北京若生智能科技有限公司
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glucagon (GlucaGen / GlucaGen Hypokit / Glucagon G)

✓ Approved

Eisai Co., Ltd. · GCGR · 重组蛋白

什么是 glucagon？

glucagon 是一种重组蛋白，由Eisai Co., Ltd.研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intramuscular (IM) Injection、Intravenous (IV)、Subcutaneous Injection。

药物档案

商品名GlucaGen, GlucaGen Hypokit, Glucagon G
公司Eisai Co., Ltd.
药物类别重组蛋白
分子靶点GCGR
给药途径Injectable (Others), Intramuscular (IM) Injection, Intravenous (IV), Subcutaneous Injection
状态Approved
来源： ClinicalTrials.gov, Eisai Co., Ltd.

作用机制

分子靶点

glucagon 作用于 1 个分子靶点：

GCGRglucagon receptor (GL-R, GGR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

glucagon 针对 2 个适应症，涉及 2 个治疗领域。

治疗领域疾病/病症分期
Gastrointestinal disordersGastrointestinal mucosal necrosis✓ Approved
Metabolism and nutrition disordersHypoglycaemia✓ Approved

相关研究文献

PubMedEndocrine oncology (Bristol, England)2026-10-26

Mahvash disease: A novel case of apparent monoallelic disease and a novel cause of hypoglycaemia.

Bano Gul G, Barry Sayka S, Khoo Bernard B, Chong Heung H et al.

Glucagon cell hyperplasia and neoplasia (GCHN), also known as Mahvash disease (MVAH), is a rare pancreatic neuroendocrine disorder. In most cases, the disorder is autosomal recessive and caused by inactivating mutations in the glucagon receptor (GCGR), leading to pancreatic α-cell hyperplasia and hyperglucagonemia, with sporadic association with hypoglycaemia. We present an adult female patient presenting with recurrent hypoglycaemia: she had an enlarged pancreas and very high levels of glucagon. Severe hypoglycaemia is not generally seen in most cases of Mahvash syndrome; this could suggest the possibility of an occult insulinoma. Genetic testing showed an essential splice variant in GCGR that predicts loss of protein production. It is most likely a single pathogenic variant in the GCGR gene, although the literature reports only a recessive phenotype. We cannot entirely exclude an autosomal recessive condition in terms of mutations in promoter or relevant intronic regions.

PMID 42929440
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PubMedHand (New York, N.Y.)2026-10-26

Glucagon-Like Peptide-1 Receptor Agonist Use Is Associated With Increased Peripheral Nerve Compression After Bariatric Surgery.

Biaggi-Ondina Andrea A, Boukind Adam A, Izadi Lillee L, Patel Aneri U AU et al.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may reduce carpal tunnel syndrome (CTS) risk but are associated with acute compressive neuropathies after rapid weight loss ("slimmer's palsy"). This study evaluated upper-extremity nerve compression rates in patients with massive weight loss after bariatric surgery alone versus concurrent GLP-1RAs. A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Adults who underwent bariatric surgery (January 2015-February 2026) were stratified by concurrent GLP-1RA therapy versus surgery alone. Propensity score matching (1:1) balanced baseline demographics and comorbidities. Primary outcomes were new CTS and cubital tunnel syndrome (CuTS). Secondary outcomes included surgical release and electrodiagnostic testing rates. Risk ratios (RRs) with 95% CIs were calculated. In total, 11 158 patients were included in each cohort. The GLP-1RA group was younger (50.6 ± 12.2 vs 53.5 ± 14.3 years, P < .001) with lower BMI (39.9 ± 8.0 vs 42.6 ± 7.9 kg/m2, P < .001). Median follow-up duration was 365 days. The GLP-1RA group had a 63% higher risk of developing CTS (RR, 1.63; 95% CI, 1.26-2.10; P < .001) and a 110% higher risk of being diagnosed with CuTS (RR, 2.10; 95% CI, 1.35-3.27; P < .001). Carpal tunnel release rates were similar between groups (RR, 1.54; 95% CI, 0.77-3.09; P = .223). Glucagon-like peptide-1 receptor agonist users were more likely to undergo electrodiagnostic testing (RR, 1.43; 95% CI, 1.06-1.91; P = .017). Adjunctive GLP-1RA therapy was associated with increased diagnoses of CTS and CuTS without higher surgical rates, suggesting greater susceptibility to nerve compression. Further studies are needed to clarify mechanisms and guide clinical monitoring.

