New pharmacological treatments for the management of obesity.
Obesity is quickly becoming the leading preventable cause of death in the USA. Over 60 obesity-related comorbidities exist which increase the complexity and cost of medical care in obese patients. Even a moderate weight loss of 5 % can reduce morbidity associated with these conditions. Lifestyle modification through caloric restriction and enhanced exercise and physical activity remain the first line treatment for obesity. The development of pharmacologic agents for the treatment of obesity has been challenged by both lack of efficacy and serious adverse side effects leading to their removal from market. Two new agents were recently approved by the US Food and Drug Administration to complement lifestyle modification in obese (BMI ≥30 kg/m(2)) and overweight patients (BMI ≥27 kg/m(2) and one obesity-related comorbidity). Lorcaserin is a novel serotonin 5-HT2C selective agonist which has been shown in three phase III studies to significantly reduce weight and cardiovascular risk factors such as diabetes. Phentermine/topiramate extended release (ER) is a novel combination of two agents which have individually been shown to significantly reduce weight. The combination agent phentermine/topiramate ER has been shown to reduce weight in overweight and obese subjects in a number of studies. This article reviews the pharmacology, clinical efficacy, and safety of these new agents compared to past and other presently available medications for the treatment of obesity.
Divisions of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA, hurt.ryan@mayo.edu.
Ryan T
RT
Hurt
Jithinraj
J
Edakkanambeth Varayil
Jon O
JO
Ebbert
D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use; D017277:Drug Approval; D004338:Drug Combinations; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D009765:Obesity / Q000188:drug therapy*; D010645:Phentermine / Q000627:therapeutic use; D000077236:Topiramate; D016896:Treatment Outcome
D019440:Anti-Obesity Agents; D001552:Benzazepines; D004338:Drug Combinations; D000077236:Topiramate; D005632:Fructose; C506658:lorcaserin; D010645:Phentermine