Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.

<h4>Background</h4> <p>We identified anti-obesity medications withdrawn since 1950 because of adverse drug reactions after regulatory approval, and examined the evidence used to support such withdrawals, investigated the mechanisms of the adverse reactions, and explored the trends...

Full description

Bibliographic Details
Main Authors: Onakpoya, I, Heneghan, C, Aronson, J
Format: Journal article
Language:English
Published: BioMed Central 2016
_version_ 1797087643603828736
author Onakpoya, I
Heneghan, C
Aronson, J
author_facet Onakpoya, I
Heneghan, C
Aronson, J
author_sort Onakpoya, I
collection OXFORD
description <h4>Background</h4> <p>We identified anti-obesity medications withdrawn since 1950 because of adverse drug reactions after regulatory approval, and examined the evidence used to support such withdrawals, investigated the mechanisms of the adverse reactions, and explored the trends over time.</p> <h4>Methods</h4> <p>We conducted searches in PubMed, the World Health Organization database of drugs, the websites of drug regulatory authorities, and selected full texts, and we hand searched references in retrieved documents. We included anti-obesity medications that were withdrawn between 1950 and December 2015 and assessed the levels of evidence used for making withdrawal decisions using the Oxford Centre for Evidence-Based Medicine criteria.</p> <h4>Results</h4> <p>We identified 25 anti-obesity medications withdrawn between 1964 and 2009; 23 of these were centrally acting, via monoamine neurotransmitters. Case reports were cited as evidence for withdrawal in 80% of instances. Psychiatric disturbances, cardiotoxicity (mainly attributable to re-uptake inhibitors), and drug abuse or dependence (mainly attributable to neurotransmitter releasing agents) together accounted for 83% of withdrawals. Deaths were reportedly associated with seven products (28%). In almost half of the cases, the withdrawals occurred within 2 years of the first report of an adverse reaction.</p> <h4>Conclusions</h4> <p>Most of the drugs that affect monoamine neurotransmitters licensed for the treatment of obesity over the past 65 years have been withdrawn because of adverse reactions. The reasons for withdrawal raise concerns about the wisdom of using pharmacological agents that target monoamine neurotransmitters in managing obesity. Greater transparency in the assessment of harms from anti-obesity medications is therefore warranted.</p>
first_indexed 2024-03-07T02:38:35Z
format Journal article
id oxford-uuid:a9a62c84-0ae7-4a40-a15e-f9d53ad03bf4
institution University of Oxford
language English
last_indexed 2024-03-07T02:38:35Z
publishDate 2016
publisher BioMed Central
record_format dspace
spelling oxford-uuid:a9a62c84-0ae7-4a40-a15e-f9d53ad03bf42022-03-27T03:09:52ZPost-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a9a62c84-0ae7-4a40-a15e-f9d53ad03bf4EnglishSymplectic Elements at OxfordBioMed Central2016Onakpoya, IHeneghan, CAronson, J <h4>Background</h4> <p>We identified anti-obesity medications withdrawn since 1950 because of adverse drug reactions after regulatory approval, and examined the evidence used to support such withdrawals, investigated the mechanisms of the adverse reactions, and explored the trends over time.</p> <h4>Methods</h4> <p>We conducted searches in PubMed, the World Health Organization database of drugs, the websites of drug regulatory authorities, and selected full texts, and we hand searched references in retrieved documents. We included anti-obesity medications that were withdrawn between 1950 and December 2015 and assessed the levels of evidence used for making withdrawal decisions using the Oxford Centre for Evidence-Based Medicine criteria.</p> <h4>Results</h4> <p>We identified 25 anti-obesity medications withdrawn between 1964 and 2009; 23 of these were centrally acting, via monoamine neurotransmitters. Case reports were cited as evidence for withdrawal in 80% of instances. Psychiatric disturbances, cardiotoxicity (mainly attributable to re-uptake inhibitors), and drug abuse or dependence (mainly attributable to neurotransmitter releasing agents) together accounted for 83% of withdrawals. Deaths were reportedly associated with seven products (28%). In almost half of the cases, the withdrawals occurred within 2 years of the first report of an adverse reaction.</p> <h4>Conclusions</h4> <p>Most of the drugs that affect monoamine neurotransmitters licensed for the treatment of obesity over the past 65 years have been withdrawn because of adverse reactions. The reasons for withdrawal raise concerns about the wisdom of using pharmacological agents that target monoamine neurotransmitters in managing obesity. Greater transparency in the assessment of harms from anti-obesity medications is therefore warranted.</p>
spellingShingle Onakpoya, I
Heneghan, C
Aronson, J
Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.
title Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.
title_full Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.
title_fullStr Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.
title_full_unstemmed Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.
title_short Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.
title_sort post marketing withdrawal of anti obesity medicinal products because of adverse drug reactions a systematic review
work_keys_str_mv AT onakpoyai postmarketingwithdrawalofantiobesitymedicinalproductsbecauseofadversedrugreactionsasystematicreview
AT heneghanc postmarketingwithdrawalofantiobesitymedicinalproductsbecauseofadversedrugreactionsasystematicreview
AT aronsonj postmarketingwithdrawalofantiobesitymedicinalproductsbecauseofadversedrugreactionsasystematicreview