Tom 18, Nr 4 (2021)
Artykuł przeglądowy
Opublikowany online: 2022-01-14
Wyświetlenia strony 2905
Wyświetlenia/pobrania artykułu 37
Pobierz cytowanie

Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Leczenie otyłości a choroby układu sercowo-naczyniowego — gdziej jesteśmy i dokąd zmierzamy?

Aleksander Siniarski12, Grzegorz Gajos12
Choroby Serca i Naczyń 2021;18(4):171-182.

Streszczenie

Według Światowej Organizacji Zdrowia w 2016 roku ponad 1,9 miliarda dorosłych w wieku co najmniej 18 lat miało nadwagę, a spośrod nich ponad 650 milionow spełniało kryteria rozpoznania otyłości. Ponadto nie ulega wątpliwości, że otyłość wiąże się z negatywnymi konsekwencjami zdrowotnymi, w tym z poważnymi powikłaniami sercowo-naczyniowymi, ponad 2-krotnie zwiększając ryzyko wystąpienia cukrzycy, nadciśnienia tętniczego i miażdżycy. Historia farmakoterapii jest długa i sięga lat 40. XX wieku. Niemniej skuteczność niektórych dostępnych wowczas lekow była niezadowalająca oraz wiązała się z poważnymi działaniami niepożądanymi. Ostatnie lata przyniosły nowe doniesienia na temat lekow z grupy agonistów receptora dla glukagonopodobnego peptydu 1, wyjściowo badane w cukrzycy, ktore okazały się korzystnie wpływać na ograniczenie śmiertelności sercowo-naczyniowej oraz całkowitej. Trwają badania służące ocenie lekow z tej grupy we wskazaniu otyłości lub nadwagi pod kątem sercowo-naczyniowych punktow końcowych. Celem niniejszej publikacji było zebranie dostępnej wiedzy na temat farmakoterapii otyłości, szczegolnie w kontekście współistnienia chorob układu sercowo-naczyniowego, tak powszechnych w tej grupie pacjentow.

Artykuł dostępny w formacie PDF

Dodaj do koszyka: 49,00 PLN

Posiadasz dostęp do tego artykułu?

