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2015 ; 100
(2
): 363-70
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Clinical review: Drugs commonly associated with weight change: a systematic
review and meta-analysis
#MMPMID25590213
Domecq JP
; Prutsky G
; Leppin A
; Sonbol MB
; Altayar O
; Undavalli C
; Wang Z
; Elraiyah T
; Brito JP
; Mauck KF
; Lababidi MH
; Prokop LJ
; Asi N
; Wei J
; Fidahussein S
; Montori VM
; Murad MH
J Clin Endocrinol Metab
2015[Feb]; 100
(2
): 363-70
PMID25590213
show ga
CONTEXT: Various drugs affect body weight as a side effect. OBJECTIVE: We
conducted this systematic review and meta-analysis to summarize the evidence
about commonly prescribed drugs and their association with weight change. DATA
SOURCES: MEDLINE, DARE, and the Cochrane Database of Systematic Reviews were
searched to identify published systematic reviews as a source for trials. STUDY
SELECTION: We included randomized trials that compared an a priori selected list
of drugs to placebo and measured weight change. DATA EXTRACTION: We extracted
data in duplicate and assessed the methodological quality using the Cochrane risk
of bias tool. RESULTS: We included 257 randomized trials (54 different drugs; 84
696 patients enrolled). Weight gain was associated with the use of amitriptyline
(1.8 kg), mirtazapine (1.5 kg), olanzapine (2.4 kg), quetiapine (1.1 kg),
risperidone (0.8 kg), gabapentin (2.2 kg), tolbutamide (2.8 kg), pioglitazone
(2.6 kg), glimepiride (2.1 kg), gliclazide (1.8 kg), glyburide (2.6 kg),
glipizide (2.2 kg), sitagliptin (0.55 kg), and nateglinide (0.3 kg). Weight loss
was associated with the use of metformin (1.1 kg), acarbose (0.4 kg), miglitol
(0.7 kg), pramlintide (2.3 kg), liraglutide (1.7 kg), exenatide (1.2 kg),
zonisamide (7.7 kg), topiramate (3.8 kg), bupropion (1.3 kg), and fluoxetine (1.3
kg). For many other remaining drugs (including antihypertensives and
antihistamines), the weight change was either statistically nonsignificant or
supported by very low-quality evidence. CONCLUSIONS: Several drugs are associated
with weight change of varying magnitude. Data are provided to guide the choice of
drug when several options exist and institute preemptive weight loss strategies
when obesogenic drugs are prescribed.