Doyle William N, Reinhart Nolan, Reddy Nikhil C, Diab Abdul-Rahman F, Sujka Joseph A, DuCoin Christopher G, Docimo Salvatore
Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, USA.
Cureus. 2023 Dec 21;15(12):e50905. doi: 10.7759/cureus.50905. eCollection 2023 Dec.
Bariatric surgery, in combination with pharmacotherapy, has been proven to be successful in combatting weight regain in adults; however, the use of anti-obesity medications to augment weight loss in adolescents before and after bariatric surgery is not well studied. In adolescent obese patients, the efficacy of anti-obesity pharmacotherapy before and after bariatric surgery on weight loss compared to no interventions in various studies was investigated. A PubMed literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed to identify studies related to the pharmacologic treatment of obesity in adolescents with a history of bariatric surgery. Inclusion criteria consisted of clinical trials, case reports, case series, chart reviews, systematic reviews, and meta-analyses written in English and published between 2005 and 2022 using our search criteria. Exclusion criteria were studies that investigated adults, did not include pharmacotherapy, and were not relevant to the outcome of interest. The initial search yielded 1275 results, which was reduced to 879 after removal of duplicates. After applying exclusion criteria, the number of articles was reduced to 63. Full articles were examined and 44 were excluded due to relevance. Nineteen articles were included in the qualitative analysis. A total of 2471 adolescents were treated with various types of pharmacotherapy, 65 of whom had a history of bariatric surgery. The results showed varied effects of pharmacotherapy with the different medications studied. However, the 65 patients were included in cohorts of patients with no history of bariatric surgery. These studies did not include data specific to adolescent bariatric surgery patients. There is a wealth of evidence highlighting the efficacy of pharmacotherapy in assisting with weight loss in adolescents with obesity; however, our literature search showed a lack of studies focusing on the use of pharmacotherapy in the adolescent bariatric surgery population. Potential limitations include missing studies in our literature search, the variability in methods between studies, and the lack of standardized quality assessment. Additionally, studies involving our objective of choice regarding bariatric surgery with anti-obesity medication were limited. Clinical trials to determine the efficacy of medications as an adjunct to bariatric surgery in preventing weight regain and leading to optimal weight loss in this population are of utmost importance.
减肥手术与药物治疗相结合，已被证明在对抗成年人的体重反弹方面是成功的；然而，在减肥手术前后使用抗肥胖药物来增加青少年的体重减轻情况尚未得到充分研究。在青少年肥胖患者中，研究了减肥手术前后抗肥胖药物治疗与各种研究中不进行干预相比对体重减轻的效果。使用系统评价和Meta分析的首选报告项目（PRISMA）指南在PubMed上进行文献检索，以识别与有减肥手术史的青少年肥胖药物治疗相关的研究。纳入标准包括2005年至2022年间使用我们的检索标准撰写并发表的英文临床试验、病例报告、病例系列、图表回顾、系统评价和Meta分析。排除标准是研究成年人、不包括药物治疗以及与感兴趣的结果无关的研究。初步检索产生了1275条结果，去除重复项后减少到879条。应用排除标准后，文章数量减少到63篇。对全文进行了审查，44篇因相关性被排除。19篇文章被纳入定性分析。共有2471名青少年接受了各种类型的药物治疗，其中65人有减肥手术史。结果显示，所研究的不同药物的药物治疗效果各不相同。然而，这65名患者被纳入了没有减肥手术史的患者队列中。这些研究没有包括针对青少年减肥手术患者的具体数据。有大量证据强调药物治疗在帮助肥胖青少年减肥方面的有效性；然而，我们的文献检索表明，缺乏针对青少年减肥手术人群使用药物治疗的研究。潜在的局限性包括我们文献检索中遗漏的研究、研究之间方法的差异以及缺乏标准化的质量评估。此外，涉及我们选择的关于减肥手术与抗肥胖药物的目标的研究有限。确定药物作为减肥手术辅助手段在预防该人群体重反弹和实现最佳体重减轻方面的疗效的临床试验至关重要。
