Obesity: The New Global Epidemic Pharmacological Treatment, Opportunities and Limits for Personalized Therapy.


Journal

Endocrine, metabolic & immune disorders drug targets
ISSN: 2212-3873
Titre abrégé: Endocr Metab Immune Disord Drug Targets
Pays: United Arab Emirates
ID NLM: 101269157

Informations de publication

Date de publication:
2020
Historique:
received: 17 10 2019
revised: 30 03 2020
accepted: 01 04 2020
pubmed: 16 5 2020
medline: 5 8 2021
entrez: 16 5 2020
Statut: ppublish

Résumé

The increase in global obesity rates over the past three decades has been remarkable, a true epidemic, both in developed and in developing countries. The projections, based on current trends, suggest an increase in the prevalence of obesity at 60% in adult men, 40% in adult women and 25% in children in 2050. Given the limitations of lifestyle and surgery interventions bariatric, drug therapy approaches for the treatment of obesity, therefore become important options. The purpose of this review is a review of the literature, based on research on MEDLINE until 2019, on the possible pharmacological options in the treatment of obesity. Currently, the FDA has approved several molecules for the treatment of obesity, both in monotherapy and in combination. Pharmacological monotherapies focus mainly on a single protein target and include orlistat, lorcaserin and liraglutide while the combination molecules propose a multitarget approach and include phentermine/topiramate and naltrexone/bupropion. All the approved drugs showed, in the different studies, a weight reduction of at least 5%, compared to placebo, in 52 weeks of observation. Phentermine-topiramate and liraglutide have been associated with the highest probability of at least 5% weight loss. Liraglutide and naltrexone-bupropion had the lowest rates of therapy discontinuation due to adverse events. The drugs, associated with the standard diet and/or exercise protocols, represent a good therapeutic opportunity to allow not only weight loss but also to reduce the risk of developing diseases caused by obesity, particularly cardiovascular diseases, and to maintain the set objectives over time. However, future research on the pharmacological treatment of obesity should encourage greater personalization of therapy, given the differences in safety, efficacy and response to therapy, in the different subpopulations of patients with obesity.

Sections du résumé

BACKGROUND BACKGROUND
The increase in global obesity rates over the past three decades has been remarkable, a true epidemic, both in developed and in developing countries. The projections, based on current trends, suggest an increase in the prevalence of obesity at 60% in adult men, 40% in adult women and 25% in children in 2050. Given the limitations of lifestyle and surgery interventions bariatric, drug therapy approaches for the treatment of obesity, therefore become important options.
AIM OBJECTIVE
The purpose of this review is a review of the literature, based on research on MEDLINE until 2019, on the possible pharmacological options in the treatment of obesity.
RESULTS RESULTS
Currently, the FDA has approved several molecules for the treatment of obesity, both in monotherapy and in combination. Pharmacological monotherapies focus mainly on a single protein target and include orlistat, lorcaserin and liraglutide while the combination molecules propose a multitarget approach and include phentermine/topiramate and naltrexone/bupropion. All the approved drugs showed, in the different studies, a weight reduction of at least 5%, compared to placebo, in 52 weeks of observation. Phentermine-topiramate and liraglutide have been associated with the highest probability of at least 5% weight loss. Liraglutide and naltrexone-bupropion had the lowest rates of therapy discontinuation due to adverse events.
CONCLUSION CONCLUSIONS
The drugs, associated with the standard diet and/or exercise protocols, represent a good therapeutic opportunity to allow not only weight loss but also to reduce the risk of developing diseases caused by obesity, particularly cardiovascular diseases, and to maintain the set objectives over time. However, future research on the pharmacological treatment of obesity should encourage greater personalization of therapy, given the differences in safety, efficacy and response to therapy, in the different subpopulations of patients with obesity.

Identifiants

pubmed: 32410565
pii: EMIDDT-EPUB-106651
doi: 10.2174/1871530320666200515112853
doi:

Substances chimiques

Anti-Obesity Agents 0
Bupropion 01ZG3TPX31
Naltrexone 5S6W795CQM
Liraglutide 839I73S42A
Orlistat 95M8R751W8

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1232-1243

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Walter Milano (W)

Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napoli, Italy.

Valeria De Biasio (V)

Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napoli, Italy.

Walter Di Munzio (W)

Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napoli, Italy.

Giuseppina Foggia (G)

Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napoli, Italy.

Anna Capasso (A)

Department of Pharmacy, University of Salerno, 84084, Fisciano, Salerno, Italy.

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Classifications MeSH