Agonistas del receptor GLP-1 y co-agonistas GIP/GLP-1 en el tratamiento de la obesidad en adolescentes y ancianos

Pérez López, Gilberto

doi:10.1016/j.medcli.2025.107122

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Este artículo forma parte de:

Obesity and GLP-1 / Obesity and GLP-1

Editado por: Silvia Pellitero-Rodríguez - University Hospital Germans Trias i Pujol Badalona
Federico Vázquez Sanmiguel - University Hospital Germans Trias i Pujol Badalona

Última actualización: Octubre 2025

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Resumen

La obesidad representa un desafío de salud pública global, con características y necesidades específicas en poblaciones adolescentes y ancianas. Los agonistas del receptor GLP-1 (péptido similar al glucagón tipo1) como liraglutida y semaglutida, así como el co-agonista de los receptores GIP (polipéptido insulinotrópico dependiente de glucosa) y GLP-1 tirzepatida, han emergido como opciones terapéuticas prometedoras para el manejo de la obesidad.

Esta revisión analiza el desarrollo clínico, la eficacia, la seguridad y la tolerabilidad de estos fármacos específicamente en adolescentes y ancianos, poblaciones habitualmente subrepresentadas en ensayos clínicos. Se detallan los hallazgos de estudios clínicos pivotales y datos de vida real, evidenciando que estos medicamentos ofrecen beneficios significativos en la reducción ponderal, aunque con consideraciones de seguridad particulares para cada grupo etario. Adicionalmente, se exploran las moléculas GLP-1 emergentes en desarrollo clínico con potencial aplicación en estas poblaciones especiales. Las conclusiones subrayan la necesidad de un enfoque personalizado considerando las diferencias fisiopatológicas, farmacocinéticas y farmacodinámicas específicas de cada grupo poblacional.

Palabras clave:

Agonistas GLP-1

Semaglutida

Tirzepatida

Liragutida

Obesidad

Adolescentes

Ancianos

Abstract

Obesity represents a global public health challenge, with specific characteristics and needs in adolescent and elderly populations. GLP-1 (glucagon-like peptide-1) receptor agonists such as liraglutide and semaglutide, as well as the GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptor co-agonist tirzepatide, have emerged as promising therapeutic options for obesity management. This review analyzes the clinical development, efficacy, safety, and tolerability of these drugs specifically in adolescents and the elderly, populations typically underrepresented in initial clinical trials. Findings from pivotal clinical studies and real-world data are detailed, showing that these medications offer significant benefits in weight reduction, albeit with particular safety considerations for each age group. Additionally, emerging GLP-1 molecules in clinical development with potential application in these special populations are explored. The conclusions emphasize the need for a personalized approach considering the specific pathophysiological, pharmacokinetic, and pharmacodynamic differences of each population group.

Keywords:

GLP-1 agonists

Semaglutide

Tirzepatide

Liraglutide

Obesity

Adolescents

Elderly

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Agonistas del receptor GLP-1 y co-agonistas GIP/GLP-1 en el tratamiento de la obesidad en adolescentes y ancianos

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