การวิเคราะห์อภิมานประสิทธิศักย์ของ Lorcaserin ในการลดขนาดร่างกาย ความดันโลหิต ระดับไขมัน และระดับน้ำตาลสะสมในเลือด
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เม.ย. 23, 2018
คำสำคัญ:
ลอคาเซอรีน ขนาดร่างกาย ความดันโลหิต ไขมันในเลือด น้ำตาลในเลือด
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บทคัดย่อ
การศึกษานี้มีวัตถุประสงค์เพื่อวัดประสิทธิศักย์ของยา lorcaserin ในการลดขนาดร่างกาย ความดันโลหิต ระดับไขมันในเลือด และน้ำตาลในเลือด ฐานข้อมูลที่ใช้สืบค้น ได้แก่ PubMed, ScienceDirect และ Cochrane Library โดยสืบค้นงานการศึกษาจนถึงเดือนกรกฏาคม พ.ศ. 2560 การศึกษาครั้งนี้คัดเลือกงานวิจัยแบบ randomized controlled trial ที่ศึกษาผลของ lorcasrin ในขนาดต่าง ๆ การศึกษาที่คัดเข้าจะถูกประเมินคุณภาพงานวิจัยด้วย Jadad’s scoring และ Cochrane’s risk of bias assessment มี 7 การศึกษา (ผู้เข้าร่วมการศึกษา 8,606 คน) ที่ถูกคัดเข้า ขนาดของยา lorcaserine ที่ใช้ คือ 10-20 มิลลิกรัมต่อวัน ให้รับประทานนาน 4 สัปดาห์ ถึง 2 ปี ผลการวิเคราะห์อภิมานพบว่า lorcaserin สามารถลดดัชนีมวลกาย (weight mean difference; WMD -0.73 kg/m2; 95 % CI -0.89, -0.58) น้ำหนักตัว (WMD -1.67 kg; 95 % CI -2.16, -1.19) รอบเอว (WMD -1.72 cm; 95 % CI -2.19, -1.25) และรอบตะโพก (WMD -0.91 cm; 95 % CI -1.67, -0.14) ผลต่อระดับไขมันพบว่าสามารถลดระดับ LDL-cholesterol (WMD -2.64 mg/dL; 95 % CI -4.34, -0.94), TC (WMD -3.48 mg/dL; 95 % CI -4.56, -2.41) และ TG (WMD -4.11 mg/dL; 95 % CI -6.51, -1.72) นอกจากนี้ยา lorcaserin สามารถลดน้ำตาลเฉลี่ยสะสมในเลือด (HbA1C) (WMD -0.25 %; 95 % CI -0.50, -0.01), fasting insulin (WMD -1.39 uIU/mL; 95 % CI -2.07, -0.72) และ HOMA-IR (WMD -0.25; 95 % CI -0.30, -0.20) ได้อย่างมีนัยสำคัญทางสถิติ ผลการศึกษาไม่พบอาการไม่พึงประสงค์ที่รุนแรงทั้งในกลุ่มที่ได้รับยาและกลุ่มเปรียบเทียบ สรุปยา lorcaserin สามารถลดขนาดร่างกาย ไขมันในเลือด HbA1C, serum insulin และ HOMA-IR
คำสำคัญ : ลอคาเซอรีน; ขนาดร่างกาย; ความดันโลหิต; ไขมันในเลือด; น้ำตาลในเลือด
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ประเภทบทความ
Medical Sciences
เอกสารอ้างอิง
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[34] American Diabetes Association, 2017, Obesity management for the treatment of type 2 diabetes, Sec. 7: In standards of medical care in diabetes 2017, Diabetes Care 40: S57-S63.
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[2] Eckel, R.H., Grundy, S.M. and Zimmet, P.Z., 2005, The metabolic syndrome, Lancet 365: 1415-1428.
