Converging Relationships of Obesity and Hyperuricemia with Special Reference to Metabolic Disorders and Plausible Therapeutic Implications

Figures & data

Figure 1 The comparison of pathophysiology of (A) obesity and (B) hyperuricemia.

Abbreviations: GFR, glomerular filtration rate, NAFLD, non-alcoholic fatty liver disease.

Table 1 Major Anti-Obesity Medications Approved by FDA

Medication	Trade Name (Company)	Description	Mechanism	Dose	Weight Loss	Main Side Effects
Phentermine HCl	Adipex/Lomaira (Teva/KVK-Tech)	amphetamine derivative	Decreases appetite to reduce food intake	15 or 37.5 mg QD or 8 mg TID	3-5%(<12 weeks)	Dry mouth, insomnia, dizziness, palpitations, constipation, and agitation, as well as irritability and mood changes
Orlistat	Xenical/Alli (Roche/GlaxoSmithKline)	Pancreatic and gastric Lipase inhibitor	Resulting fat malabsorption reduces net energy intake	60 or120 mg TID. before meals	For 60 mg TID: 2.5% For 120 mg TID: 3.4%	Malabsorption, vitamin deficiencies, oily stools, GI discomfort
Phentermine/topiramate	Qsymia (Vivus)	Amphetamine derivative/GABA inhibitor	Decreases appetite to reduce food intake	Starting dose: 3.75 mg/23 mg for 2 weeks; recommended dose: 7.5 mg/46 mg; maximum dose: 15 mg/92 mg	For 7.5/46 mg QD: 6.7% For 15/92 mg QD: 8.9%	Neurological dysfunction, constipation, dizziness, headaches, insomnia
Lorcaserin	Belviq (Arena)	Selective 5-HT2C receptor agonist	Promotes satiety on food intake	10 mg BID.	3.2%	Dizziness, headaches, GI disturbances, insomnia, fatigue
Naltrexone/bupropion	Contrave (Takeda)	Opioid antagonist/dopamine and norepinephrine reuptake antagonist	Acts on CNS pathways to reduce food intake	1 tablet (8 mg of naltrexone and 90 mg of bupropion) daily for 1 week; dose subsequently increased each week by 1 tablet per day until maintenance dose of 2 tablets twice a day at week 4	For 16/180 mg BID.:4.8%	Depression, nausea/vomiting, headaches, dizziness, cardiovascular impairment
Liraglutide	Saxenda/victoza (Novo Nordisk)	GLP-1 analogue	Both affects CNS and delay gastric emptying	Starting dose: 0.6 mg; increased weekly by 0.6 mg as tolerated to reach 3.0 mg	For 3.0 mg: 5.4%	GI discomfort, nausea, diarrhea

Abbreviations: QD, once a day; BID, twice a day; TID, three times a day.