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氯卡色林与苯丁胺联合用于体重管理:一项为期12周的随机试验性安全性研究。

Coadministration of lorcaserin and phentermine for weight management: A 12-week, randomized, pilot safety study.

作者信息

Smith Steven R, Garvey W Timothy, Greenway Frank L, Zhou Sharon, Fain Randi, Pilson Robert, Fujioka Ken, Aronne Louis J

机构信息

Center for the Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA.

Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, Florida, USA.

出版信息

Obesity (Silver Spring). 2017 May;25(5):857-865. doi: 10.1002/oby.21811.

Abstract

OBJECTIVE

To assess the short-term tolerability of lorcaserin alone or with two dose regimens of phentermine.

METHODS

This was a 12-week, randomized, double-blind, pilot safety study of N = 238 nondiabetic patients with obesity or overweight with ≥1 comorbidity randomized to lorcaserin 10 mg twice daily (BID; LOR BID) alone or with phentermine 15 mg once daily (QD; LOR BID+PHEN QD) or 15 mg twice daily (LOR BID+PHEN BID). Patients reporting ≥ 1 of 9 potentially serotonergic adverse events (AEs), mean weight loss (WL), and ≥5% WL are reported.

RESULTS

N = 238 were randomized, and N = 235 were treated. N = 94 reported potentially serotonergic AEs: 37.2% LOR BID, 42.3% LOR BID+PHEN QD, and 40.5% LOR BID+PHEN BID. AEs leading to discontinuation were reported approximately twice as often in the LOR BID+PHEN BID group versus the LOR BID group. Mean WL was 3.5 kg/3.3%, 7.0 kg/6.7%, and 7.6 kg/7.2% for LOR BID, LOR BID+PHEN QD, and LOR BID+PHEN BID, respectively. At least 5% WL was achieved by 28.2% LOR BID, 59.0% LOR BID+PHEN QD (P = 0.0002 vs. LOR BID), and 70.9% LOR BID+PHEN BID (P < 0.0001 vs. LOR BID) patients.

CONCLUSIONS

Phentermine added to lorcaserin enhanced short-term weight loss but did not increase incidence of potentially serotonergic AEs; however, phentermine twice daily increased discontinuation compared to both lorcaserin alone and lorcaserin plus phentermine once daily.

摘要

目的

评估氯卡色林单药治疗或与两种剂量方案的苯丁胺联合使用的短期耐受性。

方法

这是一项为期12周的随机、双盲、先导性安全性研究,共纳入238例患有肥胖或超重且合并≥1种疾病的非糖尿病患者,随机分为每日两次服用10mg氯卡色林(LOR BID)单药治疗组,或每日一次服用15mg苯丁胺(LOR BID+PHEN QD)或每日两次服用15mg苯丁胺(LOR BID+PHEN BID)的联合治疗组。报告了出现9种潜在的5-羟色胺能不良事件(AE)中≥1种的患者、平均体重减轻(WL)情况以及体重减轻≥5%的情况。

结果

238例患者被随机分组,235例接受治疗。94例报告了潜在的5-羟色胺能AE:LOR BID组为37.2%,LOR BID+PHEN QD组为42.3%,LOR BID+PHEN BID组为40.5%。导致停药的AE在LOR BID+PHEN BID组中的报告频率约为LOR BID组的两倍。LOR BID组、LOR BID+PHEN QD组和LOR BID+PHEN BID组的平均体重减轻分别为3.5kg/3.3%、7.0kg/6.7%和7.6kg/7.2%。分别有28.2%的LOR BID组患者、59.0%的LOR BID+PHEN QD组患者(与LOR BID组相比P=0.0002)和70.9%的LOR BID+PHEN BID组患者(与LOR BID组相比P<0.0001)实现了至少5%的体重减轻。

结论

苯丁胺与氯卡色林联合使用可增强短期体重减轻效果,但不会增加潜在的5-羟色胺能AE的发生率;然而,与氯卡色林单药治疗以及氯卡色林加每日一次苯丁胺治疗相比,每日两次服用苯丁胺会增加停药率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3760/5518190/885aa8404dfb/OBY-25-857-g001.jpg

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