[3] Kumanyika, S.K., Obarzanek, E. and Stettler, N., 2008, Populationbased prevention of obesity – The need for comprehensive promotion of healthful eating, physical activity, and energy balance – A scientific statement from American heart association council on epidemiology and prevention, inter-disciplinary committee for prevention (formerly the expert panel on population and prevention science), Circulation 118: 428-464.
[4] Eckel, R.H, Jakicic, J.M. and Ard, J.D., 2014, 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk, Circulation 129: S76-S99.
[5] U.S. Food and Drug Administration, BELVIQ (lorcaserin hydrochloride) tablets, 2012, Available Source: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/022529s003lbl.pdf, June 17, 2017.
[6] Chan, E.W., He, Y., Chui, C.S., Wong, A.Y., Lau, W.C. and Wong, I.C., 2013, Efficacy and safety of lorcaserin in obese adults: A meta-analysis of 1-year randomized controlled trials (RCTs) and narrative review on short-term RCTs, Obes. Rev. 14: 383-392.
[7] Moher, D., Liberati, A. and Tetzlaff, J, 2009, The PRISMA Group (2009) preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement, PLoS. Med. 6: e1000097.
[8] Jadad, A.R., Moore, R.A., Carroll, D. and Jenkison, C., 1996, Assessing the quality of randomize controlled trials: IS blinding necessary, Elsevier Science, Inc., 17: 1-12.
[9] Smith, S.R., Prosser, W.A. and Donahue, D.J., 2008, lorcaserin (APD356), a selective 5-HT2C agonist, reduces body weight in obese men and women, Obesity 17: 494-503.
[10] Smith, S.R., Weissman, N.J. and Anderson, C.M., 2010, Multicenter, placebo-controlled trial of lorcaserin for weight management, N. Engl. J. Med. 363: 245-256.
[11] Fidler, M.C., Sanchez, M. and Raether, B., 2011, A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: The BLOSSOM trial, J. Clin. Endocrinol. Metab. 96: 3067-3077.
[12] Martin, C.K., Redman, L.M. and Zhang, J., 2011, lorcaserin, a 5-HT2C receptor agonist, reduces body weight by decreasing energy intake without influencing energy expenditure, J. Clin. Endocrinol. Metab. 96: 837-845.
[13] O’Neil, P.M., Smith, S.R. and Weissman, N.J., 2012, Randomized placebocontrolled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: The BLOOM-DM study, Obesity 20: 1426-1436.
[14] Farr, O.M., Upadhyay, J. and Gavrieli, A., 2016, Lorcaserin administration decreases activation of brain centers in response to food cues and these emotion- and salience-related changes correlate with weight loss effects: A 4-week-long randomized, placebo-controlled, double-blind clinical trial, Diabetes 65: 2943-2953.
[15] Smith, S.R., Garvey, W.T. and Greenway, F.L., 2017, Coadministration of lorcaserin and phentermine for weight manage-ment: A 12-week, randomized, pilot safety study, Obesity 25: 857-865.
[16] Khera, R., Murad, M.H. and Chandar, A.K., 2016, Association of pharmacological treatments for obesity with weight loss and adverse events a systematic review and meta-analysis, JAMA 315: 2424-2434.
[17] Neff, L.M., Broder, M.S. and Beenhouwer, D., 2017, Network meta-analysis of lorcaserin and oral hypoglycaemics for patients with type 2 diabetes mellitus and obesity, Clin. Obes. 2017: doi: 10.1111/cob.12213
[18] Lam, D.D., Przydzial, M.J. and Ridley, S.H., 2008, Serotonin 5-HT2C receptor agonist promotes hypophagia via downstream activation of melanocortin 4 receptors, Endocrinology 149: 1323-1328.
[19] Heisler, L.K., Jobst, E.E. and Sutton, G.M., 2006, Serotonin reciprocally regulates melanocortin neurons to modulate food intake, Neuron 51: 239-249.
