Role of Pharmacotherapy in Counteracting Weight Regain in Adolescents with Severe Obesity
药物治疗在对抗严重肥胖青少年体重反弹中的作用
基本信息
- 批准号:10597681
- 负责人:
- 金额:$ 65.64万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-05-01 至 2025-03-31
- 项目状态:未结题
- 来源:
- 关键词:18 year oldAddressAdolescentAdultAreaBindingBiologicalBiological AdaptationBlood PressureBody Weight decreasedBody fatBody mass indexCardiacChildhoodClinicClinicalClinical TrialsCognitionControlled Clinical TrialsDataDesire for foodDoseDouble-Blind MethodDropsEnergy IntakeEnergy MetabolismFDA approvedFormulationGoalsHeart RateHigh PrevalenceIndividualInflammationLife Style ModificationMaintenanceMeasuresMediatingMedicalMental HealthMorbid ObesityNeurosecretory SystemsObesityOutcomeOxidative StressParticipantPatientsPeripheralPharmaceutical PreparationsPharmacotherapyPhenterminePhysiologicalPlacebo ControlPlacebosRandomizedRegulatory PathwayRelapseReplacement TherapyReportingRestRisk FactorsRoleSafetySatiationStarvationStructureSurfaceUnited States National Institutes of HealthVisceral fatWeightadult obesityarterial stiffnessbone healthcardiometabolic riskclinically relevantcomorbiditycost effectivenessimprovedmetabolic rateplacebo grouppreventprimary endpointpsychosocialresponseside effectsobrietytopiramatetotal energy expenditure
项目摘要
Abstract
Long-term weight loss maintenance is seldom achieved by individuals with obesity owing to numerous
biological adaptations occurring in the post-weight loss setting, including neuroendocrine-mediated changes in
appetite/satiety and reduction of energy expenditure. Following weight loss, peripheral and central
mechanisms respond in a way similar to starvation by conveying a sense that energy reserves have dwindled,
activating a strong counter-response to increase caloric intake. Moreover, metabolic rate drops, further
compounding the propensity for weight rebound. Adolescents with severe obesity are not immune to the
vexing issue of weight regain; therefore, effective and scalable treatments are urgently needed.
Pharmacotherapy has the potential to prevent weight regain by targeting counter-regulatory mechanisms in the
post-weight loss setting. Unfortunately, only one obesity medication is FDA-approved for long-term use in
adolescents and is seldom prescribed owing to modest efficacy and notable side effects. Among the most
promising candidates in the pediatric pipeline is the combination of phentermine and topiramate, which is the
most effective adult weight loss medication currently available. The mechanisms of action are thought to
reduce appetite, enhance satiety, and potentially increase energy expenditure, making this medication
particularly well-suited for the purpose of weight loss maintenance since it targets many of the biological
adaptations known to induce relapse and subsequent weight regain. Our group has generated preliminary
data demonstrating that both phentermine and topiramate reduce BMI in adolescents with severe obesity and
have acceptable safety profiles. In this clinical trial, we will utilize phentermine/topiramate to target counter-
regulatory pathways responsible for weight regain after meal replacement therapy (structured meals of known
caloric content) in adolescents with severe obesity with a goal of enhancing weight loss maintenance and
improving co-morbidity outcomes. Importantly, we will maximize the clinical utility and overall impact of our
study by comprehensively characterizing the safety of phentermine/topiramate utilizing sensitive measures of
cardiac autonomic function, arterial stiffness, cognition, and bone health, as well as examine the extent to
which this medication counteracts mechanisms of weight regain.
