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https://www.readbyqxmd.com/read/29388462/safety-and-tolerability-of-new-generation-anti-obesity-medications-a-narrative-review
#1
Dhiren K Patel, Fatima Cody Stanford
The prevalence of obesity and associated comorbidities is rising. Despite their weight-loss efficacy, new generation anti-obesity medications are only prescribed to a minority of adults with obesity, possibly, which in part may be due to safety concerns. This review presents detailed safety profiles for orlistat, phentermine/topiramate, lorcaserin, naltrexone/bupropion and liraglutide 3.0 mg, and discusses the associated risk-benefit profiles. Two anti-obesity medications presented safety issues that warranted further discussion; phentermine/topiramate (fetal toxicity) and liraglutide 3...
February 8, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29376439/pharmacotherapy-for-obesity-in-individuals-with-type-2-diabetes
#2
Tariq Chukir, Alpana P Shukla, Katherine H Saunders, Louis J Aronne
Type 2 diabetes (T2DM) is associated with significant morbidity and mortality. Obesity is one of the main risk factors for T2DM and its management requires a multidisciplinary approach, which may include pharmacotherapy. Areas covered: In this paper, data on efficacy, tolerability and safety of FDA-approved pharmacotherapies for obesity (orlistat, phentermine/topiramate extended-release, lorcaserin, bupropion sustained release/naltrexone sustained release and liraglutide) are reviewed, focusing on individuals with type 2 diabetes...
January 29, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29363287/effect-of-lorcaserin-alone-and-in-combination-with-phentermine-on-food-cravings-after-12-week-treatment-a-randomized-substudy
#3
Candida J Rebello, Elena V Nikonova, Sharon Zhou, Louis J Aronne, Ken Fujioka, W Timothy Garvey, Steven R Smith, Ann A Coulter, Frank L Greenway
OBJECTIVE: This study evaluated the effect of lorcaserin 10 mg twice daily (LOR BID), or with phentermine 15 mg once daily (LOR BID + PHEN QD) and 15 mg twice daily (LOR BID + PHEN BID), in conjunction with energy restriction on food cravings. METHODS: Two hundred and thirty-five patients without diabetes but with obesity or overweight and ≥ 1 comorbidity received LOR BID, LOR BID + PHEN QD, or LOR BID + PHEN BID for 12 weeks in a randomized double-blind study...
February 2018: Obesity
https://www.readbyqxmd.com/read/29305933/effects-of-weight-loss-medications-on-cardiometabolic-risk-profiles-a-systematic-review-and-network-meta-analysis
#4
Rohan Khera, Ambarish Pandey, Apoorva K Chandar, Mohammad H Murad, Larry J Prokop, Ian J Neeland, Jarett Berry, Michael Camilleri, Siddharth Singh
BACKGROUND & AIMS: We performed a systematic review and network meta-analysis to evaluate the overall and comparative effects of weight-loss medications, approved by the Food and Drug Administration (FDA) for long-term use, on cardiometabolic risk profiles of obese adults. METHODS: We performed a systematic literature review through February 28, 2017 to identify randomized clinical trials of the effects of FDA-approved weight loss medications (orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide), administered to obese adults for 1 year or more, compared with placebo or another active agent...
January 3, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29302947/fenfluramine-phentermine-is-associated-with-an-increase-in-cellular-proliferation-ex-vivo-and-in-vitro
#5
Nalini M Rajamannan
BACKGROUND: Fenfluraminephentermine (FenPhen) has been implicated in accelerated valvular heart disease, characterized by valvular regurgitation and thickening, and resembling the histopathologic lesions found in carcinoid. The study aim was to determine whether cellular proliferation is present in FenPhen-exposed valves, by utilizing an in-vitro model to test whether FenPhen has a direct mitogenic effect on cardiac valvular cells, as compared to serotonin. METHODS: Ex-vivo valves were tested for proliferation in surgically removed FenPhen-exposed valves (n = 10) and compared to proliferation levels in normal human cardiac valves removed at autopsy (n = 10)...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29301630/obesity-pathophysiology-and-management
#6
REVIEW
Kishore M Gadde, Corby K Martin, Hans-Rudolf Berthoud, Steven B Heymsfield
Obesity continues to be among the top health concerns across the globe. Despite our failure to contain the high prevalence of obesity, we now have a better understanding of its pathophysiology, and how excess adiposity leads to type 2 diabetes, hypertension, and cardiovascular disease. Lifestyle modification is recommended as the cornerstone of obesity management, but many patients do not achieve long-lasting benefits due to difficulty with adherence as well as physiological and neurohormonal adaptation of the body in response to weight loss...