[20] Nguyen, C.T., Zhou, S. and Shanahan, W., 2016, Lorcaserin in obese and overweight patients taking prohibited serotonergic agents: A retrospective analysis, Clin. Ther. 38: 1498-509.
[21] Nuffer, W., Trujillo, J.M. and Megyeri, J., 2016, A comparison of new pharmaco-logical agents for the treatment of obesity, Ann. Pharmacother. 50: 376-388.
[22] Taylor, J.R., Dietrich, E. and Powell, J., 2013, Lorcaserin for weight management, Diabetes Metab. Syndr. Obes. 6: 209-216.
[23] Harvey, J.A., 2003, Role of the serotonin 5-HT(2A) receptor in learning, Learn. Mem. 10: 355-362.
[24] Barnes, N.M. and Sharp, T., 1999, A review of central 5-HT receptors and their func-tion, Neuropharmacology 38: 1083-1152.
[25] Meltzer, H.Y., 1999, The role of serotonin in antipsychotic drug action, Neuro-psychopharmacology 21: S106-S115.
[26] Rothman, R.B., Baumann, M.H. and Savage, J.E., 2000, Evidence for possible involvement of 5-HT(2B) receptors in the cardiac valvulopathy associated with fenfluramine and other serotonergic medications, Circulation 102: 2836-2841.
[27] Fitzgerald, L.W., Burn, T.C. and Brown, B.S., 2000, Possible role of valvular serotonin 5-HT(2B) receptors in the cardiopathy associated with fenfluramine, Mol. Pharmacol. 57: 75-81.
[28] Sachdev, M., Miller, W.C., Ryan, T. and Jollis, J.G., 2002, Effect of fenfluramine-derivative diet pills on cardiac valves: A meta-analysis of observational studies, Am. Heart. J. 144: 1065-1073.
[29] Weissman, N.J., Panza, J.A., Tighe, J.F. and Gwynne, J.T., 2001, Natural history of valvular regurgitation 1 year after discontinuation of dexfenfluramine therapy: A randomized, double-blind, placebo-controlled trial, Ann. Int. Med. 134: 267-273.
[30] Hofmann, C., Penner, U. and Dorow, R., 2006, Lisuride, a dopamine receptor agonist with 5-HT2B receptor antagonist properties: absence of cardiac valvulopathy adverse drug reaction reports supports the concept of a crucial role for 5-HT2B receptor agonism in cardiac valvular fibrosis, Clin. Neuropharmacol. 29: 80-86.
[31] Thomsen, W.J., Grottick, A.J. and Menzaghi, F., 2008, Lorcaserin, a novel selective human 5-hydroxytryptamine 2C agonist: In vitro and in vivo pharmaco-logical characterization, J. Pharmacol. Exp. Ther. 325: 577-587.
[32] Smith, B.M., Smith, J.M. and Tsai, J.H., 2008, Discovery and structure-activity relationship of (1R)-8-chloro-2,3,4,5-tetrahydro-1-methyl-1H-3-benzazepine (Lorcaserin), a selective serotonin 5-HT2C receptor agonist for the treatment of obesity, J. Med. Chem. 51: 305-313.
[33] Gustafson, A., King, C. and Rey, J.A., 2013, lorcaserin (Belviq): A selective serotonin 5-HT2C agonist in the treatment of obesity, P. T. 38: 525-534.
[34] American Diabetes Association, 2017, Obesity management for the treatment of type 2 diabetes, Sec. 7: In standards of medical care in diabetes 2017, Diabetes Care 40: S57-S63.
[35] Daneschvar, H.L., Aronson, M.D. and Smetana G.W., 2016, FDA-approved anti-obesity drugs in the United States, Am. J. Med. 129: 879.e1-6.
[36] Chuemongkon, W. and , Kruetiwa, N., 2014, Lorcaserin: A novel selective 5-HT2c receptor agonist for weight reduction, Thai Pharm. Health Sci. J. 9: 34-38.