Referencje

  1. World Health Organization. Obesity and overweight: fact sheet 9 June 2021. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (October 18, 2021).
  2. Płaczkiewicz-Jankowska E, Czupryniak L, Strojek K, et al. Rozpoznawanie i leczenie otyłości. Omówienie zasad postępowania zgodnie z aktualnymi wytycznymi. https://www.mp.pl/nadwaga-i-otylosc/wytyczne/258838,rozpoznawanie-i-leczenie-otylosci-omowienie-zasad-postepowania-zgodnie-z-aktualnymi-wytycznymi (February 23, 2021).
  3. Marques A, Peralta M, Naia A, et al. Prevalence of adult overweight and obesity in 20 European countries, 2014. Eur J Public Health. 2018; 28(2): 295–300.
  4. Whitlock G, Lewington S, Sherliker P, et al. Prospective Studies Collaboration. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009; 373(9669): 1083–1096.
  5. Manson JE, Colditz G, Stampfer M, et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med. 1990; 322(13): 882–889.
  6. Calle EE, Thun M. Obesity and cancer. Oncogene. 2004; 23(38): 6365–6378.
  7. Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist. 2010; 15(6): 556–565.
  8. Waist circumference and waist-hip ratio: report of a WHO expert consultation. https://www.who.int/publications/i/item/9789241501491 (May 16, 2011).
  9. Aune D, Sen A, Prasad M, et al. BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. BMJ. 2016; 353: i2156.
  10. Tamara A, Tahapary DL. Obesity as a predictor for a poor prognosis of COVID-19: a systematic review. Diabetes Metab Syndr. 2020; 14(4): 655–659.
  11. Kim MS, Kim WJ, Khera AV, et al. Association between adiposity and cardiovascular outcomes: an umbrella review and meta-analysis of observational and Mendelian randomization studies. Eur Heart J. 2021; 42(34): 3388–3403.
  12. Flegal KM, Kit BK, Orpana H, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013; 309(1): 71–82.
  13. Visseren FLJ, Mach F, Smulders YM, et al. ESC Scientific Document Group, ESC National Cardiac Societies, ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021; 42(34): 3227–3337.
  14. Wing RR, Bolin P, Brancati FL, et al. Look AHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013; 369(2): 145–154.
  15. Polemiti E, Baudry J, Kuxhaus O, et al. BMI and BMI change following incident type 2 diabetes and risk of microvascular and macrovascular complications: the EPIC-Potsdam study. Diabetologia. 2021; 64(4): 814–825.
  16. Samborski P, Kucharski M. Historia otyłości jako zagadnienia medycznego. Acta Medicorum Pol. 2016; 6: 29–34.
  17. Colman E. Anorectics on trial: a half century of federal regulation of prescription appetite suppressants. Ann Intern Med. 2005; 143(5): 380–385.
  18. Cannistra LB, Davis SM, Bauman AG. Valvular heart disease associated with dexfenfluramine. N Engl J Med. 1997; 337(9): 636.
  19. James WP, Caterson ID, Coutinho W, et al. SCOUT Investigators. Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. N Engl J Med. 2010; 363(10): 905–917.
  20. Aminian A, Zajichek A, Arterburn DE, et al. Association of metabolic surgery with major adverse cardiovascular outcomes in patients with type 2 diabetes and obesity. JAMA. 2019; 322(13): 1271–1282.
  21. FDA requests the withdrawal of the weight-loss drug Belviq, Belviq XR (lorcaserin) from the market. Potential risk of cancer outweighs the benefits. https://www.fda.gov/drugs/drug-safety-and-availability/fda-requests-withdrawal-weight-loss-drug-belviq-belviq-xr-lorcaserin-market (October 18, 2021).
  22. Charakterystyka produktu leczniczego: Orlistat STADA 60 mg, kapsułki, twarde. http://chpl.com.pl/data_files/2012-07-26_SPC_OrlistatSTADA_60mg__VarIA001_2012-06-11.pdf (December 7, 2021).
  23. Didangelos TP, Thanopoulou AK, Bousboulas SH, et al. The ORLIstat and CArdiovascular risk profile in patients with metabolic syndrome and type 2 DIAbetes (ORLICARDIA) Study. Curr Med Res Opin. 2004; 20(9): 1393–1401.
  24. Ardissino M, Vincent M, Hines O, et al. Long-term cardiovascular outcomes after orlistat therapy in patients with obesity: a nationwide, propensity-score matched cohort study. Eur Heart J Cardiovasc Pharmacother. 2021 [Epub ahead of print].
  25. Charakterystyka produktu leczniczego: Mysimba 8 mg + 90 mg tabletki o przedłużonym uwalnianiu. http://urpl.gov.pl/sites/default/files/ChPL%20Mysimba%202016.pdf (December 7, 2021).
  26. Sharfstein JM, Psaty BM. Evaluation of the cardiovascular risk of naltrexone-bupropion: a study interrupted. JAMA. 2016; 315(10): 984–986.
  27. Nissen SE, Wolski K, Prcela L, et al. Effect of naltrexone-bupropion on major adverse cardiovascular events in overweight and obese patients with cardiovascular risk factors. JAMA. 2016; 315(10): 990–1004.
  28. Marso SP, Poulter NR, Nissen SE, et al. Design of the liraglutide effect and action in diabetes: evaluation of cardiovascular outcome results (LEADER) trial. Am Heart J. 2013; 166(5): 823–30.e5.
  29. Mann JFE, Ørsted DD, Brown-Frandsen K, et al. LEADER Steering Committee and Investigators. Liraglutide and renal outcomes in type 2 diabetes. N Engl J Med. 2017; 377(9): 839–848.
  30. Pi-Sunyer X, Astrup A, Fujioka K, et al. SCALE Obesity and Prediabetes NN8022-1839 Study Group. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015; 373(1): 11–22.
  31. Kelly AS, Auerbach P, Barrientos-Perez M, et al. NN8022-4180 Trial Investigators. A randomized, controlled trial of liraglutide for adolescents with obesity. N Engl J Med. 2020; 382(22): 2117–2128.
  32. Park JHa, Kim JuY, Choi JH, et al. Effectiveness of liraglutide 3 mg for the treatment of obesity in a real-world setting without intensive lifestyle intervention. Int J Obes (Lond). 2021; 45(4): 776–786.
  33. Charakterystyka produktu leczniczego: Saxenda, 6 mg/ml. https://ec.europa.eu/health/documents/community-register/2017/20171115139439/anx_139439_pl.pdf (December 7, 2021).
