Clinical Pharmacology Department, INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France.
Hypoxia pathophysiology laboratory (HP2), Inserm U1042, 38000, Grenoble, France.
Obes Surg. 2021 Jun;31(6):2823-2830. doi: 10.1007/s11695-021-05258-4. Epub 2021 Feb 12.
Bariatric surgery is the most effective treatment of severe obesity. However, this surgery can have an impact on the bioavailability and metabolism of oral drugs as it modifies absorption, intestinal, and hepatic metabolism, and efflux transporter activity. The clinical impact of such modifications often remains unknown. To investigate, we extracted and summarized all reports of changes in drug efficacy associated with bariatric surgery registered in the WHO pharmacovigilance database. We identified 165 drug reports affecting 128 patients. The majority involved gastric bypass surgery (77.3%). Most reports concerned drug ineffectiveness (74.7%). The most frequent modifications concerned psychotropic drugs with a reduction in efficacy. This study underlines the urgent need for more research to better characterize the impact of bariatric surgery on drug pharmacokinetics and clinical efficacy.
减重手术是治疗重度肥胖症最有效的方法。然而，这种手术会影响口服药物的生物利用度和代谢，因为它会改变吸收、肠道和肝脏代谢以及外排转运体的活性。这些改变的临床影响往往是未知的。为了研究这一点，我们从世界卫生组织药物警戒数据库中提取并总结了所有与减重手术相关的药物疗效变化报告，这些报告登记在案。我们共发现了 165 份影响 128 名患者的药物报告，其中大部分涉及胃旁路手术（77.3%）。大多数报告涉及药物无效（74.7%）。最常见的药物疗效改变与精神类药物相关，即疗效降低。这项研究强调了迫切需要开展更多研究，以更好地描述减重手术对药物药代动力学和临床疗效的影响。
