The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform
Raj Padwal - One of the best experts on this subject based on the ideXlab platform.
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canadian physicians use of Antiobesity Drugs and their referral patterns to weight management programs or providers the soccer study
Journal of Obesity, 2011Co-Authors: Raj Padwal, Suzana Damjanovic, Karleen M Schulze, Richard Lewanczuk, David C W Lau, Arya M SharmaAbstract:Antiobesity pharmacotherapy and programs/providers that possess weight management expertise are not commonly used by physicians. The underlying reasons for this are not known. We performed a cross-sectional study in 33 Canadian medical practices (36 physicians) examining 1788 overweight/obese adult patients. The frequency of pharmacotherapy use and referral for further diet, exercise, behavioral management and/or bariatric surgery was documented. If drug treatment or referral was not made, reasons were documented by choosing amongst preselected categories. Logistic regression models were used to identify predictors of Antiobesity drug use. No single Antiobesity management strategy was recommended by physicians in more than 50% of patients. Referral was most common for exercise (49% of cases) followed by dietary advice (46%), and only 5% of eligible patients were referred for bariatric surgery. Significant predictors of initiating/continuing pharmacotherapy were male sex (OR 0.70; 95% CI 0.52–0.94), increasing BMI (1.02; 95% CI 1.01–1.03), and private drug coverage (1.78; 95% CI 1.39–2.29). “Not considered” and “patient refusal” were the main reasons for not initiating further weight management. We conclude that both physician and patient factors act as barriers to the use of weight management strategies and both need to be addressed to increase uptake of these interventions.
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drug treatments for obesity orlistat sibutramine and rimonabant
The Lancet, 2007Co-Authors: Raj Padwal, Sumit R MajumdarAbstract:Antiobesity treatment is recommended for selected patients in whom lifestyle modification is unsuccessful. Two Antiobesity Drugs are currently licensed for long-term use. Orlistat, a gastrointestinal lipase inhibitor, reduces weight by around 3 kg on average and decreases progression to diabetes in high-risk patients; adverse gastrointestinal effects are common. Sibutramine, a monoamine-reuptake inhibitor, results in mean weight losses of 4-5 kg, but is associated with increases in blood pressure and pulse rate. Rimonabant, the first of the endocannabinoid receptor antagonists, reduces weight by 4-5 kg on average and improves waist circumference and concentrations of HDL cholesterol and triglyceride; however, an increased incidence of mood-related disorders has been reported. To date, all Antiobesity drug trials have been limited by their high attrition rates and lack of long-term morbidity and mortality data. Other promising Antiobesity Drugs, including those acting within the central melanocortin pathway, are in development, but are years away from clinical use. In light of the lack of successful weight-loss treatments and the public-health implications of the obesity pandemic, the development of safe and effective Drugs should be a priority. However, as new Drugs are developed we suggest that the assessment processes should include both surrogate endpoints (ie, weight loss) and clinical outcomes (ie, major obesity-related morbidity and mortality). Only then can patients and their physicians be confident that the putative benefits of such Drugs outweigh their risks and costs.
Hedvig Nordeng - One of the best experts on this subject based on the ideXlab platform.
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Cardiovascular co-medication among users of Antiobesity Drugs: a population-based study
Pharmacy world & science : PWS, 2010Co-Authors: Merethe Omdal Amundsen, Bo Engdahl, Christian Berg, Hedvig NordengAbstract:Aim The purpose of this study was to investigate to what extent patients using prescription Antiobesity Drugs (orlistat, sibutramine and rimonabant) used cardiovascular and antidiabetic Drugs. An additional aim was to investigate whether such co-medication differed according to gender, age and amount of Antiobesity Drugs used. Method Data were retrieved from the Norwegian Prescription Database (NorPD). All patients who had an Antiobesity drug (ATC code A08A) dispensed from a Norwegian pharmacy between January 2004 and December 2007 were included in the study. Results During the 4-year study period 83,717 patients had Antiobesity Drugs dispensed. One in three patients using Antiobesity Drugs had at least on one occasion used a cardiovascular and/or an antidiabetic drug concomitantly. A significantly higher percentage of men used antihypertensives (40.4 vs. 27.2%, P < 0.0005), lipid modifying agents (24.4 vs. 11.9%, P < 0.0005) and Drugs used in diabetes (12.7 vs. 6.4%, P < 0.0005) concomitantly with Antiobesity Drugs when compared to women. The percentage of patients who had concomitant drug use increased markedly with age. One in four patients had Antiobesity Drugs dispensed only once during the period 2004–2007. Conclusion Use of cardiovascular and antidiabetic Drugs among patients using Antiobesity Drugs was extensive, especially among men and elderly patients. Overall, there was a high degree of polypharmacy among users of Antiobesity Drugs. Also, many patients dispensed Antiobesity Drugs in amounts that indicated use less than the recommended daily dose, and many dispensed Antiobesity Drugs only once. When prescribing Antiobesity Drugs to patients the potential benefits of Antiobesity Drugs should be considered in relation to the patients other chronic diseases and to the total complexity of the patients drug regimen.
