研究进展825月第37卷第7期中国药事2023年口服胰高血糖素样肽-1受体激动剂研究进展及非临床评价的考虑李",尹茂山",王寅,尹华静,吴爽,戴学栋,王庆利,孙涛*,于冰*(国家药品监督管理局药品审评中心,北京100022)摘要:胰高血糖素样肽-1(Glucagon-likePeptide-1,GLP-1)是一种由肠道L细胞分泌的肠促胰素(Incretin),根据人体血糖水平调控胰岛素和胰高血糖素分泌,维持血糖稳定。胰高血糖素样肽-1受体激动剂(GLP-1ReceptorAgonists,GLP-1RA)是近年来开发的新型降糖药,通过模拟天然GLP-1而激活GLP-1受体,达到控制血糖的目的,同时GLP-1RA还具有控制体质量和改善非酒精性脂肪肝等多重临床获益,正逐步成为治疗糖尿病的第一大处方药物。目前已上市的GLP-1RA主要为注射用药,而与注射给药相比,口服制剂给药方便、治疗痛苦小,患者依从性更好。口服GLP-1RA药物已成为新的糖尿病治疗药物的重要研发方向之一。本文梳理了目前在研GLP-1RA口服小分子和肽类降糖药的研发现状,分析该靶点药物研究应用进展,并从非临床有效性和安全性方面提供评价策略,以期为同类药物的研发和应用提供参考。关键词:胰高血糖素样肽-1;胰高血糖素样肽-1受体激动剂;2型糖尿病;口服;改剂型新药;安全性;非临床评价中图分类号:R97文献标识码:A文章编号:1002-7777(2023)07-0825-09doi:10.16153/j.1002-7777.2023.07.012ResearchProgressofOralGlucagon-LikePeptide-1ReceptorAgonistsandConsiderationofNon-clinicalEvaluationLiZheng',YinMaoshant,WangYin,YinHuajing,WuShuang,DaiXuedong,WangQingli,SunTao',YuBing(CentreforDrugEvaluation,NationalMedicalProductsAdministration,Beijing100022,China)Abstract:Glucagon-likePeptide-1(GLP-1)isakindofincretinsecretedbyintestinalLcells,whichregulatesthesecretionofinsulinandglucagonaccordingtothebody'sbloodsugarlevelandmaintainsbloodsugarstability.GLP-1receptoragonists(GLP-1RA)isanewhypoglycemicdrugdevelopedinrecentyears,whichactivatesGLP-1receptorsbysimulatingnaturalGLP-1toachievethepurposeofcontrollingbloodsugar,whileGLP-1RAalsohasmultipleclinicalbenefitssuchasweightcontrolandimprovementofnon-alcoholicfattyliver,andisgraduallybecomingthefirstprescriptiondrugforthetreatmentofdiabetes.GLP-1RAthathasbeenmarketedismainlyinjectabledrugs,andcomparedwithinj...