Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity
Summary: We describe the therapeutic journey of a 33-year-old patient with early-onset obesity (BMI 56.7 kg/m2) and hyperphagia due to a likely pathogenic heterozygous melanocortin-4 receptor (MC4R) gene variant.She was unsuccessfully treated with several intensive lifestyle interventions, gastric b...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | iScience |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589004223002766 |
| _version_ | 1811161694456512512 |
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| author | Mila S. Welling Mostafa Mohseni Eline S. van der Valk Johanna M. van Hagen Jan Steven Burgerhart Mieke M. van Haelst Elisabeth F.C. van Rossum |
| author_facet | Mila S. Welling Mostafa Mohseni Eline S. van der Valk Johanna M. van Hagen Jan Steven Burgerhart Mieke M. van Haelst Elisabeth F.C. van Rossum |
| author_sort | Mila S. Welling |
| collection | DOAJ |
| description | Summary: We describe the therapeutic journey of a 33-year-old patient with early-onset obesity (BMI 56.7 kg/m2) and hyperphagia due to a likely pathogenic heterozygous melanocortin-4 receptor (MC4R) gene variant.She was unsuccessfully treated with several intensive lifestyle interventions, gastric bypass surgery (−40 kg weight loss, followed by +39.8 kg weight regain), liraglutide 3 mg (−3.8% weight loss with sustained hyperphagia), and metformin treatment. However, naltrexone-bupropion treatment led to −48.9 kg (−26.7%) weight loss, of which −39.9 kg (−38.3%) was fat mass, in 17 months of treatment. Importantly, she reported improved hyperphagia and quality of life.We describe the potential beneficial effects of naltrexone-bupropion on weight, hyperphagia, and quality of life in a patient with genetic obesity. This extensive journey shows that various anti-obesity agents can be initiated, subsequently terminated when ineffective and substituted with other anti-obesity agents to identify the most efficient anti-obesity treatment. |
| first_indexed | 2024-04-10T06:18:30Z |
| format | Article |
| id | doaj.art-6e57a4259cfa41699a86bab0b6874739 |
| institution | Directory Open Access Journal |
| issn | 2589-0042 |
| language | English |
| last_indexed | 2024-04-10T06:18:30Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | iScience |
| spelling | doaj.art-6e57a4259cfa41699a86bab0b68747392023-03-02T05:02:54ZengElsevieriScience2589-00422023-03-01263106199Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesityMila S. Welling0Mostafa Mohseni1Eline S. van der Valk2Johanna M. van Hagen3Jan Steven Burgerhart4Mieke M. van Haelst5Elisabeth F.C. van Rossum6Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the Netherlands; Obesity Center CGG, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the NetherlandsDepartment of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the Netherlands; Obesity Center CGG, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the NetherlandsDepartment of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the Netherlands; Obesity Center CGG, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the NetherlandsDepartment of Human Genetics, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, North-Holland, the NetherlandsDepartment of Internal Medicine, University Medical Center Utrecht, 3584 CX Utrecht, Utrecht, the NetherlandsDepartment of Human Genetics, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, North-Holland, the NetherlandsDepartment of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the Netherlands; Obesity Center CGG, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, South-Holland, the Netherlands; Corresponding authorSummary: We describe the therapeutic journey of a 33-year-old patient with early-onset obesity (BMI 56.7 kg/m2) and hyperphagia due to a likely pathogenic heterozygous melanocortin-4 receptor (MC4R) gene variant.She was unsuccessfully treated with several intensive lifestyle interventions, gastric bypass surgery (−40 kg weight loss, followed by +39.8 kg weight regain), liraglutide 3 mg (−3.8% weight loss with sustained hyperphagia), and metformin treatment. However, naltrexone-bupropion treatment led to −48.9 kg (−26.7%) weight loss, of which −39.9 kg (−38.3%) was fat mass, in 17 months of treatment. Importantly, she reported improved hyperphagia and quality of life.We describe the potential beneficial effects of naltrexone-bupropion on weight, hyperphagia, and quality of life in a patient with genetic obesity. This extensive journey shows that various anti-obesity agents can be initiated, subsequently terminated when ineffective and substituted with other anti-obesity agents to identify the most efficient anti-obesity treatment.http://www.sciencedirect.com/science/article/pii/S2589004223002766Biological sciencesPhysiologyHuman PhysiologyHuman metabolism |
| spellingShingle | Mila S. Welling Mostafa Mohseni Eline S. van der Valk Johanna M. van Hagen Jan Steven Burgerhart Mieke M. van Haelst Elisabeth F.C. van Rossum Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity iScience Biological sciences Physiology Human Physiology Human metabolism |
| title | Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity |
| title_full | Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity |
| title_fullStr | Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity |
| title_full_unstemmed | Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity |
| title_short | Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity |
| title_sort | successful naltrexone bupropion treatment after several treatment failures in a patient with severe monogenic obesity |
| topic | Biological sciences Physiology Human Physiology Human metabolism |
| url | http://www.sciencedirect.com/science/article/pii/S2589004223002766 |
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