Hong K, Herrmann K, Dybala C, Halseth A E, Lam H, Foreyt J P
Center for Clinical Nutrition & Applied Health Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
US Medical Affairs Department, Takeda Pharmaceuticals USA Inc., Deerfield, IL, USA.
Clin Obes. 2016 Oct;6(5):305-12. doi: 10.1111/cob.12157. Epub 2016 Aug 1.
Naltrexone/bupropion extended release (NB) is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index of ≥30 or ≥27 kg m(-2) and ≥1 weight-related comorbidity (e.g. hypertension, type 2 diabetes and dyslipidaemia). In phase 3 clinical studies, nausea occurred in significantly higher proportions of subjects randomized to NB vs. placebo (PBO). In this pooled analysis of three phase 3, 56-week, PBO-controlled studies, we characterized nausea and weight loss in NB- and PBO-treated subjects without diabetes. Subjects receiving NB (n = 1778) lost significantly more weight than those receiving PBO (n = 1160). Weight change was not significantly different between subjects reporting and not reporting nausea in either treatment arm. Severity of nausea was mild to moderate in ≥95% of all cases. In the NB arm, the highest incidence of nausea onset (9%) was reported during week 1. The median duration of mild, moderate and severe nausea in subjects receiving NB was 14, 9 and 13 days, respectively. Our results demonstrate that nausea associated with NB is rarely severe, primarily occurs early in treatment and is not a contributor to weight loss.
纳曲酮/安非他酮缓释片(NB)被指定作为低热量饮食和增加体育活动的辅助手段,用于初始体重指数≥30或≥27kg/m²且伴有≥1种与体重相关合并症(如高血压、2型糖尿病和血脂异常)的成年患者的慢性体重管理。在3期临床研究中,随机接受NB治疗的受试者中恶心发生率显著高于接受安慰剂(PBO)的受试者(PBO)。在这项对三项56周的3期PBO对照研究的汇总分析中,我们对未患糖尿病的接受NB和PBO治疗的受试者的恶心和体重减轻情况进行了描述。接受NB治疗的受试者(n = 1778)比接受PBO治疗的受试者(n = 1160)体重减轻显著更多。在两个治疗组中,报告恶心和未报告恶心的受试者之间体重变化无显著差异。在所有病例中,≥95%的恶心严重程度为轻度至中度。在NB组中,第1周报告的恶心发作发生率最高(9%)。接受NB治疗的受试者中,轻度、中度和重度恶心的中位持续时间分别为14天、9天和13天。我们的结果表明,与NB相关联的恶心很少严重,主要发生在治疗早期,且并非体重减轻的原因。