Mahgerefteh Babak, Vigue Michael, Freestone Zachary, Silver Scott, Nguyen Quang
Faculty, Internal Medicine, Valley Hospital Medical Center Internal Medicine Residency Program, Las Vegas, and Adjunct Faculty, College of Osteopathic Medicine, Touro University, NV.
Chief Resident, Valley Hospital Medical Center Internal Medicine Residency Program, and University of New England College of Osteopathic Medicine, Biddeford, ME.
Am Health Drug Benefits. 2013 Sep;6(7):423-30.
Obesity is a serious and costly disease that is growing in epidemic proportions. Obesity-related hospitalizations have nearly tripled from 1996 to 2009. If the current trend in the growth of obesity continues, the total healthcare costs attributable to obesity could reach $861 billion to $957 billion by 2030. The American Medical Association has officially recognized obesity as a disease. Obesity is a public health crisis affecting approximately more than 33% of Americans and costing the healthcare system more than $190 billion annually.
To review the 2 new drugs that were recently approved by the US Food and Drug Administration (FDA) for the treatment of obesity, lorcaserin HCl (Belviq) and phentermine/topiramate (Qsymia) and their potential impact on the treatment of obese patients.
Lifestyle modification is the first and mainstay treatment for obesity. Antiobesity drugs are indicated as adjuncts to a healthy, low-fat, low-calorie diet and an exercise plan. Currently, 4 drugs are approved by the FDA for the treatment of obesity, 2 of which were approved after June 2012. These 2 drugs, Belviq and Qsymia, have added new tools for the treatment of obesity. In addition to reducing body mass index, these drugs have been shown to reduce hemoglobin A1c levels in patients with diabetes and blood pressure levels in patients with hypertension, as well as to decrease lipid levels in patients with hyperlipidemia. This article reviews the drugs' mechanisms of action, evaluates landmark clinical studies leading to the FDA approval of the 2 drugs, their common side effects, and the benefits these new drugs can provide toward the management of the obesity epidemic that are different from other medications currently available.
The weight loss seen in patients who are using the 2 new medications has been shown to further improve other cardiometabolic health parameters, including blood pressure, blood glucose levels, and serum lipid levels. Based on clinical trials evidence, it is likely that many obese patients could benefit from these therapies, if used appropriately.
肥胖是一种严重且代价高昂的疾病，正呈流行趋势发展。与肥胖相关的住院人数从1996年到2009年几乎增加了两倍。如果肥胖增长的当前趋势持续下去，到2030年，归因于肥胖的医疗总成本可能达到8610亿美元至9570亿美元。美国医学协会已正式承认肥胖是一种疾病。肥胖是一场公共卫生危机，影响着约超过33%的美国人，每年使医疗系统花费超过1900亿美元。
回顾美国食品药品监督管理局（FDA）最近批准的用于治疗肥胖的两种新药，盐酸氯卡色林（Belviq）和苯丁胺/托吡酯（Qsymia），以及它们对肥胖患者治疗的潜在影响。
生活方式改变是肥胖的首要和主要治疗方法。抗肥胖药物被用作健康、低脂、低热量饮食和运动计划的辅助手段。目前，FDA批准了4种用于治疗肥胖的药物，其中2种是在2012年6月之后获批的。这两种药物，即Belviq和Qsymia，为肥胖治疗增添了新工具。除了降低体重指数外，这些药物还被证明可降低糖尿病患者的糖化血红蛋白水平和高血压患者的血压水平，以及降低高脂血症患者的血脂水平。本文回顾了这些药物的作用机制，评估了导致FDA批准这两种药物的具有里程碑意义的临床研究、它们的常见副作用，以及这些新药在管理肥胖流行方面与目前可用的其他药物不同的益处。
使用这两种新药的患者所实现的体重减轻已被证明可进一步改善其他心血管代谢健康参数，包括血压、血糖水平和血脂水平。基于临床试验证据，如果使用得当，许多肥胖患者可能会从这些疗法中受益。
