减重手术后肥胖患者的长期药物治疗:体重反弹的药理学预防和管理。
Long-term pharmacotherapy of obesity in patients that have undergone bariatric surgery: pharmacological prevention and management of body weight regain.
机构信息
a Sección de Nutrición , Hospital Italiano de , Buenos Aires , Argentina.
b Departamento de Farmacología. Facultad de Medicina , Instituto Universitario CEMIC , Buenos Aires , Argentina.
出版信息
Expert Opin Pharmacother. 2019 Jun;20(8):939-947. doi: 10.1080/14656566.2019.1583746. Epub 2019 Mar 18.
INTRODUCTION
The obesity epidemic continues to grow. Bariatric surgery is part of the arsenal to treat the disease. Surgery results in an effective option for patients with severe obesity but also when obesity is associated with significant comorbidities. Weight regain is frequent after bariatric surgery. Consequently, the addition of anti-obesity drugs to prevent and manage weight regain are commonly recommended even when the quality of the evidence supporting this recommendation is relatively weak. cfsda65
AREAS COVERED
The aim of this review is to summarize the available evidence concerning long-term pharmacotherapy of obesity in patients that have undergone bariatric surgery with a focus on pharmacological prevention and management of weight regain. The etiology and epidemiology of weight regain are summarized, as well as the available information about the benefits and risks of long-term pharmacotherapy in the prevention and management of recidivism.
EXPERT OPINION
The available information, mainly obtained from observational studies and small trials, is encouraging but calls for a prudent approach in the selection of appropriate agents for each individual patient and a careful follow-up to detect adverse reactions or drug interactions. Results from well-designed trials are upcoming. In the meantime, a cautious, individualized approach is advisable.
简介
肥胖症的流行仍在继续。减重手术是治疗该疾病的手段之一。对于重度肥胖症患者,以及肥胖症合并严重合并症的患者,手术是一种有效的选择。减重手术后体重会出现反弹。因此,即使支持这种推荐的证据质量相对较弱,也通常建议使用抗肥胖药物来预防和控制体重反弹。
涵盖领域
本综述旨在总结有关接受过减重手术的肥胖患者进行长期药物治疗的现有证据,重点是药物预防和控制体重反弹。本文总结了体重反弹的病因和流行病学,以及关于长期药物治疗在预防和管理复发方面的获益和风险的现有信息。
专家意见
现有的信息主要来自观察性研究和小型试验,结果令人鼓舞,但需要谨慎选择合适的药物,为每位患者量身定制,并进行仔细的随访,以发现不良反应或药物相互作用。设计良好的试验结果即将公布。在此期间,建议谨慎、个体化的方法。