Efficacy and safety of anti-obesity drugs in children and adolescents: systematic review and meta-analysis
Efficacy and safety of anti-obesity drugs in children and adolescents: systematic review and meta-analysis
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DOI：
10.1111/j.1467-789x.2009.00651.x
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发表时间：
2010-08-01
期刊：
影响因子：
8.9
通讯作者：
Wong, I. C. K.
中科院分区：
文献类型：
--
作者：
Viner, R. M.;Hsia, Y.;Wong, I. C. K.
我们对随机对照试验进行了荟萃分析，以总结抗肥胖药物在降低 BMI 和改善儿童和青少年健康方面的功效。数据来源包括 Medline、Embase、Cochrane 对照试验登记册和其他对照试验登记册，以及已确定文章的参考文献列表。所有数据来源均检索自1996年1月至2008年7月。我们检索了已批准用于儿童和青少年（年龄=6个月）的抗肥胖药物的双盲随机安慰剂对照试验。6项试验，其中4项西布曲明（患者总数=686）和2项奥利司他（n=573）符合纳入标准。没有发现利莫那班的试验。与安慰剂相比，西布曲明联合行为疗法支持使 BMI 降低 2.20 kg/m(2)（95% CI：1.57 至 2.83），奥利司他与行为支持一起使 BMI 降低 0.83 kg/m(2)（95% CI 0.47 至 1.19）。我们得出的结论是，西布曲明可使青少年的 BMI 和腰围降低约 0.63 SD，并可适度降低 BMI（效果大小约 0.24 SD），同时胃肠道副作用发生率较高。
We undertook a meta-analysis of randomized controlled trials to summarize the efficacy of anti-obesity drugs in reducing BMI and improving health in children and adolescents. Data sources included Medline, Embase, the Cochrane controlled trials register and other registers of controlled trials, together with reference lists of identified articles. All data sources were searched from January 1996 to July 2008. We searched for double blind randomized placebo controlled trials of approved anti-obesity drugs used in children and adolescents (age = 6 months. Six trials, 4 of sibutramine (total patients = 686) and 2 of orlistat (n = 573) met inclusion criteria. No trials of rimonabant were identified. Compared with placebo, sibutramine together with behavioural support reduced BMI by 2.20 kg/m(2) (95% CI: 1.57 to 2.83) and orlistat together with behavioural support reduced BMI by 0.83 kg/m(2) (95% CI 0.47 to 1.19). Sibutramine improved waist circumference, triglycerides and high density lipoprotein (HDL)-cholesterol, but raised systolic and diastolic blood pressure and pulse. Orlistat increased rates of gastrointestinal side-effects. We conclude that sibutramine in adolescents produces clinically meaningful reductions in BMI and waist circumference of approximately 0.63 SD, with improvements in cardiometabolic risk. Orlistat modestly reduces BMI (effect size approximately 0.24 SD) with a high prevalence of gastrointestinal adverse effects.