摘要
长期减肥维持很少实现的个人与肥胖,由于许多
生物适应发生在减肥后的设置,包括神经内分泌介导的变化,
食欲/饱腹感和能量消耗的减少。体重减轻后,外周和中枢
机制以类似于饥饿的方式做出反应,传递能量储备已经减少的感觉,
激活强烈的反反应以增加热量摄入。此外,代谢率下降,进一步
加重了体重反弹的倾向。患有严重肥胖症的青少年也不能免疫,
令人烦恼的体重恢复问题;因此,迫切需要有效和可扩展的治疗。
药物治疗有可能通过靶向靶向肿瘤细胞中的反调节机制来防止体重反弹。
减肥后的设置。不幸的是,只有一种肥胖药物是FDA批准的长期使用,
青少年,由于疗效不高且副作用明显,很少开处方。的最
儿科管道中有希望的候选药物是芬特明和托吡酯的组合,这是
目前可用的最有效的成人减肥药物。作用机制被认为是
降低食欲,增强饱腹感,并可能增加能量消耗,使这种药物
特别适合于减肥维持的目的,因为它靶向许多生物
适应已知会导致复发和随后的体重反弹。我们小组已经初步
数据表明芬特明和托吡酯都能降低重度肥胖青少年的BMI,
具有可接受的安全性。在这项临床试验中,我们将利用芬特明/托吡酯靶向对抗-
负责膳食替代治疗后体重恢复的调节途径(已知的结构化膳食)
热量含量),目标是加强减肥维持,
改善共病结局。重要的是,我们将最大限度地发挥我们的临床效用和整体影响,
通过使用敏感措施全面表征芬特明/托吡酯的安全性的研究,
心脏自主神经功能、动脉僵硬度、认知和骨骼健康,以及检查
这种药物会抵消体重反弹的机制。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Aaron S Kelly其他文献
865-5 Six months of weight loss improves metabolic and vascular indices in overweight adults
- DOI:
10.1016/s0735-1097(04)92230-9 - 发表时间:
2004-03-03 - 期刊:
- 影响因子:
- 作者:
Thomas P Olson;Aaron S Kelly;Alan J Bank;Daniel R Kaiser;Donald R Dengel - 通讯作者:
Donald R Dengel
1103-193 Independent relationship between C-reactive protein and markers of insulin resistance in overweight and obese children
- DOI:
10.1016/s0735-1097(04)92063-3 - 发表时间:
2004-03-03 - 期刊:
- 影响因子:
- 作者:
Aaron S Kelly;Rachel J Wetzsteon;Daniel R Kaiser;Julia Steinberger;Alan J Bank;Donald R Dengel - 通讯作者:
Donald R Dengel
Aaron S Kelly的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Aaron S Kelly', 18)}}的其他基金
Role of Pharmacotherapy in Counteracting Weight Regain in Adolescents with Severe Obesity
药物治疗在对抗严重肥胖青少年体重反弹中的作用
- 批准号:
10153776 - 财政年份:2020
- 资助金额:
$ 65.64万 - 项目类别:
Role of Pharmacotherapy in Counteracting Weight Regain in Adolescents with Severe Obesity
药物治疗在对抗严重肥胖青少年体重反弹中的作用
- 批准号:
10375470 - 财政年份:2020
- 资助金额:
$ 65.64万 - 项目类别:
Comparison of Intensive Behavioral Counseling vs. Medical Management to Treat Adolescent Severe Obesity
强化行为咨询与药物治疗治疗青少年严重肥胖的比较
- 批准号:
10398157 - 财政年份:2020
- 资助金额:
$ 65.64万 - 项目类别:
Comparison of Intensive Behavioral Counseling vs. Medical Management to Treat Adolescent Severe Obesity
强化行为咨询与药物治疗治疗青少年严重肥胖的比较
- 批准号:
10617234 - 财政年份:2020
- 资助金额:
$ 65.64万 - 项目类别:
Comparison of Intensive Behavioral Counseling vs. Medical Management to Treat Adolescent Severe Obesity
强化行为咨询与药物治疗治疗青少年严重肥胖的比较
- 批准号:
10215501 - 财政年份:2020
- 资助金额:
$ 65.64万 - 项目类别:
Enhancing Weight Loss with Financial Incentives in Teens with Severe Obesity
通过经济激励促进严重肥胖青少年的减肥
- 批准号:
9308599 - 财政年份:2017
- 资助金额:
$ 65.64万 - 项目类别:
Enhancing Weight Loss with Financial Incentives in Teens with Severe Obesity
通过经济激励促进严重肥胖青少年的减肥
- 批准号:
9891050 - 财政年份:2017
- 资助金额:
$ 65.64万 - 项目类别:
Enhancing Weight Loss Maintenance with GLP-1 in Adolescents with Severe Obesity
使用 GLP-1 加强重度肥胖青少年的减肥维持
- 批准号:
9282436 - 财政年份:2015
- 资助金额:
$ 65.64万 - 项目类别:
