Meta-analysis and Approach of the Real Impact of Anorexigenic Drugs in the Obesity in Humans: The Last Five Years of the Randomized Studies

Author(s): Ana Valéria Garcia Ramirez, Durval Ribas Filho, Idiberto José Zotarelli Filho*

Journal Name: Current Diabetes Reviews

Volume 16 , Issue 7 , 2020


Become EABM
Become Reviewer
Call for Editor

Abstract:

Introduction: Obesity shows a multifactorial disease and presents a serious public health problem, with an alarming epidemic character. According to NHANES (National Health and Nutrition Examination Survey) from 2015 to 2016, 39.6% of American adults and 18.5% of young people were obese and 7.7% of adults and 5.6% of young people had severe obesity. Brazil ranks fifth in the world ranking, with about 18 million people reaching up to 70 million overweight individuals. Despite shortterm weight loss with diet and exercise, weight regain continues to be a concern. Anti-obesity drugs, such as Sibutramine (SIB), Phentermine (PHEN), Fenproporex (FEN), Mazindol (MAZ), Amfepramone (AMFE) and Orlistat (ORL) may play a role in weight reduction in patients whose condition is refractory to non- and maintenance of weight loss.

Objective: A systematic review followed by meta-analysis of randomized clinical trials over the past five years to explore the efficacy and safety of anorexigenic drugs for weight reduction and consequent treatment of obesity.

Methods: The search strategy in MEDLINE / Pubmed, Web of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), OneFile (Gale) is as follows : - search for mesh terms (Sibutramine, Phentermine, Fenproporex, Mazindol, Amfepramone , Orlistat, Weight loss, Safety), and the use of booleans "and" between mesh terms and "or" among historical findings.

Results: It was observed that in the last five years of randomized studies no significant general complications were found, with only 5.7%. The mean overall weight loss was 6.18 (± 2.8) kg in the mean time of 12 months. The overall success rate among these drugs was 80.18%. The p-value values did not present a significant statistical difference, being p <0.05 within each drug group analyzed, for both weight and success rates.

Conclusion: The scientific findings of randomized studies on the use of anorexigenic drugs to treat obesity have shown safety and efficiency in the last five years, with a reasonable weight loss and no significant complications.

Keywords: Anorexigenic drugs, obesity, weight loss, safety, complications, exercise.

