{"id":84869,"date":"2026-06-04T11:58:30","date_gmt":"2026-06-04T11:58:30","guid":{"rendered":"https:\/\/www.cofb.org\/?p=84869"},"modified":"2026-06-08T12:01:40","modified_gmt":"2026-06-08T12:01:40","slug":"el-tractament-del-pacient-cardiometabolic-amb-arglp-1-a-les-tertulies-dactualitat-del-cofb","status":"publish","type":"post","link":"https:\/\/www.cofb.org\/ca\/2026\/06\/04\/el-tractament-del-pacient-cardiometabolic-amb-arglp-1-a-les-tertulies-dactualitat-del-cofb\/","title":{"rendered":"El tractament del pacient cardiometab\u00f2lic amb arGLP-1 a les tert\u00falies d\u2019actualitat del COFB"},"content":{"rendered":"\n

El passat 7 de maig, el Col\u00b7legi de Farmac\u00e8utics de Barcelona (COFB) <\/strong>va organitzar la tert\u00falia d\u2019actualitat \u201cAbordatge del pacient cardiometab\u00f2lic amb arGLP-1\u201d<\/strong>, amb el patrocini de Novo Nordisk<\/a>. La tert\u00falia va anar a c\u00e0rrec de la doctora Carla Morer<\/strong>, metgessa del CAP Rio de Janeiro, coordinadora del Grup de Recerca OBES-CAP d\u2019Atenci\u00f3 Prim\u00e0ria per a l\u2019Estudi de l\u2019Obesitat, subinvestigadora a la Unitat de Tractament Integral de l\u2019Obesitat Grup de Recerca de Diabetis i Metabolisme del Vall d\u2019Hebron Institut de Recerca, secretaria del Grup d\u2019Obesitat de la CAMFIC i membre del Grup PRATO de la SEED; i del farmac\u00e8utic comunitari, Crist\u00f2fol Talaver\u00f3n<\/strong>. Els vocals del COFB d\u2019Oficina de Farm\u00e0cia, Merc\u00e8 Barau<\/strong>, i d\u2019Alimentaci\u00f3 i Nutrici\u00f3, Oscar Llans\u00f3<\/strong>, van ser els encarregats de coordinar la sessi\u00f3.<\/p>\n\n\n\n

\"\"<\/a>
La Dra. Carla Morer, Crist\u00f2fol Talaver\u00f3n i Oscar Llans\u00f3 durant la presentaci\u00f3 de la tert\u00falia d’actualitat. <\/figcaption><\/figure>\n\n\n\n

Els objectius<\/strong> de la jornada van ser con\u00e8ixer la malaltia cardiometab\u00f2lica i com els arGLP-1 la regulen<\/strong>, actualitzar els nous punts diana d\u2019acci\u00f3<\/strong>, revisar l’abordatge de l\u2019obesitat i la diabetis amb els nous tractaments<\/strong>, entendre les indicacions i condicions de finan\u00e7ament de les diferents opcions terap\u00e8utiques, adquirir seguretat i confian\u00e7a en la dispensaci\u00f3 dels arGLP-1 i fomentar el seguiment farmacoterap\u00e8utic.<\/p>\n\n\n\n

El pacient cardiometab\u00f2lic<\/strong><\/h2>\n\n\n\n

La Dra. Carla Morer va iniciar la seva exposici\u00f3 explicant que, m\u00e9s enll\u00e0 de la inclusi\u00f3 dels f\u00e0rmacs per a l\u2019obesitat, \u201cal final el que estem intentant prevenir \u00e9s la malaltia cardiometab\u00f2lica\u201d<\/strong>. Per aix\u00f2, va indicar que cal con\u00e8ixer la malaltia cardiometab\u00f2lica, com es tracta avui en dia i com han canviat les guies de pr\u00e0ctica cl\u00ednica amb la inclusi\u00f3 d\u2019aquesta fam\u00edlia de f\u00e0rmacs, juntament els del GLP-2.<\/p>\n\n\n\n

