Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática

Detalhes bibliográficos
Autor(a) principal: Paumgartten, Francisco José Roma
Data de Publicação: 2016
Outros Autores: Pereira, Sabrina Schaaf Teixeira Costa, Oliveira, Ana Cecilia Amado Xavier de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/126613
Resumo: OBJECTIVE To evaluate clinical evidence on the safety and efficacy of fenproporex for treating obesity. METHODS MEDLINE, LILACS and Cochrane Controlled Trials Register were searched as well as references cited by articles and relevant documents. Two authors independently assessed the studies for inclusion and regarding risk of bias, collected data, and accuracy. Eligible studies were all those placebo-controlled that provided data on the efficacy and safety of Fenproporex to treat obesity. RESULTS Only four controlled studies met the inclusion criteria. One randomized, placebo-controlled trial on Fenproporex was found on electronic databases. Three placebo-controlled studies (in non-indexed journals) were identified by hand-searching. Patients with cardiovascular and other comorbidities were excluded in all studies. Trials lasted from 40 to 364 days and doses ranged from 20 to 33.6 mg/d. All controlled studies found that weight loss among Fenproporex-treated patients was greater than that produced by the placebo, but drug effect was modest. Fenproporex produced additional weight reductions of 4.7 kg (one year), 3.8 kg (six months) and 1.55 kg (two months) in average, in relation to diet and exercise only (three trials). Insomnia, irritability, and anxiety were the most frequently reported side effects in the four studies. CONCLUSIONS There is a paucity of randomized, placebo-controlled trials on Fenproporex and those identified here present major methodological flaws. These studies suggest that Fenproporex is modestly effective in promoting weight loss. Nonetheless, they failed to provide evidence that it reduces obesity-associated morbidity and mortality. Data from these studies are insufficient to determine the risk-benefit profile of Fenproporex. Abuse potential and amphetamine-like adverse effects are causes for concern.
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spelling Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática Safety and efficacy of fenproporex for obesity treatment: a systematic review OBJECTIVE To evaluate clinical evidence on the safety and efficacy of fenproporex for treating obesity. METHODS MEDLINE, LILACS and Cochrane Controlled Trials Register were searched as well as references cited by articles and relevant documents. Two authors independently assessed the studies for inclusion and regarding risk of bias, collected data, and accuracy. Eligible studies were all those placebo-controlled that provided data on the efficacy and safety of Fenproporex to treat obesity. RESULTS Only four controlled studies met the inclusion criteria. One randomized, placebo-controlled trial on Fenproporex was found on electronic databases. Three placebo-controlled studies (in non-indexed journals) were identified by hand-searching. Patients with cardiovascular and other comorbidities were excluded in all studies. Trials lasted from 40 to 364 days and doses ranged from 20 to 33.6 mg/d. All controlled studies found that weight loss among Fenproporex-treated patients was greater than that produced by the placebo, but drug effect was modest. Fenproporex produced additional weight reductions of 4.7 kg (one year), 3.8 kg (six months) and 1.55 kg (two months) in average, in relation to diet and exercise only (three trials). Insomnia, irritability, and anxiety were the most frequently reported side effects in the four studies. CONCLUSIONS There is a paucity of randomized, placebo-controlled trials on Fenproporex and those identified here present major methodological flaws. These studies suggest that Fenproporex is modestly effective in promoting weight loss. Nonetheless, they failed to provide evidence that it reduces obesity-associated morbidity and mortality. Data from these studies are insufficient to determine the risk-benefit profile of Fenproporex. Abuse potential and amphetamine-like adverse effects are causes for concern. OBJETIVO Avaliar a evidência clínica de segurança e eficácia do Fenproporex para tratamento da obesidade. MÉTODOS Pesquisamos publicações em qualquer idioma nas bases Medline, Lilacs Cochrane Controlled Trials Register e também referências citadas por artigos e documentos relevantes. Dois autores avaliaram independentemente os estudos para inclusão e quanto ao risco de viés, dados coletados e precisão. Foram elegíveis estudos controlados com placebo que forneceram dados sobre a eficácia e segurança do Fenproporex para tratar a obesidade. RESULTADOS Apenas quatro estudos controlados preencheram critérios de inclusão. Um estudo placebo-controlado aleatorizado do Fenproporex foi encontrado nas bases eletrônicas. Três estudos controlados (em periódicos não indexados) foram identificados por buscas manuais. Pacientes com comorbidades (cardiovasculares ou outras) foram excluídos em todos os estudos. A duração dos estudos foi de 40 a 364 dias, com doses de 20 a 33,6 