Enhancing Weight Loss Maintenance with GLP-1 in Adolescents with Severe Obesity
使用 GLP-1 加强重度肥胖青少年的减肥维持
- 批准号:
8936755 - 财政年份:2015
- 资助金额:
$ 65.64万 - 项目类别:
Enhancing Weight Loss Maintenance with GLP-1 in Adolescents with Severe Obesity
使用 GLP-1 加强重度肥胖青少年的减肥维持
- 批准号:
9115305 - 财政年份:2015
- 资助金额:
$ 65.64万 - 项目类别:
相似海外基金
Enhancing Structural Competency in School-Based Health Centers to Address LGBTQ+ Adolescent Health Equity
增强校本健康中心的结构能力,以解决 LGBTQ 青少年健康公平问题
- 批准号:
10608426 - 财政年份:2023
- 资助金额:
$ 65.64万 - 项目类别:
Application and feasability of a brief digital screening tool to address parental and adolescent tobacco and electronic cigarette use in pediatric medical care - a pilot study
简短的数字筛查工具的应用和可行性,以解决儿科医疗中父母和青少年烟草和电子烟的使用问题 - 一项试点研究
- 批准号:
486580 - 财政年份:2022
- 资助金额:
$ 65.64万 - 项目类别:
Studentship Programs
Co-design of an intervention to address alcohol use among adolescent boys and young men in Tanzania
共同设计一项干预措施,解决坦桑尼亚青春期男孩和年轻男性的饮酒问题
- 批准号:
MR/V032380/1 - 财政年份:2022
- 资助金额:
$ 65.64万 - 项目类别:
Research Grant
Complex intervention to optimise adolescent BMI pre-conception to address the double burden of malnutrition: A RCT in rural and urban South Africa
优化青少年孕前体重指数以解决营养不良的双重负担的复杂干预措施:南非农村和城市的随机对照试验
- 批准号:
MR/V005790/1 - 财政年份:2021
- 资助金额:
$ 65.64万 - 项目类别:
Research Grant
Application of a brief digital screening tool to address parental and adolescent tobacco and electronic cigarette use in pediatric medical care
应用简短的数字筛查工具来解决儿科医疗中父母和青少年烟草和电子烟的使用问题
- 批准号:
455984 - 财政年份:2021
- 资助金额:
$ 65.64万 - 项目类别:
Operating Grants
Complex intervention to optimise adolescent BMI pre-conception to address the double burden of malnutrition: A RCT in rural and urban South Africa
优化青少年孕前体重指数以解决营养不良的双重负担的复杂干预措施:南非农村和城市的随机对照试验
- 批准号:
MR/V005790/2 - 财政年份:2021
- 资助金额:
$ 65.64万 - 项目类别:
Research Grant
Development of the Cannabis Actions and Practices (CAP): A Parent-Focused Intervention to Address Adolescent Marijuana Use
大麻行动和实践 (CAP) 的发展:以家长为中心的干预措施,解决青少年大麻使用问题
- 批准号:
10057761 - 财政年份:2020
- 资助金额:
$ 65.64万 - 项目类别:
Development of the Cannabis Actions and Practices (CAP): A Parent-Focused Intervention to Address Adolescent Marijuana Use
大麻行动和实践 (CAP) 的发展:以家长为中心的干预措施,解决青少年大麻使用问题
- 批准号:
10213683 - 财政年份:2020
- 资助金额:
$ 65.64万 - 项目类别:
Targeted interventions to address the multi-level effects of gender-based violence on PrEP uptake and adherence among adolescent girls and young women in Kenya
有针对性的干预措施,以解决性别暴力对肯尼亚少女和年轻妇女接受和坚持 PrEP 的多层面影响
- 批准号:
9403567 - 财政年份:2017
- 资助金额:
$ 65.64万 - 项目类别:
Designing targeted interventions to address HIV vulnerabilities and improve clinical outcomes among conflict affected adolescent girls and young women under 25 in Northern Uganda
设计有针对性的干预措施,以解决乌干达北部受冲突影响的少女和 25 岁以下年轻妇女的艾滋病毒脆弱性并改善临床结果
- 批准号:
356145 - 财政年份:2016
- 资助金额:
$ 65.64万 - 项目类别:
Operating Grants