Emerging drugs for the treatment of obesity

ABSTRACT

Introduction: The increasing prevalence of obesity represents a huge threat to public health and the current pharmacological treatment options are limited. Bariatric surgery is by far the most effective treatment for severe obesity, highlighting the urgent need for new and improved drug therapies.

Areas covered: Based on the physiological regulation of energy homeostasis, pharmacological strategies to treat obesity are evaluated with focus on drugs in phase 2 and 3 clinical development. The potential impact of these drugs on current treatment standards and the barriers for development are discussed and set in a historical perspective of previous antiobesity medications.

Expert opinion: The radical effects of bariatric surgery have extended our understanding of the mechanisms controlling appetite and boosted the search for new drug targets in obesity treatment. Accordingly, several compounds targeting the central nervous system and/or periphery are in pipeline for obesity. These drugs should be evaluated over a wide array of end-points; in particular, long-term safety monitoring is necessary as serious adverse events may appear. Combination therapy targeting more than one pathway controlling energy balance might be necessary to achieve substantial weight loss while minimising side effects.

KEYWORDS:

• Energy homeostasis
• weight loss
• antiobesity drugs
• appetite inhibition

Declaration of interest

C Martinussen has received a PhD grant from the Danish Diabetes Academy to study the physiological effects of bariatric surgery. KN Bojsen-Møller has received a postdoc grant from the Danish Council of Independent Research to study the physiological effects of bariatric surgery. MS Svane has received a PhD grant from the University of Copenhagen to study the physiological effects of bariatric surgery. TF Dejgaard has received research support from Novo Nordisk and AstraZeneca and lecture fees from Novo Nordisk. S Madsbad has served on the advisory boards for AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Intarcia Therapeutics, Johnson & Johnson, Merck Sharp & Dohme, Novartis, Novo Nordisk and Sanofi Aventis. S Madsbad has received lecture fees from; AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk and Sanofi Aventis; and a research grant from Novo Nordisk. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper is not funded.