\u201cEl concepte pacient cardiometab\u00f2lic fa refer\u00e8ncia al fet que hi ha s\u00edndrome metab\u00f2lica per un increment de greix en zones al voltant dels \u00f2rgans, que condiciona el risc cardiovascular\u201d<\/strong>, va exposar la metgessa. En definitiva, va matisar, \u201caquesta disfunci\u00f3 metab\u00f2lica afecta els \u00f2rgans que condicionen directament la nostra esperan\u00e7a i qualitat de vida: el cor, el rony\u00f3, el fetge i el cervell\u201d<\/strong>.<\/p>\n\n\n\n

A continuaci\u00f3, la Dra. Morer va abordar l\u2019evoluci\u00f3 de la diabetis, detallant el cercle vici\u00f3s de la resist\u00e8ncia i la inflamaci\u00f3, i com es pot influir positivament en el seu curs. Va relacionar aquesta patologia amb la malaltia cardiovascular, ja que a Espanya 2 de cada 10 pacients adults amb DM2 en pateixen<\/strong>. \u201cL\u2019obesitat s\u2019associa a m\u00e9sr risc cardiovascular en pacients amb diabetis mellitus tipus 2″, va assegurar.<\/p>\n\n\n\n

\"\"<\/a>
La Dra. Morer en un moment de la seva presentaci\u00f3. <\/figcaption><\/figure>\n\n\n\n

En relaci\u00f3 amb l\u2019obesitat, la doctora va destacar que hi ha hagut un canvi de paradigma conceptual<\/strong>: \u201cL\u2019objectiu terap\u00e8utic ja no \u00e9s un n\u00famero a la b\u00e0scula, sin\u00f3 recuperar la salut metab\u00f2lica i la qualitat de vida\u201d. En aquest sentit, va assenyalar les limitacions de l\u2019\u00edndex de massa corporal (IMC), ja que no distingeix entre el greix actiu i el m\u00fascul, no t\u00e9 en compte biaixos inherents i oculta el dany metab\u00f2lic real. Per avaluar la composici\u00f3 corporal, Carla Morer va compartir diferents eines com l\u2019\u00edndex cintura i al\u00e7ada (ICA), la bioimped\u00e0ncia el\u00e8ctrica (BIA), l\u2019ecografia abdominal o l\u2019equaci\u00f3 CUN-BAE.<\/p>\n\n\n\n

Pel que fa al tractament, la Dra. Morer va confirmar que hi ha hagut un canvi d\u2019enfocament i que \u201cel pes a la b\u00e0scula ja no \u00e9s el centre gravitatori de la intervenci\u00f3\u201d i va recordar que l\u2019abordatge multidisciplinari amb prim\u00e0ria, endocrinologia i farm\u00e0cia \u00e9s obligatori.<\/p>\n\n\n\n

Abordatge terap\u00e8utic del pacient cardiometab\u00f2lic<\/strong><\/h2>\n\n\n\n

Abans d\u2019aprofundir en els f\u00e0rmacs, la doctora va incidir en la import\u00e0ncia de l\u2019estil de vida <\/strong>(nutrici\u00f3, activitat f\u00edsica, higiene del son i salut emocional), que \u00e9s \u201cl\u2019eix vertebrador imprescindible abans i durant qualsevol f\u00e0rmac\u201d per poder desenvolupar el m\u00e0xim potencial terap\u00e8utic.<\/strong><\/p>\n\n\n\n

Respecte a l’arsenal terap\u00e8utic actual, es van revisar els diferents mecanismes d’acci\u00f3 i les indicacions espec\u00edfiques<\/strong> establertes per a cada f\u00e0rmac. En aquest sentit, va fer refer\u00e8ncia a opcions com l’Orlistat<\/strong>, la combinaci\u00f3 de Naltrexona\/Bupropi\u00f3, la Liraglutida<\/strong> (3,0 mg) i la Semaglutida <\/strong>(2,4 mg), aix\u00ed com la Tirzepatida <\/strong>(en dosis de 5, 10 i 15 mg). Tots aquests f\u00e0rmacs estan indicats com a complement de la dieta i l’activitat f\u00edsica per al control cr\u00f2nic del pes <\/strong>en pacients amb obesitat o amb sobrep\u00e8s. Finalment, va esmentar la Setmelanotida<\/strong>, un f\u00e0rmac que restableix l’activitat alterada de la via del receptor MC4D i la indicaci\u00f3 del qual queda restringida exclusivament a pacients amb defici\u00e8ncia de POMC o causes gen\u00e8tiques de LEPR i MC4R.<\/p>\n\n\n\n

