医学
奥利斯特
芬特明
利拉鲁肽
西布曲明
减肥
肥胖
药物治疗
利莫那班
托吡酯
重症监护医学
二甲双胍
肥胖管理
临床试验
体重管理
糖尿病
内科学
精神科
2型糖尿病
内分泌学
受体
大麻素受体
癫痫
兴奋剂
作者
Marlene Chakhtoura,Rachelle Haber,Malak Ghezzawi,Caline Rhayem,Raya Tcheroyan,Christos S. Mantzoros
标识
DOI:10.1016/j.eclinm.2023.101882
摘要
Obesity is an epidemic and a public health threat. Medical weight management remains one of the options for the treatment of excess weight and recent advances have revolutionized how we treat, and more importantly how we will be treating obesity in the near future. Metreleptin and Setmelanotide are currently indicated for rare obesity syndromes, and 5 other medications (orlistat, phentermine/topiramate, naltrexone/bupropion, liraglutide, semaglutide) are approved for non-syndromic obesity. Tirzepatide is about to be approved, and other drugs, with exciting novel mechanisms of action primarily based on incretins, are currently being investigated in different phases of clinical trials. The majority of these compounds act centrally, to reduce appetite and increase satiety, and secondarily, in the gastrointestinal tract to slow gastric emptying. All anti-obesity medications improve weight and metabolic parameters, with variable potency and effects depending on the specific drug. The currently available data do not support a reduction in hard cardiovascular outcomes, but it is almost certain that such data are forthcoming in the very near future. The choice of the anti-obesity medication needs to take into consideration the patient's clinical and biochemical profile, co-morbidities, and drug contra-indications, as well as expected degree of weight loss and improvements in cardio-renal and metabolic risk. It also remains to be seen whether precision medicine may offer personalized solutions to individuals with obesity, and whether it may represent the future of medical weight management along with the development of novel, very potent, anti-obesity medications currently in the pipeline.FundingNone.
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