[2]
http://www.ibge.gov.br [february 2019];
[3]
Lucchetta RC, Riveros BS, Pontarolo R, et al. Systematic review and meta-analysis of the efficacy and safety of amfepramone and mazindol as a monotherapy for the treatment of obese or overweight patients. Clinics (São Paulo) 2017; 72(5): 317-24.
[http://dx.doi.org/10.6061/clinics/2017(05)10] [PMID: 28591345]
[4]
Moldovan CP, Weldon AJ, Daher NS, et al. Effects of a meal replacement system alone or in combination with phentermine on weight loss and food cravings. Obesity (Silver Spring) 2016; 24(11): 2344-50.
[http://dx.doi.org/10.1002/oby.21649] [PMID: 27664021]
[5]
Seimon RV, Espinoza D, Finer N, et al. Changes in body weight and pulse: outcome events in overweight and obese subjects with cardiovascular disease in the SCOUT trial. Int J Obes 2015; 39(5): 849-57.
[http://dx.doi.org/10.1038/ijo.2014.211] [PMID: 25520249]
[6]
Seimon RV, Espinoza D, Ivers L, et al. Changes in body weight and blood pressure: paradoxical outcome events in overweight and obese subjects with cardiovascular disease. Int J Obes 2014; 38(9): 1165-71.
[http://dx.doi.org/10.1038/ijo.2014.2] [PMID: 24406481]
[7]
Kamil S, Finer N, James WPT, Caterson ID, Andersson C, Torp-Pedersen C. Influence of sibutramine in addition to diet and exercise on the relationship between weight loss and blood glucose changes. Eur Heart J Cardiovasc Pharmacother 2017; 3(3): 134-9.
[http://dx.doi.org/10.1093/ehjcvp/pvw029] [PMID: 27680881]
[8]
Maggioni AP, Caterson ID, Urso R, et al. Relation between weight loss and causes of death in patients with cardiovascular disease: finding from the SCOUT trial. J Cardiovasc Med (Hagerstown) 2017; 18(3): 144-51.
[http://dx.doi.org/10.2459/JCM.0000000000000492] [PMID: 28002198]
[9]
Taghizadeh M, Memarzadeh MR, Asemi Z, Esmaillzadeh A. Effect of the cumin cyminum L. Intake on Weight Loss, Metabolic Profiles and Biomarkers of Oxidative Stress in Overweight Subjects: A Randomized Double-Blind Placebo-Controlled Clinical Trial. Ann Nutr Metab 2015; 66(2-3): 117-24.
[http://dx.doi.org/10.1159/000373896] [PMID: 25766448]
[10]
McVay MA, Jeffreys AS, King HA, Olsen MK, Voils CI, Yancy WS Jr. The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches. J Hum Nutr Diet 2015; 28(Suppl. 2): 16-23.
[http://dx.doi.org/10.1111/jhn.12188] [PMID: 24251378]
[11]
Panidis D, Tziomalos K, Papadakis E, et al. The role of orlistat combined with lifestyle changes in the management of overweight and obese patients with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2014; 80(3): 432-8.
[http://dx.doi.org/10.1111/cen.12305] [PMID: 23909452]
[12]
Suplicy H, Boguszewski CL, dos Santos CM, do Desterro de Figueiredo M, Cunha DR, Radominski R. A comparative study of five centrally acting drugs on the pharmacological treatment of obesity. Int J Obes 2014; 38(8): 1097-103.
[http://dx.doi.org/10.1038/ijo.2013.225] [PMID: 24287940]
[13]
Soto-Molina H, Pizarro-Castellanos M, Rosado-Pérez J, et al. Six-month efficacy and safety of amfepramone in obese Mexican patients: a double-blinded, randomized, controlled trial. Int J Clin Pharmacol Ther 2015; 53(7): 541-9.
[http://dx.doi.org/10.5414/CP202135] [PMID: 26073353]
[14]
Hollander P, Bays HE, Rosenstock J, et al. Coadministration of Canagliflozin and Phentermine for Weight Management in Overweight and Obese Individuals Without Diabetes: A Randomized Clinical Trial. Diabetes Care 2017; 40(5): 632-9.
[http://dx.doi.org/10.2337/dc16-2427] [PMID: 28289041]
[15]
Garvey WT, Ryan DH, Bohannon NJ, et al. Weight-loss therapy in type 2 diabetes: effects of phentermine and topiramate extended release. Diabetes Care 2014; 37(12): 3309-16.
[http://dx.doi.org/10.2337/dc14-0930] [PMID: 25249652]
[16]
Garvey WT, Ryan DH, Henry R, et al. Prevention of type 2 diabetes in subjects with prediabetes and metabolic syndrome treated with phentermine and topiramate extended release. Diabetes Care 2014; 37(4): 912-21.
[http://dx.doi.org/10.2337/dc13-1518] [PMID: 24103901]
[17]
Franco RR, Cominato L, Damiani D. [The effect of sibutramine on weight loss in obese adolescents]. Arq Bras Endocrinol Metabol 2014; 58(3): 243-50.
[http://dx.doi.org/10.1590/0004-2730000002825] [PMID: 24863086]
[18]
Biedermann F, Fleischhacker WW, Kemmler G, Ebenbichler CF, Lechleitner M, Hofer A. Sibutramine in the treatment of antipsychotic-induced weight gain: a pilot study in patients with schizophrenia. Int Clin Psychopharmacol 2014; 29(3): 181-4.
[http://dx.doi.org/10.1097/YIC.0000000000000022] [PMID: 24300751]
