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10.1001/jama.2016.7602 http://scihub22266oqcxt.onion/10.1001/jama.2016.7602 C5617638!5617638!27299618     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       JAMA 2016 ; 315 (22): 2424-34 Nephropedia Template TP {{tp|p=27299618|t=2016. Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis |pdf=|usr=}}{{27299618}} gab.com Text Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis JO: JAMA http://www.kidney.de/pget.php?&tw=1&pmid=27299618 #FOAvip IMPORTANCE: Five medications have been approved for the management of obesity, but data on comparative effectiveness are limited. OBJECTIVE: To compare weight loss and adverse events among drug treatments for obesity using a systematic review and network meta-analysis. DATA SOURCES: MEDLINE, EMBASE, Web of Science, Scopus, and Cochrane Central from inception to March 23, 2016; clinical trial registries. STUDY SELECTION: Randomized clinical trials conducted among overweight and obese adults treated with US Food and Drug Administration?approved long-term weight loss agents (orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, or liraglutide) for at least 1 year compared with another active agent or placebo. DATA EXTRACTION AND SYNTHESIS: Two investigators identified studies and independently abstracted data using a predefined protocol. A Bayesian network meta-analysis was performed and relative ranking of agents was assessed using surface under the cumulative ranking (SUCRA) probabilities. Quality of evidence was assessed using GRADE criteria. MAIN OUTCOMES AND MEASURES: Proportions of patients with at least 5%weight loss and at least 10% weight loss, magnitude of decrease in weight, and discontinuation of therapy because of adverse events at 1 year. RESULTS: Twenty-eight randomized clinical trials with 29018 patients (median age, 46 years; 74%women; median baseline body weight, 100.5 kg; median baseline body mass index, 36.1) were included. A median 23%of placebo participants had at least 5%weight loss vs 75%of participants taking phentermine-topiramate (odds ratio [OR], 9.22; 95%credible interval [CrI], 6.63?12.85; SUCRA, 0.95), 63%of participants taking liraglutide (OR, 5.54; 95%CrI, 4.16?7.78; SUCRA, 0.83), 55%taking naltrexone-bupropion (OR, 3.96; 95%CrI, 3.03?5.11; SUCRA, 0.60), 49%taking lorcaserin (OR, 3.10; 95%CrI, 2.38?4.05; SUCRA, 0.39), and 44%taking orlistat (OR, 2.70; 95%CrI, 2.34?3.09; SUCRA, 0.22). All active agents were associated with significant excess weight loss compared with placebo at 1 year?phentermine-topiramate, 8.8 kg (95%CrI, ?10.20 to ?7.42 kg); liraglutide, 5.3 kg (95%CrI, ?6.06 to ?4.52 kg); naltrexone-bupropion, 5.0 kg (95%CrI, ?5.94 to ?3.96 kg); lorcaserin, 3.2 kg (95%CrI, ?3.97 to ?2.46 kg); and orlistat, 2.6 kg (95%CrI, ?3.04 to ?2.16 kg). Compared with placebo, liraglutide (OR, 2.95; 95%CrI, 2.11?4.23) and naltrexone-bupropion (OR, 2.64; 95%CrI, 2.10?3.35) were associated with the highest odds of adverse event?related treatment discontinuation. High attrition rates (30%?45%in all trials) were associated with lower confidence in estimates. CONCLUSIONS AND RELEVANCE: Among overweight or obese adults, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide, compared with placebo, were each associated with achieving at least 5%weight loss at 52 weeks. Phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5%weight loss. Twit Text FOAVip Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis ????JAMA http://www.kidney.de/pget.php?&tw=1&pmid=27299618 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27299618 #FOAvip English Wikipedia <ref>{{Cite pmid|27299618}}</ref> Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis #MMPMID27299618 Khera R; Murad MH; Chandar AK; Dulai PS; Wang Z; Prokop LJ; Loomba R; Camilleri M; Singh S JAMA 2016[Jun]; 315 (22): 2424-34 PMID27299618show ga IMPORTANCE: Five medications have been approved for the management of obesity, but data on comparative effectiveness are limited. OBJECTIVE: To compare weight loss and adverse events among drug treatments for obesity using a systematic review and network meta-analysis. DATA SOURCES: MEDLINE, EMBASE, Web of Science, Scopus, and Cochrane Central from inception to March 23, 2016; clinical trial registries. STUDY SELECTION: Randomized clinical trials conducted among overweight and obese adults treated with US Food and Drug Administration?approved long-term weight loss agents (orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, or liraglutide) for at least 1 year compared with another active agent or placebo. DATA EXTRACTION AND SYNTHESIS: Two investigators identified studies and independently abstracted data using a predefined protocol. A Bayesian network meta-analysis was performed and relative ranking of agents was assessed using surface under the cumulative ranking (SUCRA) probabilities. Quality of evidence was assessed using GRADE criteria. MAIN OUTCOMES AND MEASURES: Proportions of patients with at least 5%weight loss and at least 10% weight loss, magnitude of decrease in weight, and discontinuation of therapy because of adverse events at 1 year. RESULTS: Twenty-eight randomized clinical trials with 29018 patients (median age, 46 years; 74%women; median baseline body weight, 100.5 kg; median baseline body mass index, 36.1) were included. A median 23%of placebo participants had at least 5%weight loss vs 75%of participants taking phentermine-topiramate (odds ratio [OR], 9.22; 95%credible interval [CrI], 6.63?12.85; SUCRA, 0.95), 63%of participants taking liraglutide (OR, 5.54; 95%CrI, 4.16?7.78; SUCRA, 0.83), 55%taking naltrexone-bupropion (OR, 3.96; 95%CrI, 3.03?5.11; SUCRA, 0.60), 49%taking lorcaserin (OR, 3.10; 95%CrI, 2.38?4.05; SUCRA, 0.39), and 44%taking orlistat (OR, 2.70; 95%CrI, 2.34?3.09; SUCRA, 0.22). All active agents were associated with significant excess weight loss compared with placebo at 1 year?phentermine-topiramate, 8.8 kg (95%CrI, ?10.20 to ?7.42 kg); liraglutide, 5.3 kg (95%CrI, ?6.06 to ?4.52 kg); naltrexone-bupropion, 5.0 kg (95%CrI, ?5.94 to ?3.96 kg); lorcaserin, 3.2 kg (95%CrI, ?3.97 to ?2.46 kg); and orlistat, 2.6 kg (95%CrI, ?3.04 to ?2.16 kg). Compared with placebo, liraglutide (OR, 2.95; 95%CrI, 2.11?4.23) and naltrexone-bupropion (OR, 2.64; 95%CrI, 2.10?3.35) were associated with the highest odds of adverse event?related treatment discontinuation. High attrition rates (30%?45%in all trials) were associated with lower confidence in estimates. CONCLUSIONS AND RELEVANCE: Among overweight or obese adults, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide, compared with placebo, were each associated with achieving at least 5%weight loss at 52 weeks. Phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5%weight loss. äAssociation of Pharmacological Treatments for Obesity With Weight Loss(epmc).pdf DeepDyve Pubget Overpricing