Dr Yael Mauer Details Underlying Mechanisms of GLP-1s, Patient Benefits

At an Institute for Value-Based Medicine® event hosted in conjunction with Cleveland Clinic, Yael Mauer, MD, MPH, Department of Endocrinology, Diabetes, and Metabolism, presented on the current state of knowledge in glucagon-like peptide-1 (GLP-1) receptor agonists. To elaborate on this topic in more detail, Mauer joined The American Journal of Managed Care^® for an interview to discuss the patients who can derive the most benefits from these therapies and how these medications affect the body to influence improved patient outcomes.

Transcript

What specific patient profiles or characteristics might benefit most from the GLP-1 class of medications, and how can health care providers effectively identify and tailor treatment approaches?

So, thank you for that question. That is a really good question. I think obesity is multifactorial, and we also have a lot of different tools to address obesity, so choosing the right approach is key in being able to help our patients. I think patients who would particularly benefit from GLP-1 receptor agonists are those who have difficulty with appetite control and cravings. But [they] are also ideal for patients who have metabolic disease like high blood pressure, or high cholesterol, or high blood sugars, because this medication provides a lot of metabolic benefits by lowering blood pressure, by lowering blood sugar, by lowering cholesterol. These medications decrease the chances that patients will develop diabetes if they already have elevated blood sugars. It also could be ideal for patients who have a family history of cardiovascular disease, because those patients are also at an elevated cardiovascular risk.

Can you elaborate on any recent insights or emerging research that further elucidate the underlying pathways through which these medications exert their anti-obesity effects?

I think we know some of the pathways by which the medications work, but some of the pathways we're still discovering about how the medications work. I would say mostly the medications serve their anti-obesity effects by stimulating areas of the brain that promote satiety and inhibiting areas of the brain that promote hunger, making patients feel fuller and less hungry. They also slightly increase thier energy expenditure by stimulating thermogenesis in brown adipose tissue. And one last pathway is that they slow gastric emptying, so the food sits in the in the stomach for longer periods of time, promoting satiety and promoting satiety for longer periods.