PMID 42929395
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PubMedAdvances in therapy2026-10-26

Characteristics and Treatment Utilisation Patterns of Individuals Using Tirzepatide for Type 2 Diabetes in Germany.

Füchtenbusch Martin M, Kraus Marius M, Heitmann Elke E, Wilhelm Stefan S et al.

This study describes real-world characteristics and utilisation patterns of tirzepatide among adults with type 2 diabetes in German office-based practice. This retrospective observational study analysed data from the CompuGroup Medical Healthcare Database. Cohort 1 initiated tirzepatide between 1 December 2023 and 31 March 2024 and cohort 2 between 1 July and 30 September 2024. A subgroup of cohort 1 with ≥ 6 months' follow-up data and uninterrupted tirzepatide use (cohort 1a) was also analysed. Descriptive statistics summarised baseline characteristics, prior therapy, and dosing patterns. Cohort 1 included 1223 individuals and cohort 2 included 2300; mean (± standard deviation) age was 59 ± 12 and 60 ± 12 years, respectively, and approximately 54% were male. Comorbidities, especially hypertension and dyslipidaemia, were frequent. Most individuals had prior insulin and/or glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment (cohort 1, 72.1%; cohort 2, 59.6%). A total of 458 individuals had 6 months' follow-up (cohort 1a). The most common starting dose was 2.5 mg (71.2%). Use of higher doses gradually increased over time, with 5.0 mg becoming the most prevalent; at 6 months, 35.9% of individuals received 5.0 mg and 18.6% received 10.0 mg. This first comprehensive real-world study of tirzepatide use in Germany showed tirzepatide initiation primarily after GLP-1 RA and/or insulin therapy. Most individuals remained on 5.0 mg, with a notable proportion escalating to 10.0 mg. Cohort characteristics were generally similar to those in the SURPASS trials, supporting the relevance of trial findings to clinical practice.

PMID 42928086
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PubMedDiabetes, obesity & metabolism2026-10-26

Neuropsychiatric Outcomes Associated With GLP-1 Receptor Agonist Use in Medicare Beneficiaries With Type 2 Diabetes: Variation by Treatment Pattern and Obesity Status.

Baik Seo Hyon SH, Baye Fitsum F, Xian Haotian H, Fung Kin Wah KW et al.

Glucagon-like peptide-1 (GLP-1) receptors are expressed in brain regions governing mood, reward and stress, yet the neuropsychiatric effects of GLP-1 receptor agonist (GLP-1 RA) therapy remain poorly characterized. We estimated associations between GLP-1 RA use and neuropsychiatric disorders and variation by obesity status and treatment pattern. This population-based cohort study used claims data from Medicare enrolees with Type 2 diabetes mellitus. GLP-1 RAs were compared with other second-line glucose-lowering medications and evaluated across four treatment patterns: monotherapy, switch, escalation and augmentation. Eight neuropsychiatric outcomes were examined using 1:1 propensity score-matched, covariate-adjusted stratified Cox regression with time-varying covariates. GLP-1 RA use was associated with a small increase in aggregate psychiatric disorder risk (Hazard Ratio [HR] = 1.04; 95% Confidence Interval: 1.03-1.06; 1.7 excess events/1000 person-years), of uncertain clinical significance given the large cohort size. Risk was elevated for depression (HR = 1.11; 3.0 excess events/1000 person-years) but reduced for substance use disorders (HR = 0.84; 4.1 fewer events/1000 person-years), dementia (HR = 0.87; 2.8 fewer) and suicidal/self-harm (HR = 0.81; 0.4 fewer events/1000 person-years). Associations varied by treatment pattern: monotherapy showed elevated psychiatric (HR = 1.43) and elevated emotional symptom (HR = 1.32) risks; escalation also exhibited elevated psychiatric risk, whereas switch and augmentation demonstrated reduced or null risks. Rather than a uniform class effect, the neuropsychiatric profile of GLP-1 RA appears context-dependent, differing by treatment pattern, obesity status and outcome examined. Elevated risk with monotherapy or escalation may reflect baseline clinical differences rather than pharmacological effect. Reduced risks of substance use disorders, dementia and suicidal/self-harm are reassuring.

PMID 42928425
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PubMedCureus2026-10-26

Perioperative Safety Considerations and Surgical Outcomes Associated With GLP-1-Based Therapies: A Systematic Review.