  34. Marso SP, Bain S, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016; 375(19): 1834–1844.
  35. Husain M, Birkenfeld A, Donsmark M, et al. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2019; 381(9): 841–851.
  36. Wilding JPH, Batterham RL, Calanna S, et al. STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021; 384(11): 989.
  37. Davies M, Færch L, Jeppesen OK, et al. STEP 2 Study Group. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021; 397(10278): 971–984.
  38. Wadden TA, Bailey TS, Billings LK, et al. STEP 3 Investigators. Effect of subcutaneous semaglutide vs placebo as anadjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: the STEP 3 randomized clinical trial. JAMA. 2021; 325(14): 1403–1413.
  39. Rubino D, Abrahamsson N, Davies M, et al. STEP 4 Investigators. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. JAMA. 2021; 325(14): 1414–1425.
  40. Kushner RF, Calanna S, Davies M, et al. Semaglutide 2.4 mg for the treatment of obesity: key elements of the STEP trials 1 to 5. Obesity (Silver Spring). 2020; 28(6): 1050–1061.
  41. U.S Food and Drug Administration. FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014 (October 9, 2021).
  42. Charakterystyka produktu leczniczego: Ozempic 0,25 mg; 0,5 mg oraz 1 mg. https://www.ema.europa.eu/en/documents/product-information/ozempic-epar-product-information_pl.pdf (December 7, 2021).
  43. Capristo E, Maione A, Lucisano G, et al. Effects of weight loss medications on mortality and cardiovascular events: a systematic review of randomized controlled trials in adults with overweight and obesity. Nutr Metab Cardiovasc Dis. 2021; 31(9): 2587–2595.
  44. Brown E, Wilding JPH, Barber TM, et al. Weight loss variability with SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes mellitus and obesity: Mechanistic possibilities. Obes Rev. 2019; 20(6): 816–828.
  45. Wishnofsky M. Caloric equivalents of gained or lost weight. Am J Clin Nutr. 1958; 6(5): 542–546.
  46. Verdich C, Flint A, Gutzwiller JP, et al. A meta-analysis of the effect of glucagon-like peptide-1 (7-36) amide on ad libitum energy intake in humans. J Clin Endocrinol Metab. 2001; 86(9): 4382–4389.
  47. Holst JJ, Vilsbøll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009; 297(1-2): 127–136.
  48. Sorli C, Harashima SI, Tsoukas GM, et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol. 2017; 5(4): 251–260.
  49. Ahrén Bo, Masmiquel L, Kumar H, et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): a 56-week, double-blind, phase 3a, randomised trial. Lancet Diabetes Endocrinol. 2017; 5(5): 341–354.
  50. Aroda VR, Bain S, Cariou B, et al. Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial. Lancet Diabetes Endocrinol. 2017; 5(5): 355–366.
  51. O'Neil PM, Birkenfeld AL, McGowan B, et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet. 2018; 392(10148): 637–649.
  52. Wilding JPH, Overgaard RV, Jacobsen LV, et al. Exposure-response analyses of liraglutide 3.0 mg for weight management. Diabetes Obes Metab. 2016; 18(5): 491–499.
  53. Ingwersen SH, Khurana M, Madabushi R, et al. Dosing rationale for liraglutide in type 2 diabetes mellitus: a pharmacometric assessment. J Clin Pharmacol. 2012; 52(12): 1815–1823.
  54. Overgaard RV, Petri KC, Jacobsen LV, et al. Liraglutide 3.0 mg for weight management: a population pharmacokinetic analysis. Clin Pharmacokinet. 2016; 55(11): 1413–1422.
  55. Cosentino F, Grant PJ, Aboyans V, et al. Wytyczne Europejskiego Towarzystwa Kardiologicznego dotyczące cukrzycy i stanu przedcukrzycowego współistniejących z chorobami sercowo- naczyniowymi opracowane we współpracy z Europejskim Towarzystwem Badań nad Cukrzycą ( 2019 ). Kardiol Pol. 2019; 71(11): 319–394.
  56. Newby LK. Inflammation as a treatment target after acute myocardial infarction. N Engl J Med. 2019; 381(26): 2562–2563.
  57. Kablak-Ziembicka A, Przewlocki T, Sokołowski A, et al. Carotid intima-media thickness, hs-CRP and TNF-α are independently associated with cardiovascular event risk in patients with atherosclerotic occlusive disease. Atherosclerosis. 2011; 214(1): 185–190.
  58. Bruunsgaard H, Skinhøj P, Pedersen AN, et al. Ageing, tumour necrosis factor-alpha (TNF-alpha) and atherosclerosis. Clin Exp Immunol. 2000; 121(2): 255–260.
  59. Lee YS, Jun HS. Anti-inflammatory effects of GLP-1-based therapies beyond glucose control. Mediators Inflamm. 2016; 2016: 3094642.
  60. Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med. 2019; 381(26): 2497–2505.
  61. Opstal TSJ, Fiolet ATL, van Broekhoven A, et al. LoDoCo2 Trial Investigators, LoDoCo2 Trial Investigators. Colchicine in patients with chronic coronary disease. N Engl J Med. 2020; 383(19): 1838–1847.
  62. Ridker PM, Everett BM, Thuren T, et al. CANTOS Trial Group. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017; 377(12): 1119–1131.
  63. Scheen AJ, Esser N, Paquot N. Antidiabetic agents: potential anti-inflammatory activity beyond glucose control. Diabetes Metab. 2015; 41(3): 183–194.
  64. Ceriello A, Novials A, Ortega E, et al. Glucagon-like peptide 1 reduces endothelial dysfunction, inflammation, and oxidative stress induced by both hyperglycemia and hypoglycemia in type 1 diabetes. Diabetes Care. 2013; 36(8): 2346–2350.
  65. Vergès B, Charbonnel B. After the LEADER trial and SUSTAIN-6, how do we explain the cardiovascular benefits of some GLP-1 receptor agonists? Diabetes Metab. 2017; 43(Suppl 1): 2S3–2S2S12.
  66. Ludvik B, Giorgino F, Jodar E E, et al. 78-LB: efficacy and safety of tirzepatide, a dual GIP/GLP-1 receptor agonist, compared with insulin degludec in patients with type 2 diabetes (SURPASS-3). Diabetes. 2021; 70(Suppl 1).