Diversity of pleiotropic effects of semaglutide: From potential mechanisms to real clinical outcomes

The new cardio-reno-metabolic strategy in the monitoring and treatment of patients with type 2 diabetes mellitus (T2DM) obliges the clinician to increasingly prefer early combination therapy, which provides not only reliable and safe glycemic control, but also protection against cardio-renal complications of T2DM. The drugs that meet these requirements are sodium-glucose cotransporter type 2 inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, which have shown not only a high efficacy and safety profile, but also a reduced risk of major cardiovascular diseases, chronic kidney disease and mortality. Moreover, it is currently known that the pleiotropic effects of these drugs are not limited to cardio-renal protection. This article discusses the latest data on the effects of GLP-1 receptor agonists, which open up completely unexpected prospects for the use of these drugs, such as the treatment of heart failure, non-alcoholic fatty liver disease, steatohepatitis and neurodegenerative diseases.