\u1eddi l\u1edbn m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng type 2 k\u1ebft h\u1ee3p v\u1edbi ch\u1ebf \u0111\u1ed9 \u0103n ki\u00eang v\u00e0 t\u1eadp th\u1ec3 d\u1ee5c.<\/p>\n\n\n\n

    2. C\u01a0 CH\u1ebe T\u00c1C \u0110\u1ed8NG<\/strong><\/p>\n\n\n\n

    Thu\u1ed1c Tirzepatide t\u00e1c \u0111\u1ed9ng ch\u1ee7 v\u1eadn tr\u00ean th\u1ee5 th\u1ec3 GIP (polypeptid h\u01b0\u1edbng insulin ph\u1ee5 thu\u1ed9c glucose) v\u00e0 GLP-1 (Peptid-1 gi\u1ed1ng glucagon) c\u1ee7a c\u01a1 th\u1ec3 ng\u01b0\u1eddi. Mounjaro l\u00e0 lo\u1ea1i thu\u1ed1c \u0111\u1ea7u ti\u00ean k\u00edch th\u00edch c\u1ea3 th\u1ee5 th\u1ec3 GLP-1 v\u00e0 GIP, gi\u00fap c\u1ea3i thi\u1ec7n ki\u1ec3m so\u00e1t l\u01b0\u1ee3ng \u0111\u01b0\u1eddng trong m\u00e1u. Mounjaro \u0111\u01b0\u1ee3c d\u00f9ng b\u1eb1ng c\u00e1ch ti\u00eam d\u01b0\u1edbi da m\u1ed7i tu\u1ea7n m\u1ed9t l\u1ea7n, v\u1edbi li\u1ec1u l\u01b0\u1ee3ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo s\u1ef1 dung n\u1ea1p \u0111\u1ec3 \u0111\u1ea1t m\u1ee9c \u0111\u01b0\u1eddng huy\u1ebft m\u1ee5c ti\u00eau.<\/p>\n\n\n\n

    3. HI\u1ec6U QU\u1ea2 L\u00c2M S\u00c0NG<\/strong><\/p>\n\n\n\n

    3.1. C\u1ea3i thi\u1ec7n \u0111\u01b0\u1eddng huy\u1ebft<\/strong><\/p>\n\n\n\n

    Hi\u1ec7u qu\u1ea3 c\u1ee7a Tirzepatide \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi gi\u1ea3 d\u01b0\u1ee3c, m\u1ed9t ch\u1ea5t ch\u1ee7 v\u1eadn th\u1ee5 th\u1ec3 GLP-1 (Semaglutide) v\u00e0 hai ch\u1ea5t t\u01b0\u01a1ng t\u1ef1 insulin t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i. Ba li\u1ec1u l\u01b0\u1ee3ng kh\u00e1c nhau c\u1ee7a Tirzepatide (5, 10 v\u00e0 15 mg) \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 trong n\u0103m th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u1edbi li\u1ec7u ph\u00e1p \u0111\u01a1n tr\u1ecb ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c ti\u1ec3u \u0111\u01b0\u1eddng kh\u00e1c.<\/p>\n\n\n\n

    Nh\u1eefng b\u1ec7nh nh\u00e2n ng\u1eabu nhi\u00ean nh\u1eadn \u0111\u01b0\u1ee3c li\u1ec1u Tirzepatide 15 mg \u0111\u00e3 gi\u1ea3m m\u1ee9c hemoglobin A1c (HbA1c) h\u01a1n 1,6% so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u01a1n tr\u1ecb v\u00e0 h\u01a1n 1,5% so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c khi k\u1ebft h\u1ee3p v\u1edbi insulin t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i. Trong c\u00e1c th\u1eed nghi\u1ec7m so s\u00e1nh Tirzepatide v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng kh\u00e1c, nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng Tirzepatide li\u1ec1u 15 mg \u0111\u00e3 gi\u1ea3m HbA1c h\u01a1n 0,5% so v\u1edbi Semaglutide, 0,9% so v\u1edbi insulin Degludec v\u00e0 1,0% so v\u1edbi insulin Glargine.<\/p>\n\n\n\n

