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Obesity: the New Global Epidemic. Pharmacological Treatment, Opportunities and Limits for Personalized Therapy.
Endocr Metab Immune Disord Drug Targets. 2020 May 15 [Online ahead of print]EM

Abstract

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

The purpose of this review is a review of the literature, based on a research on MEDLINE until 2019, on the possible pharmacological options in the treatment of obesity.

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 multi-target 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

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.

Authors+Show Affiliations

Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napol. Italy.Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napol. Italy.Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napol. Italy.Simple Departmental Operative Unit (U.O.S.D.), Eating Disorder Unit, ASL Napoli 2 Nord, Napol. Italy.Department of Pharmacy, University of Salerno, 84084, Fisciano, Salerno. Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32410565

Citation

Milano, Walter, et al. "Obesity: the New Global Epidemic. Pharmacological Treatment, Opportunities and Limits for Personalized Therapy." Endocrine, Metabolic & Immune Disorders Drug Targets, 2020.
Milano W, De Biasio V, Di Munzio W, et al. Obesity: the New Global Epidemic. Pharmacological Treatment, Opportunities and Limits for Personalized Therapy. Endocr Metab Immune Disord Drug Targets. 2020.
Milano, W., De Biasio, V., Di Munzio, W., Foggia, G., & Capasso, A. (2020). Obesity: the New Global Epidemic. Pharmacological Treatment, Opportunities and Limits for Personalized Therapy. Endocrine, Metabolic & Immune Disorders Drug Targets. https://doi.org/10.2174/1871530320666200515112853
Milano W, et al. Obesity: the New Global Epidemic. Pharmacological Treatment, Opportunities and Limits for Personalized Therapy. Endocr Metab Immune Disord Drug Targets. 2020 May 15; PubMed PMID: 32410565.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obesity: the New Global Epidemic. Pharmacological Treatment, Opportunities and Limits for Personalized Therapy. AU - Milano,Walter, AU - De Biasio,Valeria, AU - Di Munzio,Walter, AU - Foggia,Giuseppina, AU - Capasso,Anna, Y1 - 2020/05/15/ PY - 2019/10/17/received PY - 2020/03/30/revised PY - 2020/04/01/accepted PY - 2020/5/16/entrez KW - lorcaserin KW - naltrexone-bupropion KW - obesity KW - orlistat KW - pharmacotherapy KW - phentermine-topiramate and liraglutide. JF - Endocrine, metabolic & immune disorders drug targets JO - Endocr Metab Immune Disord Drug Targets N2 - 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: The purpose of this review is a review of the literature, based on a research on MEDLINE until 2019, on the possible pharmacological options in the treatment of obesity. 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 multi-target 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: 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. SN - 2212-3873 UR - https://www.unboundmedicine.com/medline/citation/32410565/Obesity:_the_New_Global_Epidemic._Pharmacological_Treatment,_Opportunities_and_Limits_for_Personalized_Therapy L2 - http://www.eurekaselect.com/181983/article DB - PRIME DP - Unbound Medicine ER -
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