Update on Therapeutic Options in Lipodystrophy

Akıncı, Barış; Meral, Rasimcan; Oral, Elif A.

doi:10.1007/s11892-018-1100-7

Cited by 33 publications

(79 citation statements)

References 98 publications

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“…Treating lipodystrophy-related metabolic abnormalities is a challenge, with many patients (particularly those with severe insulin resistance and hypertriglyceridaemia) unable to achieve adequate metabolic control with standard therapies [3,6]. Metreleptin is the first drug available for the specific treatment of lipodystrophy and has been a welcome addition to the conventional treatment options available.…”

Section: What Is the Current Clinical Role Of Metreleptin In Lipodystmentioning

confidence: 99%

“…diet and exercise) and pharmacotherapy for each specific complication (e.g. statins for hyperlipidaemia; glucose-lowering agents for diabetes) [2,6]. However, these conventional therapies do not address the underlying causes of LD and often provide insufficient metabolic control [6].…”

mentioning

confidence: 99%

“…statins for hyperlipidaemia; glucose-lowering agents for diabetes) [2,6]. However, these conventional therapies do not address the underlying causes of LD and often provide insufficient metabolic control [6]. These limitations and the knowledge that serum levels of leptin (an adipose tissue-secreted hormone with effects such as appetite suppression, promotion of hepatic lipolysis and glucose usage in skeletal muscle, and inhibition of insulin secretion [5,7]) tend to be low in patients with LD [2], prompted investigation of leptin replacement therapy as a potential treatment option [6].…”

mentioning

confidence: 99%

“…However, these conventional therapies do not address the underlying causes of LD and often provide insufficient metabolic control [6]. These limitations and the knowledge that serum levels of leptin (an adipose tissue-secreted hormone with effects such as appetite suppression, promotion of hepatic lipolysis and glucose usage in skeletal muscle, and inhibition of insulin secretion [5,7]) tend to be low in patients with LD [2], prompted investigation of leptin replacement therapy as a potential treatment option [6]. Metreleptin [Myalepta ® (EU); Myalept ® (USA)] is a recombinant analogue of human leptin [3,5] this change correlating with a reduction in low-density lipoprotein cholesterol [18].…”

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confidence: 99%

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Metreleptin in lipodystrophy: a profile of its use

Deeks

2019

Drugs Ther Perspect

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Metreleptin [Myalepta ® (EU); Myalept ® (USA)] is a recombinant analogue of human leptin and currently the only drug available for the specific treatment of lipodystrophy (LD). In the EU, metreleptin (administered once daily via subcutaneous injection) is indicated as replacement therapy to treat the complications of leptin deficiency in patients aged ≥ 2 years with generalized LD and in patients aged ≥ 12 years with partial LD who have failed to achieve adequate metabolic control with standard treatments. Its use in these rare settings is supported by data from open-label clinical studies and clinical practice, with the totality of evidence indicating that metreleptin improves metabolic abnormalities associated with generalized or partial LD, including in paediatric patients. Other potential benefits include improved hepatic parameters/disease, nephropathy and survival, although the impact of the drug on these outcomes would benefit from further analysis. Metreleptin is generally well tolerated.

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Section: What Is the Current Clinical Role Of Metreleptin In Lipodystmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Metreleptin in lipodystrophy: a profile of its use

Deeks

2019

Drugs Ther Perspect

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“…[29][30][31][32][33][34] Each of these is discussed in more detail below ( Table 1). 8,10,11,[14][15][16][17][18][19][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The expectation that the results of the Human Genome Project 35,36 would provide greater refi nement in classifying type 2 diabetes and guiding glucose-lowering regimens has not yet been fully realized. 37 Dozens of genetic markers are now associated with type 2 diabetes, and many are associated with phenotypic and mechanistic components of the pathophysiology of diabetes, including insulin secretion, insulin resistance, and obesity.…”

Section: ■ Types and Biomarkers Of Diabetesmentioning

confidence: 99%

Type of diabetes mellitus: Does it matter to the clinician?

Hoogwerf

2020

CCJM

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Metabolic effects of lipectomy and of adipose tissue transplantation

Davis

Hocking

Watt

et al. 2022

Obesity

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Objective: The goal of this study was to review the metabolic effects of fat transplantation.Methods: Fat (adipose tissue [AT]) transplantation has been performed extensively for many years in the cosmetic reconstruction industry. However, not all fats are equal. White, brown, and beige AT differ in energy storage and use. Brown and beige AT consume glucose and lipids for thermogenesis and, theoretically, may provide greater metabolic benefit in transplantation. Here, the authors review the metabolic effects of AT transplantation.Results: Removal of subcutaneous human AT does not have beneficial metabolic effects. Most studies find no benefit from visceral AT transplantation and some studies report harmful effects. In contrast, transplantation of inguinal or subcutaneous AT in mice has positive effects. Brown AT transplant studies have variable results depending on the model but most show benefit. Conclusions:Many technical improvements have optimized fat grafting and transplantation in cosmetic surgery. Transplantation of subcutaneous AT has the potential for significant metabolic benefits, although there are few studies in humans or using human AT. Brown AT transplantation is beneficial but not readily feasible in humans thus ex vivo "beiging" may be a useful strategy. AT transplantation may provide clinical benefits in metabolic disorders, especially in the setting of lipodystrophy.

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Update on Therapeutic Options in Lipodystrophy

Cited by 33 publications

References 98 publications

Metreleptin in lipodystrophy: a profile of its use

Metreleptin in lipodystrophy: a profile of its use

Type of diabetes mellitus: Does it matter to the clinician?

Metabolic effects of lipectomy and of adipose tissue transplantation

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