Dragano Nathalia R V, Fernø Johan, Diéguez Carlos, López Miguel, Milbank Edward
NeurObesity Group, Department of Physiology, CiMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 15706, Spain.
Hormone Laboratory, Haukeland University Hospital, N-5021 Bergen, Norway.
Neuroscience. 2020 Jun 15;437:215-239. doi: 10.1016/j.neuroscience.2020.04.034. Epub 2020 Apr 29.
In the last thirty years, obesity has reached epidemic proportions and is now regarded as a major health issue in contemporary society trending to serious economic and social burdens. The latest projections of the World Health Organization are alarming. By 2030, nearly 60% of the worldwide population could be either obese or overweight, highlighting the needs to find innovative treatments. Currently, bariatric surgery is the most effective way to efficiently lower body mass. Although great improvements in terms of recovery and patient care were made in these surgical procedures, bariatric surgery remains an option for extreme forms of obesity and seems unable to tackle obesity pandemic expansion. Throughout the last century, numerous pharmacological strategies targeting either peripheral or central components of the energy balance regulatory system were designed to reduce body mass, some of them reaching sufficient levels of efficiency and safety. Nevertheless, obesity drug therapy remains quite limited on its effectiveness to actually overcome the obesogenic environment. Thus, innovative unimolecular polypharmacology strategies, able to simultaneously target multiple actors involved in the obesity initiation and expansion, were developed during the last ten years opening a new promising avenue in the pharmacological management of obesity. In this review, we first describe the clinical features of obesity-associated conditions and then focus on the outcomes of currently approved drug therapies for obesity as well as new ones expecting to reach the clinic in the near future.
在过去三十年里,肥胖已达到流行程度,如今被视为当代社会的一个主要健康问题,且有加重经济和社会负担的趋势。世界卫生组织的最新预测令人担忧。到2030年,全球近60%的人口可能会肥胖或超重,这凸显了寻找创新治疗方法的必要性。目前,减肥手术是有效降低体重的最有效方法。尽管这些手术在恢复和患者护理方面有了很大改进,但减肥手术仍然是极端肥胖形式的一种选择,似乎无法应对肥胖症的大规模蔓延。在上个世纪,人们设计了许多针对能量平衡调节系统外周或中枢成分的药理学策略来减轻体重,其中一些达到了足够的效率和安全水平。然而,肥胖药物治疗在实际克服致肥胖环境方面的有效性仍然相当有限。因此,在过去十年中,开发了能够同时针对参与肥胖发生和发展的多个因素的创新单分子多药理学策略,为肥胖的药物治疗开辟了一条新的有前景的途径。在这篇综述中,我们首先描述肥胖相关病症的临床特征,然后重点关注目前已批准的肥胖药物治疗的结果以及预计在不久的将来进入临床的新疗法。