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Open Access Green as soon as Postprint is submitted to ZB.
Novel GLP-1-based medications for type 2 diabetes and obesity.
Endocr. Rev.:bnaf036 (2025)
The approvals of semaglutide and tirzepatide have set new benchmarks in the treatment of type 2 diabetes and obesity. Building on their success, novel GLP-1-based therapeutics are rapidly advancing. These next-generation agents engage not only GLP-1 receptors but also those for other gastro-entero-pancreatic hormones such as glucose-dependent insulinotropic polypeptide (GIP), glucagon, amylin, and peptide YY (PYY) to enhance energy uptake, storage, and expenditure through synergistic mechanisms. Both GIP receptor agonism and antagonism, particularly in combination with GLP-1 receptor agonism, have shown promise. Maridebart cafraglutide, combining GLP-1R agonism with GIPR antagonism, exemplifies this innovative approach. Glucagon co-agonists like survodutide and mazdutide have demonstrated significant weight loss and improved glycemic control. Amylin-based agents, including CagriSema (cagrilintide + semaglutide) and amycretin, enhance satiety and glycemic outcomes through complementary actions. Further innovation is seen in triple agonists such as retatrutide, which targets GIP, GLP-1, and glucagon receptors to amplify metabolic effects. Meanwhile, the emergence of orally active small-molecule GLP-1 receptor agonists like danuglipron and orforglipron, which are resistant to enzymatic degradation, marks a major advance in patient-friendly drug delivery. This review explores the mechanisms, clinical development, and therapeutic potential of these novel agents, excluding already approved drugs like liraglutide, semaglutide, and tirzepatide. We highlight how multi-receptor agonists and oral GLP-1-based therapies may reshape the future landscape of obesity and type 2 diabetes treatment by offering more effective and better-tolerated options.
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Publication type
Article: Journal article
Document type
Review
Keywords
Glucagon-like Peptide-1 ; Obesity ; Amylin ; Glucagon ; Glucose-dependent Insulinotropic Polypeptide; Glucagon-like Peptide-1; Dependent Insulinotropic Polypeptide; Gastric-inhibitory Polypeptide; Glp-1 Receptor Activation; Once-weekly Cagrilintide; Beta-cell Function; Semaglutide 2.4 Mg; Food-intake; Double-blind; Glucose-homeostasis
ISSN (print) / ISBN
0163-769X
e-ISSN
1945-7189
Journal
Endocrine Reviews
Quellenangaben
Article Number: bnaf036
Publisher
The Endocrine Society
Publishing Place
Bethesda, Md.
Reviewing status
Peer reviewed
Institute(s)
Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)