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Medicina Clínica (English Edition) Adverse effects and other aspects of drugs with incretin effect
Journal Information
Vol. 165. Issue 2.
(July 2025)
Review
Adverse effects and other aspects of drugs with incretin effect
Efectos adversos y otros aspectos de los fármacos con efecto incretínico
María D. Ballesteros-Pomara,b, Irene Bretón Lesmesb,c,
Corresponding author
irenebreton@gmail.com

Corresponding author.
a Endocrinología y Nutrición, Complejo Asistencial Universitario de León, Instituto de Investigación Biosanitaria de León (IBioLEÓN), León, Spain
b Area de Obesidad de la Sociedad Española de Endocrinología y Nutrición (ObesitySEEN), Spain
c Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañó (IiSGM), Madrid, Spain
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Tables (2)
Table 1. Adverse effects of dulaglutide, liraglutide, semaglutide and tirzepatide according to the SmPC as of October 2024.
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Table 2. Effects of incretin drugs on body composition.
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Abstract

The most frequent adverse effects related to arGLP-1 are gastrointestinal manifestations, which are usually mild to moderate and diminish after a few days or weeks of continued treatment. Although warnings about the risk of pancreatitis, pancreatic cancer or thyroid cancer continue to be maintained in the data sheets, numerous studies and meta-analyses do not indicate a causal relationship. The relationship with suicidality has not been confirmed either, but they should be prescribed with caution in patients with a history of depression or suicide attempts. The risk of bronchoaspiration should be considered in the perioperative period or with the performance of endoscopic procedures. The effect on body composition is generally favorable, but there is a risk of sarcopenia, which should be prevented. On the other hand, possible benefits are being described for its use in other clinical conditions, such as neurodegenerative diseases or addictions.

Keywords:
Obesity
arGLP-1
Adverse effects
Pancreatitis
Body composition
Addictions
Resumen

Los efectos adversos más frecuentes relacionados con arGLP-1 son manifestaciones gastrointestinales, habitualmente leves a moderados y disminuyen una vez transcurridos algunos días o semanas de tratamiento continuado. Aunque se siguen manteniendo las advertencias sobre el riesgo de pancreatitis, el cáncer de páncreas o el cáncer de tiroides en las fichas técnicas, numerosos estudios y metanálisis no indican una relación causal. No se ha confirmado tampoco la relación con riesgo de suicidio, pero deben prescribirse con precaución en pacientes con antecedentes de depresión o intentos de suicidio. El riesgo de broncoaspiración debe considerarse en el perioperatorio o con la realización de procedimientos endoscópicos. El efecto sobre la composición corporal es, en general, favorable, pero existe el riesgo de que se produzca sarcopenia, que será necesario prevenir. Por otro lado, se están describiendo posibles beneficios para su utilización en otras condiciones clínicas, como las enfermedades neurodegenerativas o las adicciones.

Palabras clave:
Obesidad
arGLP-1
Efectos adversos
Pancreatitis
Composición corporal
Adiciones

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