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use of psychotropic Drugs and analgesics among users of Antiobesity Drugs a population based study
Pharmacoepidemiology and Drug Safety, 2010Co-Authors: Merethe Omdal Amundsen, Bo Engdahl, Christian Berg, Hedvig NordengAbstract:Aim The aim of the present study was to investigate to what extent patients using prescription Antiobesity Drugs (orlistat, sibutramine and rimonabant) concomitantly or concurrently used psychotropic Drugs and analgesics and the association between this drug use and the patients' gender and age. An additional aim was to investigate the sequence of drug therapy among users of both Antiobesity Drugs and antidepressants or antipsychotics, respectively. Methods Data were retrieved from the Norwegian Prescription Database (NorPD). All patients who had an Antiobesity drug (ATC code A08A) dispensed from a Norwegian pharmacy between January 2004 and December 2007 were included in the study. Results One in four patients using Antiobesity Drugs had at least on one occasion used a psychotropic drug concomitantly. The most commonly used psychotropic Drugs were anxiolytics/hypnotics/sedatives (17.7%) and antidepressants (14.7%). Analgesics were used by 36.2%. A significantly higher percentage of women used anxiolytics/hypnotics/sedatives (18.8% vs. 14.0%, p < 0.0005), antidepressants (16.1% vs. 9.5%, p < 0.0005), antipsychotics (4.0% vs. 2.9%, p < 0.0005) and analgesics (37.8% vs. 30.5%, p < 0.0005) concomitantly with Antiobesity Drugs when compared to men. One out of ten patients using sibutramine had at least on one occasion used an interacting drug concomitantly. Conclusion Use of psychotropic Drugs and analgesics among patients using Antiobesity Drugs is extensive, especially among women. Clinicians prescribing sibutramine should be more aware of drug interactions with other prescribed Drugs. There is still insufficient information on psychiatric disorders among these patients. Copyright © 2009 John Wiley & Sons, Ltd.
Nr Samaranayake - One of the best experts on this subject based on the ideXlab platform.
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Safety of Antiobesity Drugs.
Therapeutic advances in drug safety, 2013Co-Authors: Bernard M.y. Cheung, Tommy Tsang Cheung, Nr SamaranayakeAbstract:Obesity is a major health problem worldwide. Although diet and physical activity are crucial in the management of obesity, the long-term success rate is low. Therefore Antiobesity Drugs are of great interest, especially when lifestyle modification has failed. As obesity is not an immediate life-threatening disease, these Drugs are required to be safe. Antiobesity Drugs that have been developed so far have limited efficacies and considerable adverse effects affecting tolerability and safety. Therefore, most Antiobesity Drugs have been withdrawn. Fenfluramine and dexfenfluramine were withdrawn because of the potential damage to heart valves. Sibutramine was associated with an increase in major adverse cardiovascular events in the Sibutramine Cardiovascular Outcomes (SCOUT) trial and it was withdrawn from the market in 2010. Rimonabant was withdrawn because of significant psychiatric adverse effects. Orlistat was approved in Europe and the United States for long-term treatment of obesity, but many patients cannot tolerate its gastrointestinal side effects. Phentermine and diethylpropion can only be used for less than 12 weeks because the long-term safety of these Drugs is unknown. Ephedrine and caffeine are natural substances but the effects on weight reduction are modest. As a result there is a huge unmet need for effective and safe Antiobesity Drugs. Recently lorcaserin and topiramate plus phentermine have been approved for the treatment of obesity but long-term safety data are lacking.
Elisabetta Patorno - One of the best experts on this subject based on the ideXlab platform.
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prescribing trends and clinical characteristics of patients starting Antiobesity Drugs in the united states
Diabetes Obesity and Metabolism, 2021Co-Authors: Karine Suissa, Sebastian Schneeweiss, Dong Wook Kim, Elisabetta PatornoAbstract:Aim To assess the trends in the prescribing of Antiobesity medications and the characteristics of patients recently initiating Antiobesity Drugs. Materials and methods We conducted a population-based cohort study using claims data from commercial health insurances in the United States. Patients initiating an Antiobesity drug between January 2004 and December 2018 were included. Trends in the utilization of Antiobesity medications were plotted by year, as a proportion of any Antiobesity treatment, and as initiation rates per 100 000. Descriptive statistics were used to summarize the characteristics of Antiobesity initiators. Results From 2004 to 2018, 626 216 patients started an Antiobesity medication (two per 100 000). Phentermine was the most frequently prescribed (50% in 2018). In recent years (2015-2018), among 227 692 patients who initiated an Antiobesity drug, 51% started phentermine, 19% naltrexone-bupropion, and 13% liraglutide 3.0 mg. Compared to other agents, the use of liraglutide 3.0 mg increased between 2015 and 2018. The average age of initiators was 45 years, 81% of initiators were female, 32% had hypertension, 25% had dyslipidaemia, and 6% had type 2 diabetes. Time on treatment was generally short (mean 81 days). Conclusion The overall use of Antiobesity medications remained low over the past 15 years and phentermine was the preferred Antiobesity agent. Although the use of potentially safer Antiobesity agents, for example, liraglutide 3.0 mg, has increased in recent years, phentermine remained the most frequently prescribed agent among middle-aged adults with a moderate burden of comorbidities.
Renato Pasquali - One of the best experts on this subject based on the ideXlab platform.
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Predictors of Weight Loss and Maintenance in Patients Treated With Antiobesity Drugs
Diabetes metabolic syndrome and obesity : targets and therapy, 2011Co-Authors: Federica Guaraldi, Uberto Pagotto, Renato PasqualiAbstract:Background The prevalence of obesity and related diseases has increased enormously in the last few decades, becoming a very important medical and social issue. Because of the increasing number of people who need weight loss therapies and the high costs associated with these, the search for reliable predictors of success for weight loss and weight maintenance treatments has become a priority. Objective A literature review was undertaken to identify possible predictors of outcome of weight loss and weight maintenance in patients treated with Antiobesity Drugs. Results For the majority of variables, published data are not sufficient to define their role on final outcomes. Among all considered factors, only early response to treatment appeared to be a reliable positive predictor, and diabetes a negative predictor of weight loss and maintenance. Conclusion To date, no definitive results have been obtained. Due to the great benefits of reliable predictors of outcome associated to currently available Antiobesity Drugs and those under development, identifying these predictors has to be supported and encouraged.