16569079

Source:http://linkedlifedata.com/resource/pubmed/id/16569079

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Predicate	Object
rdf:type	pubmed:Citation
lifeskim:mentions	umls-concept:C0013216, umls-concept:C0028754, umls-concept:C0036043, umls-concept:C0043096, umls-concept:C0087111
pubmed:issue	4
pubmed:dateCreated	2006-3-29
pubmed:abstractText	Some of the medications used for weight loss in the management of obesity have been associated with unacceptable morbidity and mortality. Safety concerns have led to the withdrawal of aminorex, followed by the fenfluramines in 1997, and phenylpropanolamine (norephedrine) in 2000. Aminorex was associated with an increased prevalence of primary pulmonary hypertension (PPH), fenfluramines with an increased prevalence of PPH and valvulopathy, and phenylpropanolamine with an increased risk of haemorrhagic stroke. Several studies have investigated the safety of the fenfluramines, yet the benefit-risk profile has not been conclusively quantified. This is due to several deficiencies in the published studies, including a lack of data on the baseline prevalences of comorbid conditions in obese subjects, and potential confounders and biases in the study designs. Although several studies and systematic reviews support an increased risk of PPH and valvulopathy in patients who have taken fenfluramines, without knowledge of the background prevalence it is not possible to determine if the exposure preceded the outcome. The population at higher risk of these adverse effects includes those taking higher doses or with a longer duration of exposure to fenfluramines and those with pre-existing cardiac disease or a genetic predisposition. Patients exposed to fenfluramines continue to be monitored, with some follow-up studies indicating no overall worsening in valvulopathy over time. There are limited efficacy and safety data for amfepramone (diethylpropion) and phentermine and their approval for the management of obesity is limited to short-term use. Orlistat and sibutramine are the only currently approved medications for long-term management of obesity. Although the benefit-risk profiles of sibutramine and orlistat appear positive, sibutramine continues to be monitored because of long-term safety concerns. The safety and efficacy of currently approved drug therapies have not been evaluated in children and elderly patient populations and there is limited information in adolescents, whilst the long-term safety of current and potential new drug therapies in adults will require several years of postmarketing surveillance to fully elucidate their adverse effect profiles.
pubmed:language	eng
pubmed:journal	http://linkedlifedata.com/resource/pubmed/journal/9002928
pubmed:citationSubset	IM
pubmed:chemical	http://linkedlifedata.com/resource/pubmed/chemical/Anti-Obesity Agents
pubmed:status	MEDLINE
pubmed:issn	0114-5916
pubmed:author	pubmed-author:Ioannides-DemosLisa LLL, pubmed-author:McNeilJohn JJJ, pubmed-author:ProiettoJosephJ, pubmed-author:TonkinAndrew MAM
pubmed:issnType	Print
pubmed:volume	29
pubmed:owner	NLM
pubmed:authorsComplete	Y
pubmed:pagination	277-302
pubmed:dateRevised	2009-11-3
pubmed:meshHeading	pubmed-meshheading:16569079-Anti-Obesity Agents, pubmed-meshheading:16569079-Body Weight, pubmed-meshheading:16569079-Humans, pubmed-meshheading:16569079-Obesity, pubmed-meshheading:16569079-Weight Loss
pubmed:year	2006
pubmed:articleTitle	Safety of drug therapies used for weight loss and treatment of obesity.
pubmed:affiliation	Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. lisa.demos@med.monash.edu.au
pubmed:publicationType	Journal Article, Review, Research Support, Non-U.S. Gov't