Faria André M, Mancini Marcio C, Melo Maria Edna de, Cercato Cintia, Halpern Alfredo
Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
Arq Bras Endocrinol Metabol. 2010 Aug;54(6):516-29. doi: 10.1590/s0004-27302010000600003.
Obesity prevalence has risen dramatically over the past decades, which poses a great number of patients at risk of metabolic and cardiovascular complications. Long-term efficacy of lifestyle modification isolated has shown to be modest which, therefore, urges the need of more aggressive interventions such as adjuvant pharmacotherapy or the more radical surgical approach. Bariatric surgery has proven to date to be the most effective treatment, although it may be associated with nutritional and metabolic complications not yet completely recognized. By contrast, there is limited availability of antiobesity agents currently in the market, as well as historical facts involving the suspension of previously existing medications due to safety concerns. This article aims to present recent data on clinical trials of novel weight-loss drugs with short perspective to enter the market, if approved by the regulatory agencies. This review will discuss the efficacy and safety of these compounds, which include lorcaserin (selective serotonin 5-HT2c agonist), tesofensine (triple monoamine reuptake inhibitor), liraglutide (GLP-1 analogue) and cetilistat (gastrointestinal lipase inhibitor), as well as the combination therapies of bupropion/naltrexone, bupropion/zonisamide, phentermine/topiramate and pramlintide/metreleptin.
在过去几十年中，肥胖患病率急剧上升，这使大量患者面临代谢和心血管并发症的风险。单独的生活方式改变的长期效果已显示较为有限，因此，迫切需要更积极的干预措施，如辅助药物治疗或更激进的手术方法。尽管减肥手术可能与尚未完全认识到的营养和代谢并发症有关，但迄今为止，它已被证明是最有效的治疗方法。相比之下，目前市场上抗肥胖药物的供应有限，而且由于安全问题，过去曾有过现有药物被停用的历史情况。本文旨在介绍新型减肥药物临床试验的最新数据，这些药物如果获得监管机构批准，有望在短期内进入市场。本综述将讨论这些化合物的疗效和安全性，其中包括氯卡色林（选择性5-羟色胺2c受体激动剂）、替诺芬辛（三重单胺再摄取抑制剂）、利拉鲁肽（胰高血糖素样肽-1类似物）和西替利司他（胃肠道脂肪酶抑制剂），以及安非他酮/纳曲酮、安非他酮/唑尼沙胺、苯丁胺/托吡酯和普兰林肽/美曲普明的联合疗法。
