Kakkar Ashish Kumar, Dahiya Neha
Dept. of Pharmacology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Dept. of Community Medicine, Lady Hardinge Medical College, New Delhi, India.
Eur J Intern Med. 2015 Mar;26(2):89-94. doi: 10.1016/j.ejim.2015.01.005. Epub 2015 Jan 26.
Obesity is a growing epidemic and a major contributor to the global burden of disease. Obesity strains the healthcare systems and has profound economic and psychosocial consequences. Historically, pharmacotherapy for obesity has witnessed the rise and fall of several promising drug candidates that had to be eventually withdrawn due to unacceptable safety concerns. Currently four drugs are approved for chronic weight management in obese adults: orlistat, lorcaserin, phentermine/topiramate extended release and naltrexone/bupropion extended release. While lorcaserin and phentermine/topiramate were approved by US Food and Drug Administration (FDA) in 2012, after a gap of 13 years following the licensing of orlistat, naltrexone/bupropion has been recently approved in 2014. This review provides a brief overview of these current therapeutic interventions available for management of obesity along with the evidence of their safety and efficacy. Additionally, several novel monotherapies as well as combination products are undergoing evaluation in various stages of clinical development. These therapies if proven successful will strengthen the existing armamentarium of antiobesity drugs and will be critical to combat the global public health crisis of obesity and its associated co-morbidities.
肥胖是一种日益严重的流行病,也是全球疾病负担的主要促成因素。肥胖给医疗系统带来压力,并产生深远的经济和社会心理后果。从历史上看,肥胖药物治疗见证了几种有前景的候选药物的兴衰,这些药物最终因不可接受的安全问题而不得不撤出市场。目前有四种药物被批准用于肥胖成年人的慢性体重管理:奥利司他、氯卡色林、缓释苯丁胺/托吡酯和缓释纳曲酮/安非他酮。虽然氯卡色林和苯丁胺/托吡酯于2012年被美国食品药品监督管理局(FDA)批准,这距离奥利司他获批已有13年的间隔,但纳曲酮/安非他酮最近于2014年获得批准。本综述简要概述了目前可用于管理肥胖的这些治疗干预措施以及它们的安全性和有效性证据。此外,几种新型单一疗法以及联合产品正在临床开发的各个阶段接受评估。这些疗法如果被证明是成功的,将加强现有的抗肥胖药物库,并对于应对肥胖及其相关合并症的全球公共卫生危机至关重要。