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Review
. 2025 Aug;24(8):631-650.
doi: 10.1038/s41573-025-01183-8. Epub 2025 Apr 25.

GLP-1-based therapies for diabetes, obesity and beyond

Daniel J Drucker  1
Affiliations
Review

GLP-1-based therapies for diabetes, obesity and beyond

Daniel J Drucker. Nat Rev Drug Discov. 2025 Aug.

Erratum in

Abstract

Glucagon-like peptide 1 (GLP-1)-based therapies, such as semaglutide and tirzepatide, represent highly effective treatment options for people with type 2 diabetes and obesity, enabling effective control of glucose and weight loss, while reducing cardiovascular and renal morbidity and mortality. The success of these medicines has spurred development of next-generation GLP-1-based drugs, promising greater weight loss, improved tolerability and additional options for the route and frequency of dosing. This Review profiles established and emerging GLP-1-based medicines, discussing optimization of pharmacokinetics and tolerability, engagement of new therapeutically useful pathways and safety aspects. Structurally unique GLP-1-based medicines that achieve substantially greater and rapid weight loss may impact musculoskeletal health, providing a rationale for therapeutics that more selectively target adipose tissue loss while preserving muscle mass and strength. Ongoing clinical trials in peripheral vascular disease, neuropsychiatric and substance use disorders, metabolic liver disease, arthritis, hypertension and neurodegenerative disorders may broaden indications for GLP-1-based therapeutics.

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Conflict of interest statement

Competing interests: D.J.D. has received consulting fees from Amgen, AstraZeneca Inc., Insulet, Kallyope and Pfizer Inc. and speaking fees from Boehringer Ingelheim and Novo Nordisk Inc. Mount Sinai Hospital has received investigator-initiated grant support from Amgen, Eli Lilly Inc., Novo Nordisk, Pfizer and Zealand Pharmaceuticals Inc. to support preclinical studies in the Drucker laboratory.

References

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