Per altra banda, la doctora va fer esment del posicionament de les diferents guies cl\u00edniques internacionals i nacionals<\/strong> per a l\u2019obesitat i la diabetis. Pel que fa a la farm\u00e0cia comunit\u00e0ria, Morer va remarcar que \u201c\u00e9s la xarxa de seguretat fonamental per garantir l\u2019adher\u00e8ncia, gestionar la toler\u00e0ncia i desestigmatitzar el pacient\u201d.<\/p>\n\n\n\n

Agonistes del receptor GLP-1<\/strong><\/h2>\n\n\n\n

En la segona part de la tert\u00falia d\u2019actualitat, el farmac\u00e8utic comunitari, Crist\u00f2fol Talaver\u00f3n <\/strong>va revisar les indicacions i el finan\u00e7ament de totes les mol\u00e8cules, aix\u00ed com les dosis i les presentacions i aspectes pr\u00e0ctics d\u2019administraci\u00f3 i conservaci\u00f3 a tenir en compte de la semaglutida injectable <\/strong>(Ozempic i Wegovy), la semaglutida oral <\/strong>(Rybelsus), la Liraglutida <\/strong>i alternatives gen\u00e8riques <\/strong>(Diavic i Plyzari) i la Tirzepatida <\/strong>(Mounjaro).<\/p>\n\n\n\n

Pel que fa al finan\u00e7ament, Talaver\u00f3n va recordar que no totes les indicacions s\u00f3n finan\u00e7ades<\/strong> pel Sistema Nacional de Salut (SNS).<\/p>\n\n\n\n

La farm\u00e0cia comunit\u00e0ria clau en el seguiment farmac\u00e8utic i en les recomanacions als pacients amb tractament amb arGLP-1<\/strong><\/h2>\n\n\n\n

\u201cEl seguiment farmacoterap\u00e8utic d\u2019un pacient que utilitza agonistes del receptor GLP-1\u00e9s clau per garantir l\u2019adher\u00e8ncia i minimitzar l\u2019abandonament a causa dels efectes secundaris\u201d<\/strong>, va destacar el farmac\u00e8utic. En aquest sentit, va especificar que \u00e9s recomanable centrar els esfor\u00e7os en la gesti\u00f3 de l\u2019estrat\u00e8gia de dosificaci\u00f3 i conservaci\u00f3, l\u2019educaci\u00f3 en el maneig d\u2019efectes gastrointestinals i el monitoratge de par\u00e0metres cl\u00ednics.<\/p>\n\n\n\n

\"\"<\/a><\/figure>\n\n\n\n

Per evitar reguany ponderal<\/strong>, Talaver\u00f3n va recomanar fer exercici de for\u00e7a, consumir aliments rics en prote\u00efna i individualitzar el tractament per trobar la dosi \u00f2ptima pel pacient, sempre sota prescripci\u00f3 m\u00e8dica.<\/p>\n\n\n\n

Per tancar la seva exposici\u00f3, el farmac\u00e8utic va recordar que \u201cel f\u00e0rmac \u00e9s una eina m\u00e9s, en l\u2019abordatge del pacient amb obesitat. Ha d\u2019anar acompanyat de canvis d\u2019h\u00e0bits nutricional i f\u00edsic, i la valoraci\u00f3 de necessitat d\u2019intervenci\u00f3 psicol\u00f2gica\u201d<\/strong>.<\/p>\n\n\n\n

Amb el patrocini de:<\/strong><\/p>\n\n\n\n

\"\"<\/a><\/figure>\n","protected":false},"excerpt":{"rendered":"

El passat 7 de maig, el Col\u00b7legi de Farmac\u00e8utics de Barcelona (COFB) va organitzar la tert\u00falia d\u2019actualitat \u201cAbordatge del pacient cardiometab\u00f2lic amb arGLP-1\u201d, amb el patrocini de Novo Nordisk. La tert\u00falia va anar a c\u00e0rrec de la doctora Carla Morer, metgessa del CAP Rio de Janeiro, coordinadora del Grup de 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