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肥胖的药物治疗持续走低。

The unrelenting fall of the pharmacological treatment of obesity.

机构信息

Endocrinology Unit, Department of Medical and Surgical Sciences, and Center for Applied Biomedical Sciences, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum, Via Massarenti 9, 40138, Bologna, Italy.

出版信息

Endocrine. 2013 Dec;44(3):598-609. doi: 10.1007/s12020-013-9983-1. Epub 2013 May 16.

Abstract

Nowadays pharmacological therapy to limit obesity has reached a critical stage: not only have Authorities limited the use of antiobesity drugs due to their proven inefficacy and dangerous side effects, but bariatric surgery has delivered better results. At present, when the number of obese subjects is growing exponentially worldwide and more and more pathological mechanisms inducing fat accumulation have been discovered, no drugs are available to help patients and physicians to limit one the most dreadful causes of death. Following the failures of promising drugs as sibutramine and rimonabant, many companies stopped to invest in the field of obesity pharmacotherapy. At the same time, leading Authorities have started to require more solid evidence before providing authorization for these drugs to enter the market. This review aims at revising the failed promises of antiobesity drugs and describing the few potential future candidates in order to shed some light in the still uncertain field of antiobesity drugs. It also provides a critical contribution to the ongoing debate among scientists, clinicians, patients and Authorities on the possibility to treat obesity with pharmacological drugs.

摘要

如今,限制肥胖的药理学治疗已经到了一个关键阶段:不仅由于抗肥胖药物已被证明无效和有危险的副作用,管理当局已限制了其使用,而且减肥手术已经带来了更好的效果。目前,随着全球肥胖人群的数量呈指数级增长,并且发现了越来越多导致脂肪堆积的病理机制,没有药物可帮助患者和医生限制肥胖这一最可怕的死亡原因之一。在作为西布曲明和利莫那班等有前途的药物失败之后,许多公司停止投资肥胖症的药物治疗领域。与此同时,主要管理当局已开始要求在为这些药物进入市场提供授权之前提供更确凿的证据。这篇综述旨在回顾抗肥胖药物失败的承诺,并描述少数潜在的未来候选药物,以期在抗肥胖药物这一仍不确定的领域提供一些启示。它还为科学家、临床医生、患者和管理当局之间关于用药物治疗肥胖的可能性的持续辩论做出了重要贡献。

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