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Research Article Volume 18 Issue 2
From venom to precision medicine: cardiometabolic and hepatoprotective advances in incretin-based therapies
Ney Carter do Carmo Borges
Received: June 16, 2025 | Published: June 27, 2025
Citation: Borges NCC. From venom to precision medicine: cardiometabolic and hepatoprotective advances in incretin-based therapies. J Cardiol Curr Res. 2025;18(2):35-49. DOI: 10.15406/jccr.2025.18.00622
Abstract
Background: Incretin-based therapies have revolutionized the treatment of type 2 diabetes mellitus (T2DM), obesity, and cardiometabolic disorders. Originating from the venom of Heloderma suspectum, these agents now represent a diverse class of GLP-1 receptor agonists and multi-receptor incretin mimetics with profound metabolic effects. Objectives: To provide a comprehensive review of the pharmacological properties, clinical efficacy, cardiometabolic and hepatic benefits of all approved and investigational incretin-based therapies, including GLP-1, GIP, and glucagon co-agonists. Methods: A structured narrative review was conducted using data from phase 2–3 clinical trials, regulatory submissions, and mechanistic studies. Pharmacokinetic profiles, comparative efficacy, and safety data were critically analyzed and synthesized into tables and figures. Results: GLP-1 receptor agonists (GLP-1RAs) such as liraglutide, semaglutide, and dulaglutide have demonstrated significant reductions in HbA1c and weight, alongside cardiovascular benefits with relative risk reductions in MACE ranging from 12% to 26%. Newer agents like tirzepatide and mazdutide offer dual and triple agonism with greater efficacy in metabolic endpoints and liver fat reduction. Pharmacokinetic optimizations, including acylation, Fc-fusion, and oral non-peptidic platforms, have expanded patient access and adherence. Conclusion: Incretin therapies have evolved from peptide-based glucose modulators into multi-organ protective agents. With emerging triple agonists and oral innovations, incretin-based treatment is poised to become central in preventing and managing complex cardiometabolic and hepatic diseases.
Keywords: GLP-1 receptor agonists, tirzepatide, semaglutide, mazdutide, retatrutide, obesity, MASLD, pharmacokinetics, cardiovascular outcomes, liver protection
©2025 Borges. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.