Rodrigues da Cunha Mayte M, Rodrigues da Cunha Marco Túlio MT

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for the management of type 2 diabetes mellitus and obesity. Their effects on gastric emptying have raised concerns in the perioperative setting, where standard fasting protocols are used to reduce aspiration risk. However, the clinical significance of altered gastric physiology and its implications for perioperative management remain uncertain. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD420261289189). A comprehensive literature search identified studies evaluating perioperative gastric physiology and procedural safety outcomes associated with GLP-1 RA use in adults undergoing procedures requiring sedation or general anesthesia. Outcomes included delayed gastric emptying, residual gastric contents, aspiration or regurgitation events, and perioperative management adaptations. Sixteen studies met the inclusion criteria, comprising seven observational studies and nine case reports or case series. Observational evidence demonstrated an association between GLP-1 RA use, particularly semaglutide, and increased residual gastric contents or delayed gastric emptying despite adherence to standard fasting protocols. These findings were identified primarily through gastric ultrasound and endoscopic assessment. In contrast, clinically apparent aspiration or regurgitation events were uncommon and were reported predominantly in case-based literature. Larger observational studies did not demonstrate a clear increase in aspiration or broader perioperative complications. Identification of retained gastric contents also influenced clinical management in several reports, resulting in changes to anesthetic planning, additional gastric assessment, or postponement of elective procedures. GLP-1 RA therapy is associated with alterations in gastric physiology that may challenge the assumptions underlying standard preoperative fasting protocols. Although increased residual gastric contents are consistently reported, current evidence does not establish a corresponding increase in clinically significant aspiration events. Individualized preoperative risk assessment, including consideration of medication exposure and selective use of gastric ultrasound, may assist perioperative decision-making. Further prospective studies are needed to quantify aspiration risk and establish evidence-based perioperative management strategies.

PMID 42928739
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PubMedCureus2026-10-26

IcoSema in Weight Management and Glycaemic Control: A Systematic Review and Meta-Analysis.

Nouh Mahmoud Ismail MI, Karrar Hani Raka HR, AlButi Hala H, Alhendi Rehab Salah Aldin RSA et al.

IcoSema is a once-weekly, fixed-ratio injection that combines insulin icodec, a weekly basal insulin, with semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. It is intended to control fasting and post-meal glucose in a single weekly injection whilst limiting the weight gain and hypoglycaemia that accompany insulin therapy. Its pivotal trials each used a different comparison treatment, and the only previous pairwise synthesis pooled them into single estimates carrying extreme statistical heterogeneity. We therefore re-synthesised the randomised evidence using a comparator-specific approach. Eight sources (PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), ClinicalTrials.gov, and citation searching) were searched from inception to September 5, 2026, for randomised controlled trials of IcoSema in adults with type 2 diabetes. Two reviewers independently screened records, extracted data, and applied Cochrane Risk of Bias 2. Covariate-adjusted treatment differences were combined by random-effects inverse-variance meta-analysis, stratified by comparator class, with an exploratory all-comparator pool retained for comparison only and certainty rated with GRADE. Four phase 3 trials (3,138 participants) were eligible: COMBINE 1, 2, 3 and 4. Against basal insulin alone (COMBINE 1 and 4; two trials, 1,776 participants), IcoSema lowered HbA1c by 0.74 percentage points (95% confidence interval (CI) -0.95 to -0.53; I² = 63%), reduced body weight by 5.15 kg (95% CI -6.10 to -4.19; I² = 70%), and reduced clinically significant or severe hypoglycaemia (rate ratio 0.35, 95% CI 0.14 to 0.87; I² = 84%). Against semaglutide alone (COMBINE 2; single trial), IcoSema lowered HbA1c by a further 0.44 percentage points (95% CI -0.56 to -0.33), but body weight was 4.54 kg higher (95% CI 3.84 to 5.23), with no significant difference in hypoglycaemia. Against daily basal-bolus insulin (COMBINE 3; single trial), IcoSema met non-inferiority for HbA1c (-0.06 percentage points, 95% CI -0.22 to 0.09), reduced body weight by 6.72 kg (95% CI -7.58 to -5.86), and reduced hypoglycaemia (rate ratio 0.12, 95% CI 0.08 to 0.17). Exploratory pooling across all comparators produced estimates with I² of 92%-99.5% that should not be read as an overall treatment effect. The effects of IcoSema on glycaemia, weight, and hypoglycaemia differ in size, and for body weight in direction, according to the regimen it is compared with; comparator-specific estimates, not a single pooled figure, should inform interpretation.

PMID 42928846
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