Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Digestive Health Institute, University Hospitals, Cleveland, OH, USA.
Obes Surg. 2024 May;34(5):1415-1424. doi: 10.1007/s11695-024-07181-w. Epub 2024 Mar 21.
A significant proportion of patients experience insufficient weight loss or weight regain after bariatric surgery. There is a paucity of literature describing anti-obesity medication (AOM) use following bariatric surgery. We sought to identify prevalence and trends of AOM use following bariatric surgery.
We utilized the IBM Explorys® database to identify all adults with prior bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy). Those prescribed AOMs (semaglutide, liraglutide, topiramate, phentermine/topiramate, naltrexone/bupropion, orlistat) within 5 years of surgery were further identified. Data was analyzed to characterize AOM utilization among different age, demographic, and comorbid populations.
A total of 59,160 adults with prior bariatric surgery were included. Among AOMs studies, prevalence of use was highest for topiramate (8%), followed by liraglutide (2.9%), phentermine/topiramate (1.03%), naltrexone/bupropion (0.95%) semaglutide (0.52%), and orlistat (0.17%). Age distribution varied, with the highest utilization among those age 35-39 years for topiramate, 40-44 years for phentermine/topiramate and naltrexone/bupropion, 45-49 years for semaglutide, and 65-69 years for liraglutide and orlistat. African American race was associated with higher utilization across all AOMs. Among comorbidities, hypertension, hyperlipidemia, and diabetes mellitus were most associated with AOM use.
Despite a relatively high incidence of weight regain, AOMs are underutilized following bariatric surgery. It is imperative that barriers to their use be addressed and that AOMs be considered earlier and more frequently in patients with insufficient weight loss or weight regain after bariatric surgery.
相当一部分患者在接受减重手术后体重减轻不足或体重反弹。关于减重手术后使用抗肥胖药物（AOM）的文献很少。我们旨在确定减重手术后使用 AOM 的流行率和趋势。
我们利用 IBM Explorys®数据库确定了所有接受过减重手术（胃旁路手术或袖状胃切除术）的成年人。在手术后 5 年内开处 AOM（司美格鲁肽、利拉鲁肽、托吡酯、 phentermine/topiramate、纳曲酮/安非他酮、奥利司他）的患者被进一步确定。分析数据以描述不同年龄、人口统计学和合并症人群中 AOM 的使用情况。
共纳入 59160 名接受过减重手术的成年人。在 AOM 研究中，托吡酯的使用率最高（8%），其次是利拉鲁肽（2.9%）、 phentermine/topiramate（1.03%）、纳曲酮/安非他酮（0.95%）、司美格鲁肽（0.52%）和奥利司他（0.17%）。年龄分布不同，托吡酯的使用率最高的是 35-39 岁人群， phentermine/topiramate 和纳曲酮/安非他酮的使用率最高的是 40-44 岁人群，司美格鲁肽的使用率最高的是 45-49 岁人群，利拉鲁肽和奥利司他的使用率最高的是 65-69 岁人群。非裔美国人的种族与所有 AOM 的使用率较高有关。在合并症中，高血压、高血脂和糖尿病与 AOM 的使用最相关。
尽管体重反弹的发生率相对较高，但减重手术后 AOM 的使用不足。必须解决其使用的障碍，并且在减重手术后体重减轻不足或体重反弹的患者中，更早且更频繁地考虑使用 AOM。