[19]
Thomas EA, Mcnair B, Bechtell JL, Ferland A, Cornier MA, Eckel RH. Greater hunger and less restraint predict weight loss success with phentermine treatment. Obesity (Silver Spring) 2016; 24(1): 37-43.
[http://dx.doi.org/10.1002/oby.21244] [PMID: 26584649]
[20]
Han S, Jeon S, Hong T, et al. Exposure-response model for sibutramine and placebo: suggestion for application to long-term weight-control drug development. Drug Des Devel Ther 2015; 9: 5185-94.
[http://dx.doi.org/10.2147/DDDT.S85435] [PMID: 26392753]
[21]
Grilo CM, White MA, Masheb RM, Gueorguieva R. Predicting meaningful outcomes to medication and self-help treatments for binge-eating disorder in primary care: The significance of early rapid response. J Consult Clin Psychol 2015; 83(2): 387-94.
[http://dx.doi.org/10.1037/a0038635] [PMID: 25622201]
[22]
Acosta A, Camilleri M, Shin A, et al. Quantitative gastrointestinal and psychological traits associated with obesity and response to weight-loss therapy. Gastroenterology 2015; 148(3): 537-546.e4.
[http://dx.doi.org/10.1053/j.gastro.2014.11.020] [PMID: 25486131]
[23]
Grilo CM, Masheb RM, White MA, et al. Treatment of binge eating disorder in racially and ethnically diverse obese patients in primary care: randomized placebo-controlled clinical trial of self-help and medication. Behav Res Ther 2014; 58: 1-9.
[http://dx.doi.org/10.1016/j.brat.2014.04.002] [PMID: 24857821]
[24]
Jørgensen ME, Torp-Pedersen C, Finer N, et al. Association between serum bilirubin and cardiovascular disease in an overweight high risk population from the SCOUT trial. Nutr Metab Cardiovasc Dis 2014; 24(6): 656-62.
[http://dx.doi.org/10.1016/j.numecd.2013.12.009] [PMID: 24534073]
[25]
Parks EP, Zemel B, Moore RH, Berkowitz RI. Change in body composition during a weight loss trial in obese adolescents. Pediatr Obes 2014; 9(1): 26-35.
[http://dx.doi.org/10.1111/j.2047-6310.2012.00139.x] [PMID: 23382092]
[26]
Konofal E, Zhao W, Laouénan C, et al. Pilot Phase II study of mazindol in children with attention deficit/hyperactivity disorder. Drug Des Devel Ther 2014; 8: 2321-32.
[http://dx.doi.org/10.2147/DDDT.S65495] [PMID: 25525331]
[27]
Al-Tahami BAM, Al-Safi Ismail AA, Sanip Z, et al. Metabolic and Inflammatory Changes with Orlistat and Sibutramine Treatment in Obese Malaysian Subjects. J Nippon Med Sch 2017; 84(3): 125-32.
[http://dx.doi.org/10.1272/jnms.84.125] [PMID: 28724846]
[28]
Smith SR, Garvey WT, Greenway FL, et al. Coadministration of lorcaserin and phentermine for weight management: A 12-week, randomized, pilot safety study. Obesity (Silver Spring) 2017; 25(5): 857-65.
[http://dx.doi.org/10.1002/oby.21811] [PMID: 28440045]
[29]
Kargulewicz A, Szulińska M, Kujawska-Łuczak M, et al. Improvement of serum adiponectin and leptin concentrations: effects of a low-calorie or isocaloric diet combined with metformin or orlistat - a prospective randomized open-label trial. Eur Rev Med Pharmacol Sci 2016; 20(18): 3868-76.
[PMID: 27735028]
[30]
Arzola-Paniagua MA, García-Salgado López ER, Calvo-Vargas CG, Guevara-Cruz M. Efficacy of an orlistat-resveratrol combination for weight loss in subjects with obesity: A randomized controlled trial. Obesity (Silver Spring) 2016; 24(7): 1454-63.
[http://dx.doi.org/10.1002/oby.21523] [PMID: 27221771]
[31]
Chukhin E, Terevnikov V, Takala P, et al. Is there an interrelationship between the effects of antipsychotics on psychopathology and on metabolism? Nord J Psychiatry 2016; 70(3): 190-4.
[http://dx.doi.org/10.3109/08039488.2015.1074283] [PMID: 26450657]
[32]
Moini A, Kanani M, Kashani L, Hosseini R, Hosseini L. Effect of orlistat on weight loss, hormonal and metabolic profiles in women with polycystic ovarian syndrome: a randomized double-blind placebo-controlled trial. Endocrine 2015; 49(1): 286-9.
[http://dx.doi.org/10.1007/s12020-014-0426-4] [PMID: 25294011]
[33]
Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 510 2011 updated March 2011.
[34]
Sahebkar A, Simental-Mendía LE, Kovanen PT, Pedone C, Simental-Mendía M, Cicero AFG. Effects of orlistat on blood pressure: a systematic review and meta-analysis of 27 randomized controlled clinical trials. J Am Soc Hypertens 2018; 12(2): 80-96.
[http://dx.doi.org/10.1016/j.jash.2017.12.002] [PMID: 29275922]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 16
ISSUE: 7
Year: 2020
Published on: 23 July, 2020
Page: [750 - 758]
Pages: 9
DOI: 10.2174/1573399815666191113125247
Price: $65

Article Metrics

PDF: 56
HTML: 6
EPUB: 2