Status of pharmacotherapy in current care of obese
Authors:
Petr Sucharda
Authors‘ workplace:
3. interní klinika 1. LF UK a VFN v Praze
Published in:
Čas. Lék. čes. 2017; 156: 319-322
Category:
Review Articles
Overview
Weight loss drugs or anti-obesity drugs have a long history but are still far from being successful. Only in two last decades have the drugs been launched, which, when appropriately indicated, may be significantly beneficial to patients in need of weight loss as they are comparably effective to intensive programs to promote changes in eating habits and lifestyles. The combination naltrexone/bupropion is promising for food intake control including the reward mechanism, but the experience with its use has only been short-term. The lipase inhibitor orlistat remains the safest therapeutic option. The already restricted use of phentermine, newly classified as a controlled opiate substance, has become practically blocked. The range of weight loss drugs can be extended with some antidiabetics, particularly liraglutide and gliflozins. A number of other substances is still in the research stage.
Keywords:
obesity, overweight, pharmacotherapy, naltrexone, bupropion, reward system
Sources
1. Bray GA. Treatment of obesity with drugs in the new millennium. In: Eckel RH (ed.). Obesity. Mechanism and Clinical Management. Lippincott Williams & Wilkins, Philadelphia, 2003.
2. Bray G, Kim KK, Wilding J. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev 2017; 18: 715–723.
3. Maggioni AP, Caterson ID, Urso R et al. Relation between weight loss and causes of death in patients with cardiovascular disease: finding from the SCOUT trial. J Cardiovasc Med (Hagerstown) 2017; 18: 144–151.
4. James WP, Avenell A, Broom J, Whitehead J. A one-year trial to assess the value of orlistat in the management of obesity. Int J Obes Relat Metab Disord 1997; 21(Suppl 3): S24–S30.
5. Acharya NV, Wilton LV, Shakir SA. Safety profile of orlistat: results of a prescription-event monitoring study. Int J Obes (Lond) 2006; 30: 1645–1652.
6. Filippatos TD, Derdemezis CS, Gazi IF et al. Orlistat-associated adverse effects and drug interactions: a critical review. Drug Saf 2008; 31: 53–65.
7. Zhi J, Moore R, Kanitra L, Mulligan TE. Effects of orlistat, a lipase inhibitor, on the pharmacokinetics of three highly lipophilic drugs (amiodarone, fluoxetine, and simvastatin) in healthy volunteers. J Clin Pharmacol 2003; 43: 428–435.
8. MacWalter RS, Fraser HW, Armstrong KM. Orlistat enhances warfarin effect. Ann Pharmacother 2003; 37: 510–512.
9. Langlois KJ, Forbes JA, Bell GW, Grant GF jr. A double-blind clinical evaluation of the safety and efficacy of phentermine hydrochloride (Fastin) in the treatment of exogenous obesity. Curr Ther Res Clin Exp 1974; 16: 289–296.
10. Billes SK, Sinnayah P, Cowley MA. Naltrexone/bupropion for obesity: an investigational combination pharmacotherapy for weight loss. Pharmacol Res 2014; 84: 1–11.
11. Greenway FL, Fujioka K, Plodkowski RA et al.; COR-I Study Group. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2010; 376: 595–605.
12. Apovian CM, Aronne L, Rubino D et al.; COR-II Study Group. A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR II). Obesity 2013; 21: 935–943.
13. Hollander P, Gupta AK, Plodkowski R et al.; COR-Diabetes Study Group. Effects of naltrexone sustained-release/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes. Diabetes Care 2013; 36: 4022–4029.
14. Fujioka K, Plodkowski R, O'Neil PM et al. The relationship between early weight loss and weight loss at 1 year with naltrexone ER/bupropion ER combination therapy. Int J Obes (Lond) 2016; 40: 1369–1375.
15. Hong K, Herrmann K, Dybala C et al. Naltrexone/bupropion extended release-induced weight loss is independent of nausea in subjects without diabetes. Clin Obes 2016; 6: 305–312.
