Rise in antiobesity drug prescribing for children and adolescents in the UK: a population-based study
Rise in antiobesity drug prescribing for children and adolescents in the UK: a population-based study
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DOI：
10.1111/j.1365-2125.2009.03528.x
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发表时间：
2009-12-01
影响因子：
3.4
通讯作者：
Wong, Ian C. K.
中科院分区：
文献类型：
--
作者：
Viner, Russell M.;Hsia, Yingfen;Wong, Ian C. K.
center dot在英国，抗肥胖药物西布曲明和奥利司他未被许可用于儿童和青少年，或USA.center dot临床试验表明抗肥胖药物在肥胖青少年中有效且耐受性良好。本研究补充的内容center dot在过去8年中，儿童和青少年中未被许可的抗肥胖药物的处方显著增加years.center。国际儿童肥胖症的流行促使越来越多的人使用未经许可的抗肥胖药物，这些药物在儿童和青少年中的疗效和安全性研究得很差。我们调查了使用未经许可的减肥药（奥利司他，西布曲明和利莫那班）在儿童和青少年（0-18岁）在UK. METHODSPupulation-based处方数据从英国全科医学研究数据库之间的1999年1月1日和2006年12月31日。抗肥胖药物处方的年流行率从1999年的0.006/1000 [95%置信区间（CI）0.0007，0.0113]显著上升至2006年的0.091/1000（95% CI 0.07，0.11），增加了15倍，在两种性别中观察到相似的增加。大多数处方是为>= 14岁的人开出的，尽管有25张处方是为< 12岁的儿童开出的。奥利司他占所有处方的78.4%;只有一名患者被处方利莫那班。然而，大约45%的患者在1个月后停用奥利司他，25%的患者停用西布曲明。奥利司他和西布曲明的估计平均治疗持续时间分别为3和4个月，分别为。CONCLUSIONSPrecribing未经许可的抗肥胖药物在儿童和青少年中显着增加，在过去的8年。大多数在患者可以看到体重获益之前就迅速停药，这表明它们在一般人群中使用时耐受性差或疗效差。需要进一步研究儿童和青少年临床人群中抗肥胖药物的有效性和安全性。
center dot The antiobesity drugs sibutramine and orlistat are not licensed for use in children and adolescents in the UK or USA.center dot Clinical trials suggest antiobesity drugs are effective and well-tolerated in obese adolescents.WHAT THIS STUDY ADDScenter dot Prescribing of unlicensed antiobesity drugs in children and adolescents has increased significantly in the past 8 years.center dot Most prescribed antiobesity drugs in children and adolescents are rapidly discontinued before patients can see clinical benefit, suggesting they are poorly tolerated or poorly efficacious.AIMSThe international childhood obesity epidemic has driven increased use of unlicensed antiobesity drugs, whose efficacy and safety are poorly studied in children and adolescents. We investigated the use of unlicensed antiobesity drugs (orlistat, sibutramine and rimonabant) in children and adolescents (0-18 years) in the UK.METHODSPopulation-based prescribing data from the UK General Practice Research Database between 1 January 1999 and 31 December 2006.RESULTSA total of 452 subjects received 1334 prescriptions during the study period. The annual prevalence of antiobesity drug prescriptions rose significantly from 0.006 per 1000 [95% confidence interval (CI) 0.0007, 0.0113] in 1999 to 0.091 per 1000 (95% CI 0.07, 0.11) in 2006, a 15-fold increase, with similar increases seen in both genders. The majority of prescriptions were made to those >= 14 years old, although 25 prescriptions were made for children < 12 years old. Orlistat accounted for 78.4% of all prescriptions; only one patient was prescribed rimonabant. However, approximately 45% of the patients ceased orlistat and 25% ceased sibutramine after only 1 month. The estimated mean treatment durations for orlistat and sibutramine were 3 and 4 months, respectively.CONCLUSIONSPrescribing of unlicensed antiobesity drugs in children and adolescents has dramatically increased in the past 8 years. The majority are rapidly discontinued before patients can see weight benefit, suggesting they are poorly tolerated or poorly efficacious when used in the general population. Further research into the effectiveness and safety of antiobesity drugs in clinical populations of children and adolescents is needed.