Tom 13, Nr 5 (2016)
Wytyczne / stanowisko ekspertów
Opublikowany online: 2017-01-03
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Stanowisko Zespołu Ekspertów dotyczące zastosowania produktu leczniczego Mysimba® (chlorowodorek bupropionu i chlorowodorek naltreksonu) we wspomaganiu leczenia otyłości i nadwagi (BMI ≥ 27 kg/m2) z chorobami towarzyszącymi
Choroby Serca i Naczyń 2016;13(5):333-346.
Streszczenie
Leczenie nadwagi i otyłości jest trudnym i długotrwałym procesem, wymagającym zarówno prawidłowego rozpoznania przyczyn rozwoju tych chorób, jak i wdrażania metod adekwatnych do stanu zdrowia pacjenta. Podstawą leczenia jest zmiana stylu życia prowadząca do uzyskania ujemnego bilansu energetycznego (zmiana nawyków żywieniowych i zwiększenie aktywności fizycznej). Niemniej duża grupa pacjentów w celu ułatwienia realizacji zaleceń dotyczących zmian stylu życia wymaga wsparcia farmakologicznego i/lub sychoterapeutycznego. Ostatni szczebel leczenia otyłości II stopnia z powikłaniami i otyłości III stopnia stanowi leczenie operacyjne.
Możliwości stosowania farmakoterapii wspomagającej leczenie otyłości są bardzo ograniczone, przez ostatnie 6 lat na polskim rynku dostępny był wyłącznie orlistat. Obecnie po zarejestrowaniu przez EMA w marcu 2015 roku, od listopada 2016 roku, dostępny jest złożony produkt leczniczy Mysimba® zawierający dwie substancje czynne — chlorowodorek bupropionu i chlorowodorek naltreksonu. Ze względu na addytywne działanie tych substancji czynnych w ośrodkowym układzie nerwowym zarówno na poziomie jądra łukowatego podwzgórza (stymulacja odczucia sytości), jak i zlokalizowanego w obszarze limbicznym układu nagrody (hamowanie apetytu) lek ten budzi nadzieję na zwiększenie skuteczności w leczeniu otyłości. Celem niniejszego stanowiska jest pomoc lekarzom praktykom w podejmowaniu decyzji o zastosowaniu produktu leczniczego Mysimba® tak, aby uzyskać jak najwięcej korzyści z leczenia dla pacjenta przy jak najniższym ryzyku.
Słowa kluczowe: bupropionnaltreksonleczenie nadwagi i otyłościskutecznośćbezpieczeństwo
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