Study summary · research use only
Potential role of new therapies in modifying cardiovascular risk in overweight patients with metabolic risk factors
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This review article discusses potential therapies for modifying cardiovascular risk in overweight patients with metabolic risk factors. The authors describe systems mediating hunger and satiety (serotonin, norepinephrine, dopamine, endocannabinoid, and others) and summarize weight-loss agents in preclinical or early studies, including centrally acting compounds (such as APD356) and peripheral-to-central agents (cholecystokinin receptor agonists, ghrelin receptor antagonists). They note rimonabant, a cannabinoid-1-receptor antagonist, had completed phase III trials, mention agents targeting adipose or fatty-acid metabolism (such as AOD9604), drugs that may reduce metabolic complications without treating obesity (acipimox, pioglitazone), and gastric pacemaker devices under study.
Abstract
The serotonin, norepinephrine, dopamine, and endocannabinoid systems, as well as a host of other systems, mediate hunger and satiety signals. Weight loss agents that modulate appetite through pure central nervous system pathways (e.g., APD356, a selective serotonin receptor agonist) and peripheral signals to central nervous system pathways (e.g., cholecystokinin receptor agonists and ghrelin receptor antagonists) are in preclinical or early phase studies. Both devices and pharmacological compounds that facilitate weight loss and/or target multiple components of metabolic risk also are in development. One of the medications that has completed extensive phase III clinical trials and may become available in the foreseeable future is rimonabant, a selective cannabinoid 1-receptor antagonist. Drugs that improve adipose tissue function or fatty acid metabolism (e.g., AOD9604) also are in clinical trials. Some currently available medications may reduce metabolic complications without treating obesity per se (e.g., acipimox, pioglitazone). Surgically implanted gastric pacemaker systems that modulate vagus nerve activity and delay gastric emptying are under study.
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