MULTIDIRECTIONAL CLINICAL BENEFITS OF GLP-1 AGONISTS: A REVIEW OF EFFICACY IN WEIGHT LOSS AND CARDIOVASCULAR PROTECTION

Abstract

Objective: The aim of this article is to systematically review and synthesize current knowledge on the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in obesity therapy and their role in the prevention of cardiovascular and renal complications [1, 2]. The paper focuses on evaluating the clinical efficacy of novel molecules, such as semaglutide and tirzepatide, and analyzing molecular mechanisms extending beyond glycemic control [3, 4]. Methodology: An analysis of the literature from 2017–2026 was conducted, including 30 selected publications, comprising the results of key phase III trials (STEP, SURMOUNT, SELECT programs), meta-analyses, and real-world evidence studies [5, 6]. The analysis evaluated data on BMI reduction, the risk of major adverse cardiovascular events (MACE), and parameters of renal and cardiac function [7, 8]. Results: The analysis demonstrated that modern GLP-1RAs allow for a body mass reduction of 14.9–20.9%, which in certain populations constitutes an alternative to bariatric surgery [9, 10, 11]. It was shown that the use of semaglutide reduces the risk of MACE by 20% in patients with obesity without diabetes (SELECT trial) [12] and improves prognosis in patients with heart failure with preserved ejection fraction (HFpEF) [13]. Additionally, significant nephroprotective and anti-inflammatory effects were confirmed, manifested by a reduction in hsCRP levels and stabilization of atherosclerotic plaques [14, 15, 16]. Conclusions: GLP-1 receptor agonists constitute the foundation of a new therapeutic strategy, combining effective obesity treatment with multiorgan protection [17]. Despite proven efficacy, challenges such as high therapy costs, the risk of losing fat-free mass, and implementation Barries require further optimization of patient care [18, 19, 20]