Pharmacotherapy in the Treatment of Obesity

Open access

Abstract

Background and Aims: In the last three decades, obesity and its related co morbidities has quickly increased. Sometime, obesity was viewed as a serious health issue in developed countries alone, but now is recognized as a worldwide epidemic, and its associated costs are enormous. Obesity is related with various diseases, like hypertension, type 2 diabetes mellitus (T2DM), dyslipidemia, chronic cardiovascular diseases, respiratory conditions, alongside chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). This review purpose is to provide data on the current anti-obesity drugs, also available and in the development. Material and Methods: We searched MEDLINE from 2006 to the present to collect information on the anti-obesity pharmacotherapy. Results and Conclusions: In the patients with obesity related comorbidities, there may be an adaptation of the anti-obesity pharmacotherapy to the patients’ needs, in respect to the improvements of the cardiometabolic parameters. Although their efficacy was proven, the anti-obesity pharmacotherapies have presented adverse events that require a careful monitoring during treatment. The main obstacle for approve new drugs seems to be the ratio between the risks and the benefits, because of a long-time background of perilous anti-obesity drugs.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Ng M Fleming T Robinson M et al. Global regional and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384: 766-81 2014.

  • 2. WHO. Obesity and overweight. WHO fact sheet N°311. World Health Organization website. Geneva Switzerland: World Health Organization; 2016 [http://www.who.int/mediacentre/factsheets/fs311/en. Accessed September 10 2016].

  • 3. de Onis M Blossner M Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92: 1257-1264 2010.

  • 4. Chan RS Woo J. Prevention of Overweight and Obesity: How Effective is the Current Public Health Approach. Int J Environ Res Public Health 7: 765-783 2010.

  • 5. Halford JCG. Pharmacotherapy for obesity. Appetite 46: 6-10 2006.

  • 6. Colon-Gonzalez F Kim G Lin J Valentino M Waldman S. Obesity pharmacotherapy: What is next? Mol Aspects Med 34: 71-83 2013.

  • 7. Sweeting AN Hocking SL Markovic TP. Pharmacotherapy for the treatment of obesity. Mol Cell Endocrinol 418: 173-183 2015.

  • 8. Cheung BMY Cheung TT Samaranayake NR. Safety of antiobesity drugs. Ther Adv Drug Saf 4: 171-181 2013.

  • 9. Moreira Fa Crippa Ja. The psychiatric sideeffects of rimonabant. Rev Bras Psiquiatr 31: 145-153 2009.

  • 10. André A Gonthier MP. The endocannabinoid system: Its roles in energy balance and potential as a target for obesity treatment. Int J Biochem Cell Biol 42: 1788-1801 2010.

  • 11. Scheen AJ. Cardiovascular risk-benefit profile of sibutramine. Am J Cardiovasc Drug 10: 321-34 2010.

  • 12. Hsu YW Chu DC Ku PW Liou TH Chou P. Pharmacotherapy for Obesity: Past Present and Future. J Exp Clin Med 2:118-123 2010.

  • 13. Weir MA Beyea MM Gomes T et al. Orlistat and acute kidney injury: an analysis of 953 patients. Arch Intern Med 171: 703-704 2011.

  • 14. Kakkar AK Dahiya N. Drug treatment of obesity: Current status and future prospects. Eur J Intern Med 26: 89-94 2015.

  • 15. Torgerson JS Hauptman J Boldrin MN Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 27: 155-161 2004.

  • 16. Tonstad S Rossner S Rissanen A Astrup A. Medical management of obesity in Scandinavia 2016. Obesity Medicine 1: 38-44 2016.

  • 17. Dutton CA Barnes MN. Anti-obesity pharmacotherapy: Future perspectives utilising 5-HT2C receptor agonists. Drug Discov Today Ther Strateg 3: 577-583 2006.

  • 18. Smith SR Weissman NJ Anderson CM et al. Behavioral Modification and Lorcaserin for Overweight and Obesity Management (BLOOM) Study Group. Multicenter placebo-controlled trial of lorcaserin for weight management. N Engl J Med 363: 245-256 2010.

  • 19. European Medicines Agency Withdrawal of the marketing authorisation application for Belviq (lorcaserin). Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Medicine_QA/2013/05/WC500143811.pdf [Accessed 12 September 2016].

