Past, present and future of obesity pharmacotherapy
Authors:
Ľ. Fábryová
Authors‘ workplace:
Metabol KLINIK s. r. o., Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, Bratislava, Slovenská republika, vedúci lekár MUDr. Ľubomíra Fábryová, PhD.
Published in:
Vnitř Lék 2010; 56(10): 1058-1064
Category:
Obesity 2010
Overview
Obese (BMI ≥ 30 kg/ m2) and overweight (BMI ≥ 25 and < 30 kg/ m2) individuals are at high risk of developing serious chronic health problems, including type 2 diabetes, hypertension, dyslipidemia, and cardiovascular disease. Caloric restriction, increased physical activity and behavioral therapy remain the primary treatment options for the management of body weight in these individuals. When a weight loss of 5– 10% cannot be achieved in 3– 6 months by lifestyle changes drug therapy might be indicated. This review will provide a brief history of obesity pharmacotherapy, discuss the status of currently available obesity drugs and outline the future drug development. A medical need exists for the development of novel weight loss therapies or combinations of known therapies.
Key words:
obesity – pharmacotherapy – orlistat – combination therapy – new antiobesitics
Sources
1. World Health Organization. Obesity and overweight. Fact Sheet No. 311. September 2006. Available from: http:/ / www.who.intlmediacentre/ factsheets/ fs311/ en/ index.html.
2. Aronne LJ, Nelinson DS, Lillo JL et al. Obesity as a disease state: a new paradigm for diagnosis and treatment. Clin Cornerstone 2009; 9: 9– 29.
3. Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab 2004; 89: 2583– 2589.
4. Tsigos K, Hainer V, Basdevant A et al. Obesity Management Task Force of the European Association for the Study of Obesity. Management of obesity in adults: European clinical practice guidelines. Obes Facts 2008; 1: 106– 116.
5. Tsigos C, Hainer V, Basdevant A et al. Obesity Management Task Force Európskej obezitologickej spoločnosti (European Association for the Study of Obesity) Liečba obezity u dospelých: Európske odporúčania pre klinickú prax. Diabetes a obezita 2009; 17: 10– 20.
6. Fried M, Hainer V, Basdevant A et al. Interdisciplinary European guidelines for surgery for severe (morbid) obesity. Obes Surg 2007; 17: 260– 270.
7. Fried M, Hainer V, Basdevant A et al. Interdisciplinárne európske odporúčania pre chirurgickú liečbu ťažkej obezity. Diabetes a obezita 2009; 17: 22– 28.
8. Weigle DS. Pharmacological therapy of obesity: past, present and future. J Clin Endocrinol Metab 2003; 88: 2462– 2469.
9. Council on Pharmacy and Chemistry 1935. Dinitrophenol not acceptable for N. N. R. JAMA 1935; 105: 31– 33.
10. Smith HJ, Roche AH, Jausch MF et al. Cardiomyopathy associated with amphetamine administration. Am Heart J 1976; 91: 792– 797.
11. Gurtner HP. Aminorex and pulmonary hypertension. A review. Cor Vasa 1985; 27: 160– 171.
12. Mark EJ, Patalas ED, Chang HT et al. Fatal pulmonary hypertension associated with short‑term use of fenfluramine and phentermine. N Engl J Med 1997; 337: 602– 606.
13. Connolly HM, Crary JL, McGoon MD et al. Valvular heart disease associated with fenfluramine- phentermine. N Engl J Med 1997; 337: 581– 588.
14. Addy C, Jumes P, Rosko K et al. Pharmacokinetics, safety, and tolerability of phentermine in healthy participants receiving taranabant, a novel cannabinoid‑ 1 receptor (CB1R) inverse agonist. J Clin Pharmacol 2009; 49: 1228– 1238.
15. Morgenstern LB, Wilterdink JL, Horwitz RI. Phenylpropanolamine and the risk of hemorrhagic stroke. N Engl J Med 2000; 343: 1826– 1832.
16. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000; 343: 1833– 1838.
17. Payer J, Hainer V, Ondrejka P et al. Sibutramin in obesity treatment (multicenter, open, prospective 12- month‑ long study). Vnitř Lék 2004; 50: 825– 829.
18. James WP. The SCOUT study: risk‑benefit profile of sibutramine in overweight high risk cardiovascular patients. Eur Heart J Suppl 2005; 7 (Suppl L): L44– L48.
