Huerta-Cruz Juan Carlos, Rocha-González Héctor Isaac, Kammar-García Ashuin, Canizales-Quinteros Samuel, Barranco-Garduño Lina Marcela, Reyes-García Juan Gerardo
Unidad de Investigación en Farmacología, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosio Villegas, Secretaría de Salud, Calzada de Tlalpan 4502, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico.
Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Col. Casco de Santo Tomas, Miguel Hidalgo, Mexico City 11340, Mexico.
J Clin Med. 2022 Jun 4;11(11):3211. doi: 10.3390/jcm11113211.
The weight loss response to anti-obesity drugs is highly variable and poorly understood, which does not allow us to know, in advance, in which subjects the drug will be effective and in which it will not. The objective of this study was to explore the body weight reduction in kilograms in the first month (1mo-BWRkg) and the development of tolerance as predictors of 6-month efficacy for treatment with 1 mg mazindol twice a day. One hundred ninety-six obese subjects were individually or jointly analyzed. Approximately 60% of subjects developed tolerance to mazindol and achieved increasing proportional levels of 6-month efficacy according to 1mo-BWRkg intervals (<1 kg, 1 to <2 kg, 2 to <4 kg and ≥4 kg). Both moT and 1mo-BWRkg were significantly correlated with the mean percentage body weight reduction (BWR%) after 6-months of treatment. The qualitative analysis of both predictors on the progressive efficacy of mazindol was used to classify patients according to expected efficacy (inefficient, slightly effective, partially effective, or fully effective), based on the mean percentage efficacy and the number of subjects reaching a BWR% of <5%, 5 to <10%, 10 to <15% or ≥15%. In conclusion, combined 1mo-BWRkg and moT were early predictors for the progressive efficacy of 6-month mazindol anti-obesity therapy. This finding represents progress in predictive, preventive, and personalized medicine which could serve for estimating the expectations of individual efficacy with the use of the drug. and highlights the basic principle of personalized medicine, “one size does not fit all”.
抗肥胖药物的减肥效果差异很大且了解不足，这使我们无法提前知晓哪些受试者使用该药物会有效，哪些则无效。本研究的目的是探讨每日两次服用1毫克马吲哚治疗时，第一个月体重减轻的千克数（1个月体重减轻千克数，1mo - BWRkg）以及耐受性的发展情况，以此作为6个月疗效的预测指标。对196名肥胖受试者进行了单独或综合分析。根据1mo - BWRkg区间（<1千克、1至<2千克、2至<4千克和≥4千克），约60%的受试者对马吲哚产生了耐受性，并在6个月时达到了不同比例的疗效提升。治疗6个月后，moT和1mo - BWRkg均与平均体重减轻百分比（BWR%）显著相关。基于平均疗效百分比以及体重减轻百分比达到<5%、5至<10%、10至<15%或≥15%的受试者数量，利用这两个预测指标对马吲哚逐步疗效的定性分析，将患者按预期疗效（无效、轻度有效、部分有效或完全有效）进行分类。总之，1mo - BWRkg和moT相结合是6个月马吲哚抗肥胖治疗逐步疗效的早期预测指标。这一发现代表了预测、预防和个性化医学方面的进展，可用于评估使用该药物时个体疗效的预期，并突出了个性化医学的基本原则，即“一刀切并不适用所有人”。
