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Vol. 29. Issue 6.
Pages 256-264 (November - December 2017)
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Vol. 29. Issue 6.
Pages 256-264 (November - December 2017)
Review article
Past, present and future of pharmacotherapy for obesity
Pasado, presente y futuro de la farmacoterapia para la obesidad
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David Benaigesa,b,c,
Corresponding author
96002@parcdesalutmar.cat

Corresponding author.
, Juan Pedro-Boteta,b,c, Juana A. Flores-Le Rouxa,b,c, Elisenda Climenta, Albert Godaya,b,c
a Servicio de Endocrinología y Nutrición, Hospital del Mar de Barcelona, Barcelona, Spain
b Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
c Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
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Tables (2)
Table 1. Clinical efficacy of drugs approved for the treatment of obesity in phase III studies.
Table 2. Characteristics of drugs approved for the treatment of obesity.
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Abstract

Conventional treatment for obesity with diet, exercise and bariatric surgery has limitations; thus, it is necessary to have pharmacological tools. In the past, different drugs were marketed that were withdrawn due to safety problems. There are currently 3 drugs approved by the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) for obesity therapy (orlistat, combination of bupropion and delayed-release naltrexone and liraglutide) and two more only authorized by FDA (lorcaserin and the combination of phentermine and extended release topiramate). It is recommended to use as a second therapeutic line and its choice should be individualized taking into account multiple aspects such as expected weight loss, route of administration, safety profile and cost. Currently there are several drugs under development that act on different therapeutic targets.

Keywords:
Obesity
Overweight
Pharmacotherapy
Weight loss
Drug treatment
Resumen

El tratamiento convencional de la obesidad con dieta y ejercicio así como la cirugía bariátrica tienen sus limitaciones, por lo que es necesario disponer de fármacos para su tratamiento. En el pasado se comercializaron diferentes fármacos que fueron retirados por problemas de seguridad. Actualmente existen 3 fármacos aprobados por la Agencia Europea del Medicamento (EMA) y la Food and Drug Administration (FDA) para el tratamiento de la obesidad (orlistat, combinación de bupropión y naltrexona de liberación retardada y liraglutida) y 2 más solo autorizados por la FDA (lorcaserina y la combinación de fentermina y topiramato de liberación prolongada). Se aconseja su uso como segunda línea terapéutica y su elección debe individualizarse teniendo en cuenta múltiples aspectos como la pérdida de peso esperada, la vía de administración, su perfil de seguridad y el coste. Por otra parte, actualmente existen varios fármacos en vías de desarrollo que actúan sobre diferentes dianas terapéuticas.

Palabras clave:
Obesidad
Exceso de peso
Farmacoterapia
Pérdida de peso
Tratamiento con fármacos

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