16. Garvey WT, Ryan DH, Look M et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr 2012; 95: 297–308.
17. Astrup A, Rössner S, Van Gaal L et al.; NN8022-1807 Study Group. Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet 2009; 374: 1606–1616.
18. Apovian C, Palmer K, Fain R et al. Effects of lorcaserin on fat and lean mass loss in obese and overweight patients without and with type 2 diabetes mellitus: the BLOSSOM and BLOOM-DM studies. Diabetes Obes Metab 2016; 18: 945–948.
19. Bhat SP, Sharma A. Current drug targets in obesity pharmacotherapy – a review. Curr Drug Targets 2017; 18: 983–993.
20. Lomenick JP, Buchowski MS, Shoemaker AH. A 52-week pilot study of the effects of exenatide on body weight in patients with hypothalamic obesity. Obesity (Silver Spring) 2016; 24: 1222–1225.
21. Salehi P, Hsu I, Azen CG et al. Effects of exenatide on weight and appetite in overweight adolescents and young adults with Prader-Willi syndrome. Pediatr Obes 2017; 12: 221–228.
22. Fitchett D, Butler J, van de Borne P et al.; EMPA-REG OUTCOME® trial investigators. Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrum of heart failure risk in the EMPA-REG OUTCOME® trial. Eur Heart J 2017, doi: 10.1093/eurheartj/ehx511.
23. Fitchett D, Zinman B, Wanner C et al.; EMPA-REG OUTCOME® trial investigators. Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME® trial. Eur Heart J 2016; 37: 1526–1534.
24. Hayashi T, Fukui T, Nakanishi N et al. Dapagliflozin decreases small dense low-density lipoprotein-cholesterol and increases high-density lipoprotein 2-cholesterol in patients with type 2 diabetes: comparison with sitagliptin. Cardiovasc Diabetol 2017; 16: 8.
25. Kim DD, Krishnarajah J, Lillioja S et al. Efficacy and safety of beloranib for weight loss in obese adults: a randomized controlled trial. Diabetes Obes Metab 2015; 17: 566–572.
26. McCandless SE, Yanovski JA, Miller J et al. Effects of MetAP2 inhibition on hyperphagia and body weight in Prader-Willi syndrome: A randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab 2017; 19(12): 1751–1761.
27. Timmers S, Konings E, Bilet L et al. Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans. Cell Metab 2011; 14: 612–622.
28. Crovesy L, Ostrowski M, Ferreira DMTP et al. Effect of Lactobacillus on body weight and body fat in overweight subjects: a systematic review of randomized controlled clinical trials. Int J Obes (Lond) 2017; 4: 1607–1614.
29. Heymsfield SB, Wadden TA. Mechanisms, patophysiology, and management of obesity. N Engl J Med 2017; 376: 254–266.
30. Sullivan S, Edmundowicz SA, Thompson CC. Endoscopic bariatric and metabolic therapies: new and emerging technologies. Gastroenterology 2017; 152: 1791–1801.
31. Forner PM, Ramacciotti T, Farey JE, Lord RV. Safety and effectiveness of an endoscopically placed duodenal-jejunal bypass device (EndoBarrier®): Outcomes in 114 Patients. Obes Surg 2017, doi: 10.1007/s11695-017-2939-4.
32. Weiss CR, Kathait AS. Bariatric embolization: a new and effective option for the obese patient? Expert Rev Gastroenterol Hepatol 2017; 11: 293–302.
33. Bai ZB, Qin YL, Deng G et al. Bariatric embolization of the left gastric arteries for the treatment of obesity: 9-month data in 5 patients. Obes Surg 2017, doi: 10.1007/s11695-017-2979-9.
34. Khera R, Murad MH, Chandar AK et al. Association of pharmacological treatments for obesity with weight loss and adverse events: A systematic review and meta-analysis. JAMA 2016; 315: 2424–2434.
35. Dong Z, Xu L, Liu H et al. Comparative efficacy of five long-term weight loss drugs: quantitative information for medication guidelines. Obes Rev 2017; 18: 1377–1385.
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