mg/d. Todos os estudos controlados encontraram maior perda de peso entre pacientes tratados com Fenproporex, comparados aos que receberam placebo, mas o efeito foi modesto. O Fenproporex causou reduções adicionais de peso de 4,7 kg (após um ano), 3,8 kg (após seis meses) e 1,55 kg (após dois meses), em média, em relação à dieta e exercício apenas (três ensaios). Insônia, irritabilidade e ansiedade foram os eventos colaterais mais frequentes nos quatro estudos. CONCLUSÕES Ensaios clínicos placebo-controlado aleatorizado do Fenproporex são escassos e os estudos controlados identificados apresentam importantes falhas metodológicas. Esses estudos sugerem que o Fenproporex é modestamente eficaz em promover perda de peso. Entretanto, eles não fornecem evidências de que o Fenproporex atenua a morbidade e mortalidade associada à obesidade. Esses estudos são insuficientes para avaliar o perfil risco-benefício do Fenproporex. Potencial de abuso e efeitos adversos do tipo anfetamínico são motivos de preocupação. Universidade de São Paulo. Faculdade de Saúde Pública2016-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/12661310.1590/S1518-8787.2016050006208Revista de Saúde Pública; Vol. 50 (2016); 25Revista de Saúde Pública; Vol. 50 (2016); 25Revista de Saúde Pública; v. 50 (2016); 251518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/rsp/article/view/126613/123622Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessPaumgartten, Francisco José RomaPereira, Sabrina Schaaf Teixeira CostaOliveira, Ana Cecilia Amado Xavier de2018-02-26T17:09:54Zoai:revistas.usp.br:article/126613Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2018-02-26T17:09:54Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
Safety and efficacy of fenproporex for obesity treatment: a systematic review
title Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
spellingShingle Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
Paumgartten, Francisco José Roma
title_short Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
title_full Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
title_fullStr Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
title_full_unstemmed Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
title_sort Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática
author Paumgartten, Francisco José Roma
author_facet Paumgartten, Francisco José Roma
Pereira, Sabrina Schaaf Teixeira Costa
Oliveira, Ana Cecilia Amado Xavier de
author_role author
author2 Pereira, Sabrina Schaaf Teixeira Costa
Oliveira, Ana Cecilia Amado Xavier de
author2_role author
author
dc.contributor.author.fl_str_mv Paumgartten, Francisco José Roma
Pereira, Sabrina Schaaf Teixeira Costa
Oliveira, Ana Cecilia Amado Xavier de
description OBJECTIVE To evaluate clinical evidence on the safety and efficacy of fenproporex for treating obesity. METHODS MEDLINE, LILACS and Cochrane Controlled Trials Register were searched as well as references cited by articles and relevant documents. Two authors independently assessed the studies for inclusion and regarding risk of bias, collected data, and accuracy. Eligible studies were all those placebo-controlled that provided data on the efficacy and safety of Fenproporex to treat obesity. RESULTS Only four controlled studies met the inclusion criteria. One randomized, placebo-controlled trial on Fenproporex was found on electronic databases. Three placebo-controlled studies (in non-indexed journals) were identified by hand-searching. Patients with cardiovascular and other comorbidities were excluded in all studies. Trials lasted from 40 to 364 days and doses ranged from 20 to 33.6 mg/d. All controlled studies found that weight loss among Fenproporex-treated patients was greater than that produced by the placebo, but drug effect was modest. Fenproporex produced additional weight reductions of 4.7 kg (one year), 3.8 kg (six months) and 1.55 kg (two months) in average, in relation to diet and exercise only (three trials). Insomnia, irritability, and anxiety were the most frequently reported side effects in the four studies. CONCLUSIONS There is a paucity of randomized, placebo-controlled trials on Fenproporex and those identified here present major methodological flaws. These studies suggest that Fenproporex is modestly effective in promoting weight loss. Nonetheless, they failed to provide evidence that it reduces obesity-associated morbidity and mortality. Data from these studies are insufficient to determine the risk-benefit profile of Fenproporex. Abuse potential and amphetamine-like adverse effects are causes for concern.
publishDate 2016
dc.date.none.fl_str_mv 2016-01-01
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dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/126613
10.1590/S1518-8787.2016050006208
url https://www.revistas.usp.br/rsp/article/view/126613
identifier_str_mv 10.1590/S1518-8787.2016050006208
dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/126613/123622
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 50 (2016); 25
Revista de Saúde Pública; Vol. 50 (2016); 25
Revista de Saúde Pública; v. 50 (2016); 25
1518-8787
0034-8910
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