Vascular Physiology Unit, Institute of Child Health, London, UK.
Curr Opin Cardiol. 2013 Sep;28(5):584-91. doi: 10.1097/HCO.0b013e3283642a4c.
The incidence of obesity and its associated comorbidities have significantly increased over the years with adverse health and financial consequences for society. Lifestyle changes are essential for the prevention and treatment of obesity but their benefit appears limited as inadequate and nonsustained weight loss results have been reported. Pharmacotherapy is frequently advocated as part of a weight loss strategy. In this review, we will discuss the antiobesity drugs with Food and Drug Administration approval and their cardiovascular implications.
Orlistat (Xenical) remains the single monotherapy that has approval in Europe. Topiramate (Topamax) and phentermine have long been approved in the United States, whereas lorcaserin and the extended release combination of phentermine with topiramate have recently gained approval. The development of single peptides targeting gut hormones or other host signals related to obesity may represent promising therapeutic options.
Despite the recent failures of a number of antiobesity drugs, the pharmacotherapy of obesity is progressing rapidly. Treating the obese cardiovascular patient has proven challenging. Efficacy, safety and the sustainability of weight loss are key areas of focus in drug development strategies.
近年来，肥胖及其相关合并症的发病率显著上升，给社会带来了不良的健康和经济后果。生活方式的改变对于肥胖的预防和治疗至关重要，但由于报道的减肥效果不足且不可持续，其益处似乎有限。药物治疗经常被作为减肥策略的一部分。在这篇综述中，我们将讨论获得美国食品和药物管理局批准的减肥药及其对心血管的影响。
奥利司他（赛尼可）仍然是唯一在欧洲获得批准的单一药物疗法。曲美布汀（Topamax）和安非他酮在美国长期获得批准，而 lorcaserin 和安非他酮与托吡酯的延长释放组合最近也获得了批准。针对肠道激素或其他与肥胖相关的宿主信号的单一肽的开发可能代表有前途的治疗选择。
尽管最近有许多减肥药都失败了，但肥胖的药物治疗正在迅速发展。治疗肥胖的心血管患者具有挑战性。疗效、安全性和减肥的可持续性是药物开发策略的重点关注领域。
