Potential role of new therapies in modifying cardiovascular risk in overweight patients with metabolic risk factors.
The serotonin, norepinephrine, dopamine, and endocannabinoid systems, as well as a host of other systems, mediate hunger and satiety signals. Weight loss agents that modulate appetite through pure central nervous system pathways (e.g., APD356, a selective serotonin receptor agonist) and peripheral signals to central nervous system pathways (e.g., cholecystokinin receptor agonists and ghrelin receptor antagonists) are in preclinical or early phase studies. Both devices and pharmacological compounds that facilitate weight loss and/or target multiple components of metabolic risk also are in development. One of the medications that has completed extensive phase III clinical trials and may become available in the foreseeable future is rimonabant, a selective cannabinoid 1-receptor antagonist. Drugs that improve adipose tissue function or fatty acid metabolism (e.g., AOD9604) also are in clinical trials. Some currently available medications may reduce metabolic complications without treating obesity per se (e.g., acipimox, pioglitazone). Surgically implanted gastric pacemaker systems that modulate vagus nerve activity and delay gastric emptying are under study.
Jensen
Michael D
MD
Endocrine Research Unit, Division of Endocrinology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. Jensen.Michael@Mayo.edu
D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001067:Appetite Depressants / Q000627:therapeutic use; D001069:Appetite Regulation / Q000502:physiology; D050110:Bariatric Surgery / Q000295:instrumentation / Q000379:methods; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D006801:Humans; D024821:Metabolic Syndrome / Q000188:drug therapy*; D008954:Models, Biological; D009765:Obesity / Q000188:drug therapy* / Q000601:surgery; D050177:Overweight / Q000187:drug effects*; D012307:Risk Factors; D035703:Therapies, Investigational; D015431:Weight Loss / Q000187:drug effects
D019440:Anti-Obesity Agents; D001067:Appetite Depressants