19. Torp- Pedersen C, Caterson I, Coutinho Wet al. SCOUT Investigators. Cardiovascular responses to weight management and sibutramine in high‑risk subjects: an analysis from the SCOUT trial. Eur Heart J 2007; 28: 2915– 2923.
20. Weeke P, Andersson C, Fosbøl EL et al. The weight lowering effect of sibutramine and its impact on serum lipids in cardiovascular high risk patients with and without type 2 diabetes mellitus – an analysis from the SCOUT lead‑ in period. BMC Endocr Disord 2010; 10: 3.
21. Finer N. Does pharmacologically induced weight loss improve cardiovascular outcome? Impact of anti‑obesity agents on cardiovascular risk factors. Eur Heart J 2005; 7 (Suppl L): L32– L38.
22. McClendon K, Riche DM, Uwaifo GI. Orlistat: current status in clinical therapeutics. Expert Opin Drug Saf 2009; 8: 724– 744.
23. Torgerson JS, Hauptman J, Boldrin MN et al. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004; 27: 155– 161.
24. Sjöström L. Analysis of the XENDOS study (Xenical in the prevention of diabetes in obese subjects). Endocr Pract 2006; 12 (Suppl 1): 31– 33.
25. Rössner S, Sjöström L, Noack R et al. Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. European Orlistat Obesity Study Group. Obes Res 2000; 8: 49– 61.
26. Bray GA. Medications for weight reduction. Endocrinol Metab Clin North Am 2008; 37: 923– 942.
27. Padwal RS, Majumdar SR. Drug treatments for obesity: orlistat, sibutramine and rimonabant. Lancet 2007; 369: 71– 77.
28. Wadden TA, Berkowitz RI, Womble LG et al. Effects of sibutramine plus orlistat in obese women following 1 year of treatment by sibutramine alone: a placebo‑ controlled trial. Obes Res 2000; 8: 431– 437.
29. Smith SR, Prosser WA, Donahue DJ et al. Lorcaserin (APD356), a selective 5- HT(2C) agonist, reduces body weight in obese men and women. Obesity 2009; 17: 494– 503.
30. Akbas F, Gasteyger A, Sjödin A et al. A critical review of the cannabinoid receptor as a drug target for obesity management. Obes Rev 2009; 10: 58– 67.
31. Gadde KM, Allison DB. Combination pharmaceutical therapies for obesity. Expert Opin Pharmacother 2009; 10: 921– 925.
32. Adis Data Information BV. Naltrexone/ Bupropion Contrave; Naltrexone SR/ Bupropion SR. Drugs RD 2010; 10: 25– 32.
33. Kopelman P, Bryson A, Hickling R et al. Cetilistat (ATL‑ 962), a novel lipase inhibitor: a 12‑week randomized, placebo‑ controlled study of weight reduction in obese patients. Int J Obes (Lond) 2007; 31: 494– 499.
34. Siddiqui NI. Incretin mimetics and DPP‑ 4 inhibitors: new approach to treatment of type 2 diabetes mellitus. Mymensingh Med J 2009; 18: 113– 124.
35. Lee M, Aronne LJ. Weight management for type 2 diabetes mellitus: global cardiovascular risk reduction. Am J Cardiol 2007; 99: 68B– 79B.
36. Svačina Š. Léčba obezity u metabolického syndromu. Vnitř Lék 2009; 55: 622– 625.
37. Bhushan R, Elkind‑ Hirsch KE, Bhushan M et al. Exenatide use in the management of metabolic syndrome: a retrospective database study. Endocr pract 2008; 14: 993– 999.
38. Moran TH, Dailey MJ. Minireview: Gut peptides: targets for antiobesity drug development? Endocrinology 2009; 150: 2526– 2530.
39. Ravussin E, Smith SR, Mitchell JA. Enhanced weight loss with pramlintide/ metreleptin: an integrated neurohormonal approach to obesity pharmacotherapy. Obesity 2009; 17: 1736– 1743.
40. Smith SR, Aronne LJ, Burns CM et al. Sustained weight loss following 12- months pramlintide treatment as an adjunct to lifestyle intervention in obesity. Diabetes Care 2008; 31: 1816– 1823.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2010 Issue 10
Most read in this issue
- Genetics of obesity
- Adipose tissue hormones
- Obesity prevention
- The incidence of obesity and its complications in the Czech Republic