کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2814342 | 1569522 | 2011 | 5 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Psychiatric adverse effects of rimonobant in adults with Prader Willi syndrome Psychiatric adverse effects of rimonobant in adults with Prader Willi syndrome](/preview/png/2814342.png)
BackgroundPrader Willi syndrome (PWS) without strict environmental modifications can lead to obesity associated with significant morbidity and mortality. In addition to increased appetite, these individuals have decreased energy expenditure with lower insulin like growth factor 1 (IGF1), which contributes to adiposity. No effective treatment is available for this condition. Endocannabinoid receptor CB1 antagonist, rimonobant, has been effective for treatment of obesity in adult subjects. Rimonabant promotes weight loss by multiple proposed mechanisms, including decreased appetite and lipogenesis, and increased energy expenditure. Therefore, we conducted this pilot study to evaluate the effect of rimonabant on body weight and composition of adults with PWS.MethodThis was a double blind placebo controlled study. Body weight, total fat mass, fasting ghrelin, leptin, IGF1 and insulin like growth factor binding protein (IGFBP-3) were collected at baseline, and after 90 and 180 days of treatment with placebo or 20 mg of rimonabant.ResultsDue to psychiatric adverse effects, 50% of subjects in the rimonabant group withdrew, and the study was terminated early (N = 10) for safety concerns. There was a trend for weight loss, lower fat mass and higher IGF1 level at the end of study in this group. Leptin followed the fat mass and decreased with rimonabant treatment.ConclusionRimonabant administration may be efficacious for weight loss in adults with PWS; unfortunately it is associated with an unacceptably high risk of psychiatric side effects. Future CB1 antagonists will need a better psychiatric profile before considered in the treatment of obesity in this genetic condition.
Journal: European Journal of Medical Genetics - Volume 54, Issue 1, January–February 2011, Pages 14–18