  • 20. *** Qsymia® Prescribing Information. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/022580s010s011s012lbl.pdf [Accessed 12 September 2016].

  • 21. Kaplan LM. Pharmacologic therapies for obesity. Gastroenterol Clin North Am 39: 69-79 2010.

  • 22. European Medicines Agency Refusal of the marketing authorisation for Qsiva (phentermine/topiramate). Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Summary_of_opinion_Initial_authorisation/human/002350/WC500139215.pdf [Accessed 12 September 2016].

  • 23. Billes KS Sinnayah P Cowley AM. Naltrexone/bupropion for obesity: An investigational combination pharmacotherapy for weight loss. Pharmacol Res 84: 1-11 2014.

  • 24. Wharton S. Current Perspectives on Long-term Obesity Pharmacotherapy. Can J Diabetes 40: 184-191 2016.

  • 25. Reece AS. Hypothalamic opioid-melanocortin appetitive balance and addictive craving. Med Hypotheses 76: 132-137 2011.

  • 26. Patel D. Pharmacotherapy for the management of obesity. Metabolism 64: 1376-1385 2015.

  • 27. Rigas N Ionica FE Popescu F. Therapy with GLP-1 agonists and dipeptidyl-peptidase IV inhibitors in type 2 diabetes mellitus. Rom J Diabetes Nutr Metab Dis 18: 361-368 2011.

  • 28. Pi-Sunyer X Astrup A Fujioka K et al. A randomized controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 373: 11-22 2015.

  • 29. *** Saxenda® Prescribing Information. 2015. Available from URL: http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/206321s001lbl.pdf.

  • 30. ***Saxenda® Summary of Product Characteristics. 2015. Available from URL: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/003780/WC500185786.pdf.

  • 31. Adan RA. Mechanisms underlying current and future anti-obesity drugs. Trends Neurosci 36: 133-140 2013.

  • 32. Deveaux V Cadoudal T Ichigotani Y et al. Cannabinoid CB2 receptor potentiates obesity-associated inflammation insulin resistance and hepatic steatosis. PLoS One 4: e5844 2009.

  • 33. Ghoshal S Zhu Q Asteian A et al. TNP [N2- (m-Trifluorobenzyl) N6-(p-nitrobenzyl) purine] ameliorates diet induced obesity and insulin resistance via inhibition of the IP6K1 pathway. Moll Metab 5: 903-917 2016.

  • 34. *** Orexigen(R) Therapeutics Phase 2b Trial for Empatic(TM) Meets Primary Efficacy Endpoint Demonstrating Significantly Greater Weight Loss Versus Comparators in Obese Patients. Available from: http://ir.orexigen.com/phoenix.zhtml%3Fc=207034%26p=irol-newsArticle%26ID=1336796%26highlight [Accessed 15 September 2016].

  • 35. Halpern B Oliveira E Faria A et al. Combinations of drugs in the treatment of obesity. Pharmaceuticals 3: 2398-2415 2010.

  • 36. Hughes TE Kim DD Marjason J Proietto J Whitehead JP Vath JE. Ascending dose-controlled trial of beloranib a novel obesity treatment for safety tolerability and weight loss in obese women. Obesity 21: 1782-1788 2013.

  • 37. Kim DD Krishnarajah J Lillioja S et al. Efficacy and safety of beloranib for weight loss in obese adults: a randomized controlled trial. Diabetes Obes Metab 17: 566-572 2015.

  • 38. *** Zafgen Company press release. Available from: http://www.zafgen.com/docs/default-source/defaultdocument-library/click-here.pdf?sfvrsn=0

  • 39. Heal D Gosden J Smith S. What is the prognosis for new centrally-acting anti-obesity drugs? Neuropharmacology 63: 132-146 2012.

  • 40. Martin K Mani M Mani A. New targets to treat obesity and the metabolic syndrome. Eur J Pharmacol 763: 64-74 2015.

Search
Journal information
Impact Factor


CiteScore 2018: 0.19

SCImago Journal Rank (SJR) 2018: 0.128
Source Normalized Impact per Paper (SNIP) 2018: 0.229

Metrics
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 284 128 4
PDF Downloads 147 81 3