January 2, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29287757/efficacy-of-adjuvant-weight-loss-medication-after-bariatric-surgery
#7
Zubaidah Nor Hanipah, Elie C Nasr, Emre Bucak, Philip R Schauer, Ali Aminian, Stacy A Brethauer, Derrick Cetin
BACKGROUND: Some patients do not achieve optimal weight loss or regain weight after bariatric surgery. In this study, we aimed to determine the effectiveness of adjuvant weight loss medications after surgery for this group of patients. SETTING: An academic medical center. METHODS: Weight changes of patients who received weight loss medications after bariatric surgery from 2012 to 2015 at a single center were studied. RESULTS: Weight loss medications prescribed for 209 patients were phentermine (n = 156, 74...
January 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29212337/-status-of-pharmacotherapy-in-current-care-of-obese
#8
Petr Sucharda
Weight loss drugs or anti-obesity drugs have a long history but are still far from being successful. Only in two last decades have the drugs been launched, which, when appropriately indicated, may be significantly beneficial to patients in need of weight loss as they are comparably effective to intensive programs to promote changes in eating habits and lifestyles. The combination naltrexone/bupropion is promising for food intake control including the reward mechanism, but the experience with its use has only been short-term...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29156182/obesity-pharmacotherapy
#9
REVIEW
Katherine H Saunders, Devika Umashanker, Leon I Igel, Rekha B Kumar, Louis J Aronne
Although diet, physical activity, and behavioral modifications are the cornerstones of weight management, weight loss achieved by lifestyle modifications alone is often limited and difficult to maintain. Pharmacotherapy for obesity can be considered if patients have a body mass index (BMI) of 30 kg/m2 or greater or BMI of 27 kg/m2 or greater with weight-related comorbidities. The 6 most commonly used antiobesity medications are phentermine, orlistat, phentermine/topiramate extended release, lorcaserin, naltrexone sustained release (SR)/bupropion SR, and liraglutide 3...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29151591/us-health-policy-and-prescription-drug-coverage-of-fda-approved-medications-for-the-treatment-of-obesity
#10
G Gomez, F C Stanford
OBJECTIVE: Obesity is now the most prevalent chronic disease in the United States, which amounts to an estimated $147 billion in health care spending annually. The Affordable Care Act (ACA) enacted in 2010 included provisions for private and public health insurance plans that expanded coverage for lifestyle/behavior modification and bariatric surgery for the treatment of obesity. Pharmacotherapy, however, has not been included despite their evidence-based efficacy. We set out to investigate the coverage of Food and Drug Administration-approved medications for obesity within Medicare, Medicaid and ACA-established marketplace health insurance plans...
November 20, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29132230/combination-therapy-for-obesity
#11
John Ph Wilding
Obesity is a chronic disease with serious consequences and although lifestyle modification is considered first line treatment, it is often ineffective, especially in the long term. Relatively few people with obesity will undergo the most effective currently available treatment of bariatric surgery. Pharmacotherapy can bridge the gap between lifestyle modification and surgery, but many monotherapies have only modest efficacy or require high doses with unacceptable side effects. As with many other areas of medicine, combination therapy is now becoming accepted as a way of optimising efficacy for weight management, whilst minimising adverse effects...
November 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29044720/observational-comparative-effectiveness-of-pharmaceutical-treatments-for-obesity-within-the-veterans-health-administration
#12
Ted R Grabarczyk
STUDY OBJECTIVE: To compare the effectiveness of weight-management medications used to assist with weight loss in real-world clinical practice in the Veterans Health Administration (VHA). DESIGN: Retrospective, multicenter, observational cohort study. DATA SOURCE: National VA Corporate Data Warehouse. PATIENTS: A total of 66,035 VA patients aged 18 years or older with a body mass index of 25 kg/m2 or greater who had an initial fill for a study medication (orlistat [6153 patients], phentermine [304 patients], lorcaserin [298 patients], or phentermine-topiramate extended release [233 patients]) or participation in the VA's MOVE! weight-management program with at least three total visits in a clinic coded as a MOVE clinic in the subsequent 24 weeks (59,047 patients) between January 1, 2012, and July 1, 2016...
January 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29038069/study-protocol-and-rationale-for-a-randomized-double-blinded-crossover-trial-of-phentermine-topiramate-er-versus-placebo-to-treat-binge-eating-disorder-and-bulimia-nervosa
#13
Shebani Sethi Dalai, Sarah Adler, Thomas Najarian, Debra Lynn Safer
INTRODUCTION: Bulimia nervosa (BN) and binge eating disorder (BED) are associated with severe psychological and medical consequences. Current therapies are limited, leaving up to 50% of patients symptomatic despite treatment, underscoring the need for additional treatment options. Qsymia, an FDA-approved medication for obesity, combines phentermine and topiramate ER. Topiramate has demonstrated efficacy for both BED and BN, but limited tolerability. Phentermine is FDA-approved for weight loss...
