PDF(Pubmed)
Abstract：
The aim of this narrative review is to synthesize the available data describing the efficacy and safety of medications approved for obesity management and to provide an overview of upcoming agents in development. A literature search of PubMed, Medline, and Embase databases identified relevant articles describing medications approved in the U.S., Australia, U.K., and/or Europe. Papers were selected based on relevance and originality, with phase 3 clinical trials and meta-analyses preferentially included. Six medications are widely approved for long-term weight management in conjunction with lifestyle interventions in people with body mass index (BMI) ≥30 kg/m2 or BMI ≥27 kg/m2 and at least one medical condition related to excess weight. Compared with lifestyle interventions alone, all medications approved for obesity management are more effective for long-term weight loss and improvements in cardiometabolic risk factors. Older obesity medications are associated with mean weight losses in the range of 5-10%. The new generation of agents, including the injectable incretin analogues semaglutide and tirzepatide are associated with sustained mean weight reductions of 15-20%, along with substantial benefits on a range of health outcomes. Several novel agents are under development, with multi-hormone receptor agonists and oral formulations likely to become available in the coming years. As effective treatment options expand, cost and availability will need to be addressed to enable equitable access to treatment. Other important challenges for clinical practice and research include the need for long-term strategies to prevent and manage weight regain and loss of lean muscle and bone mineral density.
摘要：
这篇叙述性综述的目的是综合描述批准用于肥胖管理的药物的有效性和安全性的可用数据，并提供即将开发的药物的概述。PubMed的文献检索，Medline,Embase数据库确定了描述美国批准的药物的相关文章，澳大利亚,英国，和/或欧洲。论文是根据相关性和原创性选择的，优先纳入3期临床试验和荟萃分析。在体重指数（BMI）≥30kg/m2或BMI≥27kg/m2以及至少一种与超重相关的医疗状况的人群中，六种药物被广泛批准用于长期体重管理。与单纯的生活方式干预相比，所有批准用于肥胖管理的药物对于长期减重和改善心脏代谢危险因素更有效.老年肥胖药物与5-10%范围内的平均体重减轻相关。新一代的代理人，包括可注射的肠降血糖素类似物司马鲁肽和替舒帕肽与持续的平均体重减轻15-20%相关,以及一系列健康结果的实质性益处。几种新型制剂正在开发中，多激素受体激动剂和口服制剂可能在未来几年内可用。随着有效治疗方案的扩大，需要解决成本和可用性问题，以实现公平获得治疗的机会。临床实践和研究的其他重要挑战包括需要长期策略来预防和管理体重恢复以及瘦肌肉和骨矿物质密度的损失。
