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小儿肥胖症药物治疗的系统评价

A Systemic Review of Pharmacological Management of Pediatric Obesity.

作者信息

Gupta Surendra

机构信息

Department of Pediatrics, Children's Medical Center of Fresno, Fresno, California, USA.

出版信息

J Pharm Bioallied Sci. 2025 May;17(Suppl 1):S215-S221. doi: 10.4103/jpbs.jpbs_661_24. Epub 2025 Feb 25.

Abstract

BACKGROUND

There is a growing need for safe and effective treatment due to the rise in child obesity rates worldwide. The effectiveness and safety of pediatric obesity drugs were reviewed in this systematic review based on international research.

TECHNIQUES

PubMed, Cochrane Library, and Embase searches were performed to locate pediatric randomized controlled trials of antiobesity medications. Demographics, medication effectiveness, adverse events, and quality of life were all analyzed.

FINDINGS

There were 12 studies totaling 4,331 children in the review. The age range of the participants was 8.8 to 16.3 years, and their baseline BMI was between 26.2 and 41.7 kg/m. Medication combinations such as phentermine/topiramate, metformin, extended-release metformin, topiramate, exenatide, and liraglutide were frequently studied. The amount that each medication decreased BMI varied somewhat, with liraglutide exhibiting the most decrease (-5.88 kg/m). Comparator groups and pediatric antiobesity medication users experienced comparable adverse events and study discontinuation rates. Medication dose adjustments were more common in pediatric cases (10.6% vs. 1.7%; RR = 3.74 [95% CI: 1.51 to 9.26]). Quality of life increased in all trials, however, not specifically for pediatric cases.

CONCLUSION

In conclusion, metformin, topiramate, exenatide, liraglutide, and the combination of topiramate and phentermine may lower BMI in children; however, more studies are required to ascertain their long-term safety and effectiveness. Children and adolescents with pediatric obesity may benefit from a tailored, multidisciplinary strategy that incorporates lifestyle modifications, pharmaceutical therapies, and psychological support to assist manage the condition and enhance the health and well-being of those affected.

摘要

背景

由于全球儿童肥胖率上升,对安全有效的治疗方法的需求日益增加。本系统评价基于国际研究对儿科肥胖药物的有效性和安全性进行了综述。

方法

通过检索PubMed、Cochrane图书馆和Embase来查找抗肥胖药物的儿科随机对照试验。对人口统计学、药物疗效、不良事件和生活质量进行了分析。

结果

该综述纳入了12项研究,共4331名儿童。参与者的年龄范围为8.8至16.3岁,他们的基线体重指数在26.2至41.7kg/m之间。经常研究的药物组合有苯丁胺/托吡酯、二甲双胍、缓释二甲双胍、托吡酯、艾塞那肽和利拉鲁肽。每种药物降低体重指数的幅度有所不同,利拉鲁肽降低幅度最大(-5.88kg/m)。对照组和儿科抗肥胖药物使用者经历的不良事件和研究停药率相当。儿科病例中药物剂量调整更为常见(10.6%对1.7%;RR=3.74[95%CI:1.51至9.26])。所有试验中生活质量均有所提高,但并非专门针对儿科病例。

结论

总之,二甲双胍、托吡酯、艾塞那肽、利拉鲁肽以及托吡酯和苯丁胺的组合可能会降低儿童的体重指数;然而,需要更多研究来确定它们的长期安全性和有效性。患有儿科肥胖症的儿童和青少年可能会从量身定制的多学科策略中受益,该策略包括生活方式改变、药物治疗和心理支持,以帮助管理病情并改善受影响者的健康和福祉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bc/12156768/bbcedc4cf4e7/JPBS-17-215-g001.jpg

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