Off-label drugs for weight management.
Off-label drugs for weight management.
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DOI：
10.2147/dmso.s95299
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Hendricks EJ
中科院分区：
文献类型：
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作者：
Hendricks EJ
肥胖和超重这一全球性流行病目前影响着世界28亿至35亿人口，而且没有任何减少的迹象。现在被认为是慢性疾病的治疗包括药物治疗，被认为是综合治疗的重要组成部分。新药研发势头强劲，但美国食品和药物管理局（fda）批准减肥药的步伐却十分缓慢，只有少数获批的药物可用于治疗肥胖。在过去的20年里，美国食品和药物管理局批准了208种治疗癌症的药物，118种治疗心血管疾病的药物，168种治疗神经系统疾病的药物，223种内分泌药物，但只有6种治疗肥胖的药物，其中2种已经退出市场。目前，只有9种药物被FDA批准用于治疗肥胖。美国医生在努力治疗越来越多的过度肥胖患者时，已经转向使用标签外药物。芬特明是治疗肥胖最常用的药物。虽然仅被批准用于短期使用，但自1959年首次批准以来，美国医生已成功地将其用于长期使用。这种药物经证明是安全有效的，比它所治疗的疾病要安全得多。芬特明和二乙基丙丙酮（一种同样安全但效果稍差的药物）都是仿制药，因此价格低廉。这些药物受到了不恰当的诽谤，因为它们的二维结构图类似于安非他明，也因为对它们潜在副作用的未经证实的假设。面对日益严重的流行病，世界范围内的肥胖和超重患者应该得到处方这些药物可以提供的有效治疗，如果康复和更频繁地使用。在更有效的药物获得批准之前，美国医生可能会继续使用任何被证明对这种疾病有用的标签外药物。
The global pandemic of obesity and overweight now affects between 2.8 and 3.5 billion of the world population and shows no signs of abatement. Treatment for what is now recognized as a chronic disease includes pharmacotherapy, considered an essential component of comprehensive therapy. New drug discovery is robust, but the pace of the US Food and Drug Administration approval for obesity drugs has been glacial, and only a handful of approved drugs are available for treating obesity. In the last 20 years, the US Food and Drug Administration has approved 208 drugs for cancer, 118 for cardiovascular diseases, 168 for neurological diseases, and 223 endocrinologic drugs, but only 6 for obesity, 2 of which have been taken off market. Currently, there are only 9 drugs approved by the FDA for obesity treatment. US physicians have turned to off-label drug use in their effort to care for increasing numbers of patients with excess adiposity. Phentermine is the most commonly used drug for treating obesity. Although approved only for short-term use, US physicians have used it successfully for long-term since its initial approval in 1959. This drug, used off-label for long-term, has proven to be safe and effective, far safer than the disease it is used to treat. Phentermine and diethylpropion, an equally safe but somewhat less effective drug, are both generic and therefore inexpensive. These drugs have been maligned inappropriately because their two-dimensional structure diagrams resemble amphetamine and also because of unproven presumptions about their potential adverse effects. In the face of an increasing epidemic, worldwide obese and overweight patients deserve effective treatment that prescribing these drugs could provide, if rehabilitated and used more frequently. US physicians will likely continue to use any drug proven useful off-label for this illness until such time as more effective drugs are approved.