Incrétines et twincrétines : le futur ? Indications, bénéfices et aspects pratiques de leur prescription
(2026) Louvain médical — Vol. 145, n° 1, p. 10-14 (2026)
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- (en) [Incretins and twincretins: the future? Indications, benefits, and practical aspects of prescribing them] Obesity is a chronic, multifactorial disease whose global prevalence continues to rise. It is associated with significant cardiometabolic, hepatic, and psychological complications. Incretin-based therapies, including glucagon-like peptide-1 (GLP-1) receptor agonists (RA) and dual GLP-1/glucose-dependent insulinotropic peptide (GIP) RAs, have transformed the management of obesity and type 2 diabetes. Semaglutide and tirzepatide result in a substantial mean weight loss of 15 to 20% in non-diabetic individuals and improve glycemic control in patients with type 2 diabetes. Large cardiovascular outcome trials have demonstrated significant reductions in major adverse cardiovascular events. Increasing evidence also shows hepatoprotective effects in metabolic dysfunction-associated steatohepatitis (MASH), with semaglutide now being FDA-approved for MASH with moderate-to-severe fibrosis. Tirzepatide also improves steatohepatitis in MASH patients. GLP-1/glucagon RAs, such as survodutide, and triple (GLP-1/GIP/glucagon) RAs, such as retatrutide, demonstrate even greater metabolic efficacy, including substantial reductions in liver fat. Adverse events are mostly gastrointestinal, mild, and temporary. Rare risks include gallstones and pancreatitis. Very rare ocular complications have been reported, but they need to be confirmed. Since weight regain often occurs after treatment is stopped, long-term use is required. Although incretin therapies represent a major advance in obesity treatment, they must be integrated into a comprehensive, multidisciplinary care pathway, balancing long-term benefits, safety, and cost considerations.
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Loumaye, A. (2026). Incrétines et twincrétines : le futur ? Indications, bénéfices et aspects pratiques de leur prescription. Louvain médical, 145(1), 10-14. https://hdl.handle.net/2078.5/276567 (Original work published 2026)