Boutet K, Frachon I, Jobic Y, Gut-Gobert C, Leroyer C, Carlhant-Kowalski D, Sitbon O, Simonneau G, Humbert M
Université Paris-Sud11, UPRES EA 2705, Centre National de Référence de l'Hypertension Artérielle Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine-Béclère, Paris, France.
Eur Respir J. 2009 Mar;33(3):684-8. doi: 10.1183/09031936.00086308.
Since 1976, benfluorex has been approved in Europe as a hypolipidemic and hypoglycemic drug, and is commonly used in the treatment of the metabolic syndrome. As a derivative of fenfluramine with an appetite suppressant action, benfluorex is preferentially used in overweight patients. In contrast to fenfluramine and dexfenfluramine, to date, benfluorex has not been reported to be associated with frequent cardiovascular side-effects. The present study reports five cases of severe pulmonary arterial hypertension and one case of valvular heart disease occurring in patients exposed to benfluorex. These individuals were middle age, diabetic females with a body mass index ranging 24.2-49 kg x m(-2). No definite causal effect for cardiovascular disease with benfluorex can be drawn from such case reports. However, as benfluorex, like dexfenfluramine and fenfluramine, is metabolised into active metabolite norfenfluramine, further extensive assessment of drug exposure in newly diagnosed pulmonary arterial hypertension or valvular heart disease patients is warranted.
自1976年以来，苯氟雷司在欧洲已被批准作为一种降血脂和降血糖药物，常用于治疗代谢综合征。作为具有食欲抑制作用的芬氟拉明衍生物，苯氟雷司优先用于超重患者。与芬氟拉明和右芬氟拉明不同，迄今为止，尚未有报道称苯氟雷司与频繁的心血管副作用有关。本研究报告了5例暴露于苯氟雷司的患者发生严重肺动脉高压和1例瓣膜性心脏病。这些个体为中年糖尿病女性，体重指数范围为24.2 - 49 kg·m⁻² 。从这些病例报告中无法得出苯氟雷司与心血管疾病有明确因果关系的结论。然而，由于苯氟雷司与右芬氟拉明和芬氟拉明一样，会代谢为活性代谢产物去甲芬氟拉明，因此有必要对新诊断的肺动脉高压或瓣膜性心脏病患者的药物暴露情况进行进一步广泛评估。
