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纳曲酮/安非他酮在现实环境中对超重和肥胖患者的有效性及安全性

The Effectivity and Safety of Naltrexone/Bupropion in Patients Suffering from Overweight and Obesity in a Real-World Setting.

作者信息

Jense Marijn T F, Knibbeler Lars, Hoogma Roel P L M, Palm-Meinders Inge H, Greve Jan Willem M, Boerma Evert-Jan G

机构信息

Zuyderland Medical Center, Heerlen, The Netherlands.

Nederlandse Obesitas Kliniek Zuid, Heerlen, The Netherlands.

出版信息

Obes Facts. 2025 Apr 21:1-8. doi: 10.1159/000545967.

Abstract

INTRODUCTION

Bariatric and metabolic surgery carries risks of complications and may affect food tolerance. For patients who are overweight or do not meet surgical criteria, alternative weight loss strategies must be explored. One such option is naltrexone/bupropion (NB) treatment. This study evaluates the impact of NB treatment combined with lifestyle intervention on weight loss over 12 months in a real-world setting.

METHODS

A retrospective cohort study included all patients initiating NB treatment at the Dutch Obesity Clinic from February 2021 to October 2022.

RESULTS

Among 98 patients (17.5% male; median age 49 [43-53]; median BMI 35.4 [33.0-39.1]), mean percentage total weight loss (SD) was 7.9% (4.2) at 3 months, 10.3% (6.5) at 6 months, and 11.5% (8.3) at 12 months. During the buildup phase, 23.5% of patients experienced nausea/vomiting, 19.4% reported headaches, and 28.6% had constipation. At optimal dosage, 39.8% experienced side effects, with 33% reporting multiple symptoms. Treatment discontinuation within 12 months occurred in 52.7% of patients.

CONCLUSION

NB treatment combined with lifestyle intervention results in significant weight loss after 6 and 12 months. Despite high discontinuation rates due to multiple reasons including side effects, NB treatment in combination with lifestyle intervention may be of interest for a specific population.

摘要

引言

减肥和代谢手术存在并发症风险,且可能影响食物耐受性。对于超重或不符合手术标准的患者,必须探索其他减肥策略。纳曲酮/安非他酮(NB)治疗就是这样一种选择。本研究评估了在现实环境中,NB治疗联合生活方式干预对12个月内体重减轻的影响。

方法

一项回顾性队列研究纳入了2021年2月至2022年10月在荷兰肥胖诊所开始接受NB治疗的所有患者。

结果

98例患者(男性占17.5%;中位年龄49岁[43 - 53岁];中位体重指数35.4[33.0 - 39.1])中,3个月时平均总体重减轻百分比(标准差)为7.9%(4.2),6个月时为10.3%(6.5),12个月时为11.5%(8.3)。在剂量增加阶段,23.5%的患者出现恶心/呕吐,19.4%报告有头痛,28.6%有便秘。在最佳剂量时,39.8%的患者出现副作用,其中33%报告有多种症状。52.7%的患者在12个月内停止治疗。

结论

NB治疗联合生活方式干预在6个月和12个月后可显著减轻体重。尽管由于包括副作用在内的多种原因导致停药率较高,但NB治疗联合生活方式干预可能对特定人群有意义。

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