    3.2 Ki\u1ec3m so\u00e1t c\u00e2n n\u1eb7ng<\/strong><\/p>\n\n\n\n

    Nh\u1eefng ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u ph\u1ea7n l\u1edbn b\u00e9o ph\u00ec v\u1edbi BMI (ch\u1ec9 s\u1ed1 kh\u1ed1i c\u01a1 th\u1ec3) trung b\u00ecnh t\u1eeb 32 \u0111\u1ebfn 34 kg\/chi\u1ec1u cao (m2<\/sup>). Trong s\u1ed1 c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ecdn ng\u1eabu nhi\u00ean v\u1edbi li\u1ec1u khuy\u1ebfn c\u00e1o t\u1ed1i \u0111a 15 mg, m\u1ee9c gi\u1ea3m c\u00e2n trung b\u00ecnh v\u1edbi tirzepatide \u0111\u01a1n tr\u1ecb cao h\u01a1n 15 pound (6,80 kg) so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c v\u00e0 h\u01a1n 23 pound (10,43 kg) so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c khi ph\u1ed1i h\u1ee3p v\u1edbi insulin. M\u1ee9c gi\u1ea3m c\u00e2n trung b\u00ecnh v\u1edbi li\u1ec1u tirzepatide 15 mg cao h\u01a1n 12 pound (5,44 kg) so v\u1edbi Semaglutide, 29 pound (13,15 kg) so v\u1edbi insulin Degludec v\u00e0 27 pound (12,25 kg) so v\u1edbi insulin Glargine. Nh\u1eefng b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb insulin m\u00e0 kh\u00f4ng c\u00f3 Tirzepatide c\u00f3 xu h\u01b0\u1edbng t\u0103ng c\u00e2n trong qu\u00e1 tr\u00ecnh nghi\u00ean c\u1ee9u.<\/p>\n\n\n\n

    4. S\u1eec D\u1ee4NG<\/strong><\/p>\n\n\n\n

    4.1. Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/p>\n\n\n\n

    C\u1ea3i thi\u1ec7n vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf ng\u01b0\u1eddi l\u1edbn m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng type 2 k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 \u0103n ki\u00eang v\u00e0 t\u1eadp th\u1ec3 d\u1ee5c.<\/p>\n\n\n\n

    H\u1ea1n ch\u1ebf s\u1eed d\u1ee5ng:<\/p>\n\n\n\n

    – Ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed vi\u00eam t\u1ee5y.<\/p>\n\n\n\n

    – Kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng cho b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 1.<\/p>\n\n\n\n

    4.2. Li\u1ec1u v\u00e0 \u0111\u01b0\u1eddng d\u00f9ng<\/strong><\/p>\n\n\n\n

    \u0110\u01b0\u1eddng d\u00f9ng: ti\u00eam d\u01b0\u1edbi da.<\/p>\n\n\n\n

    Li\u1ec1u khuy\u1ebfn c\u00e1o:<\/p>\n\n\n\n

    – Li\u1ec1u kh\u1edfi \u0111\u1ea7u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 2,5 mg m\u1ed7i tu\u1ea7n m\u1ed9t l\u1ea7n.<\/p>\n\n\n\n

    – Sau 4 tu\u1ea7n, t\u0103ng l\u00ean 5 mg m\u1ed7i tu\u1ea7n m\u1ed9t l\u1ea7n.<\/p>\n\n\n\n

    – Sau \u00edt nh\u1ea5t 4 tu\u1ea7n, n\u1ebfu c\u1ea7n ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft, t\u0103ng 2,5 mg v\u1edbi li\u1ec1u hi\u1ec7n t\u1ea1i.<\/p>\n\n\n\n

