New Medications for Treatment of Obesity: Metabolic and Cardiovascular Effects

Pucci, Andrea; Finer, Nick

doi:10.1016/j.cjca.2014.11.010

Cited by 53 publications

(43 citation statements)

References 88 publications

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“…First, phentermine/topiramate has been rejected by the EMA on the grounds that its benefits do not outweigh its risks, while the new drug application for lorcaserin was withdrawn when it became clear that it would suffer a similar fate [12,13]. The different stances of the FDA and EMA and the particular focus of regulatory authorities on cardiovascular risk are discussed by Pucci & Finer [14]. A number of articles and letters have been published recently that question the value of these drugs, or support them provided they are discontinued in patients who do not achieve weight loss of at least 5 kg within 12 weeks [6,13].…”

Section: Disappointments Past and Presentmentioning

confidence: 99%

“…Already launched in the United States in October 2014, it was recommended for approval in Europe in December 2014, despite the FDA being concerned about its cardiovascular effects [14]. The European Commission is being lobbied by a consortium of European consumer groups that is concerned by its cardiovascular safety [20].…”

Section: Recent Approvalsmentioning

confidence: 99%

“…However, the dose level for use in obesity (under the brand name Saxenda) is 3 mg once daily, compared with a maximum dose of 1.8 mg for diabetes. Being a peptide, liraglutide is administered by subcutaneous injection [14,25]. This may restrict its widespread use in obesity and thereby mitigate the impact of any unforeseen risks.…”

Section: Recent Approvalsmentioning

confidence: 99%

“…There is however some concern about a slight increase in heart rate. The clinical relevance of this is being addressed in a long term study [14]. A study in mice showed that injection of liraglutide in the ventromedial nucleus of the hypothalamus stimulates brown adipose tissue thermogenesis [28].…”

Section: Recent Approvalsmentioning

confidence: 99%

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Horizons in the Pharmacotherapy of Obesity

Arch

2015

Curr Obes Rep

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Abstract:Obesity drugs have had a chequered history. In the recent past, only the low efficacy, pancreatic lipase inhibitor orlistat was available worldwide and it was little used. The 5HT2C agonist lorcaserin, and two combinations of old drugs have been approved in the United States but not in Europe. The diabetes drug liraglutide has been approved in both the US and Europe and seems likely to be most widely accepted. In view of regulators' caution in approving obesity drugs, some (like beloranib) may initially be progressed for niche obesity markets. New drug targets have been identified in brown adipose tissue with the aim of not only activating thermogenesis but also increasing the capacity for thermogenesis in this tissue. Attempts are being made to match the efficacy of bariatric surgery by mimicking multiple gut hormones. Unapproved pharmacotherapies are tempting for some patients. Others remain optimistic about more conventional routes to pharmacotherapy.3

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Section: Disappointments Past and Presentmentioning

confidence: 99%

Section: Recent Approvalsmentioning

confidence: 99%

Section: Recent Approvalsmentioning

confidence: 99%

Section: Recent Approvalsmentioning

confidence: 99%

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Horizons in the Pharmacotherapy of Obesity

Arch

2015

Curr Obes Rep

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“…A meta-analysis revealed that the 2 year therapy with the orlistat had no significant reduction on the mortality. 12,13,14,15,16 However the side effects of orlistat observed are high and the patients might suffer from compliance issues as well. Thus, the physician must administer caution while selecting and prescribing orlistat to obese patients.…”

Section: Discussionmentioning

confidence: 99%

Weight Reduction; To Evaluate in Obese Patients With Orlistat as Compared to Placebo Using Body Mass Index in an Opd Settings

Abid¹,

Rehman

Hameed

2017

TPMJ

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ABSTRACT… Objective: Obesity is a serious disease and a precursor to other morbidities such as CVD and type 2 DM. Lifestyle modifications are recommended to control obesity along with pharmacological and surgical interventions. In this study, we evaluate the beneficial effects of orlistat in BMI reduction of obese patients in an OPD setup of Azad Jammu Kashmir. Study Design: It is a quasi-experimental placebo controlled trial. Setting: Divisional Headquarters Hospital Mirpur Azad Kashmir. Period: October 2013 to March 2014. Methods: 75 patients were enrolled having BMI of more than 27 using BMI machine model 2012. 38 Patients were randomly selected to receive orlistat 120 mg B.D for two months. 32 patients were given placebo and the reduction in BMI between the two arms was analyzed using SPSS 20. Results: After two months of study, significant reduction of 2.78 kg +/-1.718 kg in weight was observed in the study group. The reduction in average BMI in study group was 1.867 with -5.21 % reduction in BMI vs control group which had an average BMI reduction of 0.46 with -1.411% reduction in BMI. The p value is 0.001. 37.71% of patients taking orlistat reported side effects such as flatulence, fatty stools and myalgia which were 8%, 18.91% and 10.8% respectively. Conclusions: Orlistat along with life style modification is effective in BMI reduction of patients significantly as compared to placebo and may be helpful in reducing the morbidity and mortality in the long term. However, caution should be administered with orlistat because of high incidence of associated side effects. Key words:BMI, CVD, ORLISTAT, Weight Reduction. Article Citation: Abid R, Bashir-ur-Rehman, Hameed H. Weight reduction; To evaluate in obese patients with orlistat as compared to placebo using body mass index in an OPD settings.

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Insulin resistance and the metabolic syndrome

Krentz

Scuteri

2017

Diabetes in Old Age

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New Medications for Treatment of Obesity: Metabolic and Cardiovascular Effects

Cited by 53 publications

References 88 publications

Horizons in the Pharmacotherapy of Obesity

Horizons in the Pharmacotherapy of Obesity

Weight Reduction; To Evaluate in Obese Patients With Orlistat as Compared to Placebo Using Body Mass Index in an Opd Settings

Insulin resistance and the metabolic syndrome

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