From the *Department of Pharmacy, Kingsbrook Jewish Medical Center, Brooklyn, NY; and †Montefiore Medical Center, Bronx, NY.
Cardiol Rev. 2014 Jan-Feb;22(1):43-50. doi: 10.1097/CRD.0000000000000001.
Obesity is a risk factor for a wide range of conditions, including cardiovascular disease. Although lifestyle modifications remain the cornerstone for the management of obesity, pharmacologic agents may be a helpful addition to patients who have comorbidities and do not respond adequately to diet and exercise. Lorcaserin and phentermine/topiramate ER are 2 long-awaited agents, approved in 2012 for obesity management, 13 years since orlistat received US Food and Drug Administration approval in 1999. Lorcaserin is a serotonin agonist, whereas phentermine/topiramate is a combination of a sympathomimetic agent and an antiepileptic drug; both these agents have been shown to reduce weight significantly and improve cardiovascular and metabolic parameters, such as blood pressure, lipids, and HbA1C. This article reviews the pharmacology and clinical efficacy and safety of each of these agents. The differences among the three available agents for long-term management of obesity will also be examined.
肥胖是多种疾病的风险因素，包括心血管疾病。尽管生活方式改变仍然是肥胖管理的基石，但对于合并症且饮食和运动不能充分反应的患者，药物治疗可能是一种有益的补充。氯卡色林和盐酸安非他酮/托吡酯缓释片是两种期待已久的药物，于 2012 年获批用于肥胖症管理，距离 1999 年奥利司他获得美国食品药品监督管理局批准已经过去了 13 年。氯卡色林是一种血清素激动剂，而盐酸安非他酮/托吡酯是一种拟交感神经药和抗癫痫药的组合；这两种药物都已被证明能显著减轻体重，并改善血压、血脂和 HbA1C 等心血管和代谢参数。本文回顾了这两种药物的药理学、临床疗效和安全性。还将检查三种可用于肥胖长期管理的药物之间的差异。