    – Li\u1ec1u t\u1ed1i \u0111a l\u00e0 15 mg m\u1ed7i tu\u1ea7n m\u1ed9t l\u1ea7n.<\/p>\n\n\n\n

    – D\u00f9ng thu\u1ed1c m\u1ed7i tu\u1ea7n m\u1ed9t l\u1ea7n v\u00e0o b\u1ea5t k\u1ef3 th\u1eddi \u0111i\u1ec3m n\u00e0o trong ng\u00e0y.<\/p>\n\n\n\n

    – Lu\u00e2n phi\u00ean c\u00e1c v\u1ecb tr\u00ed ti\u00eam \u1edf b\u1ee5ng, \u0111\u00f9i ho\u1eb7c b\u1eafp tay.<\/p>\n\n\n\n

    4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/p>\n\n\n\n

    – Ti\u1ec1n s\u1eed c\u00e1 nh\u00e2n ho\u1eb7c gia \u0111\u00ecnh b\u1ecb ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn gi\u00e1p th\u1ec3 tu\u1ef7 ho\u1eb7c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng \u0111a u tuy\u1ebfn n\u1ed9i ti\u1ebft type 2.<\/p>\n\n\n\n

    – Qu\u00e1 m\u1eabn nghi\u00eam tr\u1ecdng \u0111\u00e3 bi\u1ebft v\u1edbi tirzepatide ho\u1eb7c b\u1ea5t k\u1ef3 t\u00e1 d\u01b0\u1ee3c trong Mounjaro\u2122.<\/p>\n\n\n\n

    4.4. T\u00e1c d\u1ee5ng ph\u1ee5<\/strong><\/p>\n\n\n\n

    C\u00e1c ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i th\u01b0\u1eddng g\u1eb7p nh\u1ea5t, \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u22655% b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Tirzepatide (Mounjaro\u2122) l\u00e0: bu\u1ed3n n\u00f4n, ti\u00eau ch\u1ea3y, gi\u1ea3m c\u1ea3m gi\u00e1c th\u00e8m \u0103n, n\u00f4n m\u1eeda, t\u00e1o b\u00f3n, kh\u00f3 ti\u00eau v\u00e0 \u0111au b\u1ee5ng.<\/p>\n\n\n\n

    ThS.DS. Ph\u1ea1m C\u1ea3nh Em<\/strong> t\u1ed5ng h\u1ee3p<\/strong><\/p>\n\n\n\n

    T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/strong><\/p>\n\n\n\n

    1. FDA, \u201cFDA Approves Novel, Dual-Targeted Treatment for Type 2 Diabetes,\u201d May 13, 2022 [Online]. Available: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-novel-dual-targeted-treatment-type-2-diabetes<\/a>.<\/p>\n\n\n\n

    2. Dahl D, Onishi Y, Norwood P, Huh R, Bray R, Patel H, Rodr\u00edguez \u00c1. Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients With Type 2 Diabetes: The SURPASS-5 Randomized Clinical Trial. JAMA. 2022, 327(6):534-545. DOI: 10.1001\/jama.2022.0078. 3. FDA, \u201cMOUNJAROTM<\/sup> (tirzepatide) Injection, for subcutaneous use,\u201d 2022. Available: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2022\/215866s000lbl.pdf.<\/p>\n","protected":false},"excerpt":{"rendered":"

    B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – d\u1ea1ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng m\u00e3n t\u00ednh v\u00e0 ti\u1ebfn tri\u1ec3n trong \u0111\u00f3 c\u01a1 th\u1ec3 kh\u00f4ng t\u1ea1o ra ho\u1eb7c s\u1eed d\u1ee5ng insulin m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3, d\u1eabn \u0111\u1ebfn l\u01b0\u1ee3ng glucose trong m\u00e1u t\u0103ng cao. M\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nh\u01b0ng nhi\u1ec1u b\u1ec7nh nh\u00e2n v\u1eabn kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau \u0111\u01b0\u1eddng huy\u1ebft khuy\u1ebfn c\u00e1o. 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