October 14, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29024559/comparative-efficacy-of-five-long-term-weight-loss-drugs-quantitative-information-for-medication-guidelines
#14
REVIEW
Z Dong, L Xu, H Liu, Y Lv, Q Zheng, L Li
Quantitative information is scarce in current obesity medication guidelines, and they do not clearly reflect the differences in the efficacy characteristics among various drugs. This study quantitatively assessed the efficacy characteristics of five FDA-approved long-term weight loss drugs. Potentially eligible studies were obtained from public databases. Using the differences in the weight change from baseline between the drug group and the corresponding placebo group as the major indicator of efficacy, a time-effect model was established, and crucial pharmacodynamic parameters, such as the maximal efficacy, drug onset time and rate of body weight regain after the maximal efficacy point, were used to reflect the differences in efficacy among the five drugs...
December 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29024552/current-pharmacotherapies-for-obesity-a-practical-perspective
#15
REVIEW
Angela Golden
BACKGROUND AND PURPOSE: To review the currently available pharmacotherapies for obesity management with a particular focus on the United States. METHODS: Narrative review based on literature searches and the latest prescribing information (up to July 2017). CONCLUSIONS: Obesity pharmacotherapies may assist those individuals who have obesity, or overweight with comorbidities, who have failed to maintain weight loss with lifestyle modifications alone (caloric restriction and increased physical activity)...
October 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28957720/application-of-gas-chromatography-tandem-mass-spectrometry-for-the-determination-of-amphetamine-type-stimulants-in-blood-and-urine
#16
Mateusz Kacper Woźniak, Marek Wiergowski, Justyna Aszyk, Paweł Kubica, Jacek Namieśnik, Marek Biziuk
Amphetamine, methamphetamine, phentermine, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA), and 3,4-methylenedioxy-N-ethylamphetamine (MDEA) are the most popular amphetamine-type stimulants. The use of these substances is a serious societal problem worldwide. In this study, a method based on gas chromatography-tandem mass spectrometry (GC-MS/MS) with simple and rapid liquid-liquid extraction (LLE) and derivatization was developed and validated for the simultaneous determination of the six aforementioned amphetamine derivatives in blood and urine...
September 18, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28936885/psychoactive-substances-belonging-to-the-amphetamine-class-potently-activate-brain-carbonic-anhydrase-isoforms-va-vb-vii-and-xii
#17
Andrea Angeli, Fabio Vaiano, Francesco Mari, Elisabetta Bertol, Claudiu T Supuran
Identifying possible new biological activities of psychoactive substances belonging to various chemical classes may lead to a better understanding of their mode of action and side effects. We report here that amines structurally related to amphetamine, a widely used psychoactive substance, such as amphetamine, methamphetamine, phentermine, mephentermine, and chlorphenteramine, potently activate several carbonic anhydrase (CA, EC 4.2.1.1) isoforms involved in important physiological functions. Of the 11 investigated human (h) isoforms, the widespread hCA I and II, the secreted hCA VI, as well as the cytosolic hCA XIII, and membrane-bound hCA IX and XIV were poorly activated by these amines, whereas the extracellular hCA IV, the mitochondrial enzymes hCA VA/VB, the cytosolic hCA VII, and the transmembrane isoform hCA XII were potently activated...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28935287/past-present-and-future-of-pharmacotherapy-for-obesity
#18
David Benaiges, Juan Pedro-Botet, Juana A Flores-Le Roux, Elisenda Climent, Albert Goday
Conventional treatment for obesity with diet, exercise and bariatric surgery has limitations; thus, it is necessary to have pharmacological tools. In the past, different drugs were marketed that were withdrawn due to safety problems. There are currently 3 drugs approved by the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) for obesity therapy (orlistat, combination of bupropion and delayed-release naltrexone and liraglutide) and two more only authorized by FDA (lorcaserin and the combination of phentermine and extended release topiramate)...
September 18, 2017: Clínica e Investigación en Arteriosclerosis
https://www.readbyqxmd.com/read/28863437/serotonin-and-catecholamines-in-the-development-and-progression-of-heart-valve-diseases
#19
Elliott Goldberg, Juan B Grau, Jacqueline H Fortier, Elisa Salvati, Robert J Levy, Giovanni Ferrari
Heart valve diseases (HVDs) arise from a number of different processes that affect both the structure and function of the valve apparatus. Despite diverse aetiologies, treatments for HVDs are limited to percutaneous or surgical interventions. The search for medical therapies to prevent or slow the progression of HVDs has been hampered by our poor understanding of the progression from subclinical to symptomatic phases, and our limited knowledge of the molecular signals that control the susceptibility of valve interstitial cells to pathological remodeling...
July 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28818558/current-and-emerging-pharmacotherapies-for-obesity-in-australia
#20
REVIEW
Samantha Hocking, Anthony Dear, Michael A Cowley
BACKGROUND: Obesity is a major issue in Australia and globally. Many individuals struggle to maintain weight loss with lifestyle modification, and adjunctive pharmacotherapy may help. Historically, there have been limited pharmacotherapies for managing obesity. In addition, previous treatments such as phentermine-fenfluramine, rimonabant and sibutramine were withdrawn due to safety issues, resulting in lingering safety concerns. METHODS: This is a narrative review of published data examining four new pharmacotherapy options for weight management in Australia...
August 14, 2017: Obesity Research & Clinical Practice
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