Systematic review and meta-analysis of the efficacy and safety of amfepramone and mazindol as a monotherapy for the treatment of obese or overweight patients

The aim of this study was to evaluate efficacy and safety of amfepramone, fenproporex and mazindol as a monotherapy for the treatment of obese or overweight patients. A systematic review of primary studies was conducted, followed by a direct meta-analysis (random effect) and mixed treatment comparison. Medline and other databases were searched. Heterogeneity was explored through I2 associated with a p-value. Of 739 identified publications, 25 were included in the meta-analysis. The global evaluation of Cochrane resulted in 19 studies with a high level of bias and six with unclear risk. Due to the lack of information in primary studies, direct meta-analyses were conducted only for amfepramone and mazindol. Compared to placebo, amfepramone resulted in higher weight loss in the short-term (<180 days; mean difference (MD) -1.281 kg; p<0.05; I2: 0.0%; p=0.379) and long-term (≥180 days; MD -6.518 kg; p<0.05; I2: 0.0%; p=0.719). Only studies with long-term follow up reported efficacy in terms of abdominal circumference and 5-10% weight reduction. These results corroborated the finding that the efficacy of amfepramone is greater than that of placebo. Treatment with mazindol showed greater short-term weight loss than that with placebo (MD -1.721 kg; p<0.05; I2: 0.9%; p=0.388). However, metabolic outcomes were poorly described, preventing a meta-analysis. A mixed treatment comparison corroborated the direct meta-analysis. Considering the high level of risk of bias and the absence of important published outcomes for anti-obesity therapy assessments, this study found that the evaluated drugs showed poor evidence of efficacy in the treatment of overweight and obese patients. Robust safety data were not identified to suggest changes in their regulatory status.

Effects of sumpathomimetic anorexigenic agent [fenfluramine] on some hepatic, haematological and thyroid functions in rabbits

Fenfluramine is a sympathomimetic-anorexigenic amphetamine derivative. Fentluramine may affect variable body systems during continuous use. No data as regard the influence of fenfluramine on ferrokinetics and hence this necessitates a proper line of investigation. This study was performed on 40 male Rabbits, divided into two groups; group I for studying liver functions,% saturation of transferrin, and some haematological parameters, group II for studying thyroid functions and radio-active 58Fe ferrokinetics. The results had shown that: 1. The chemical had led to significant decrease in liver functions and in serum iron. 2. No significant change was shown in the haematological parameters. 3. There was significant decrease in radio-iron in the plasma. 4. There was significant increase in T3 and T4. Thus the drug might have a deleterious effect on ferrokinetics, liver cells and thyroid gland therefore, it should be used cautiously