市販後に分かる薬の安全性と最近の撤退薬  7.Fenfluramine/Dexfenfluramineと心臓弁膜症について

書誌事項

タイトル別名
  • 7. Fenfluramine / Dexfenfluramine and Valvulopathies

抄録

Obesity precipitates diabetes and hypertension and other known risk factors of cardiovascular diseases and stroke. Calorie control, exercise and lifestyle changes are recommended to achieve and maintain an appropriate BMI but drug therapy may also be one of the options for refractory cases. Fenfluramine marketed in 1973 and dexfenfluramine approved in 1996 were appetite-suppressant drugs widely used with phentermine (“fen-phen” or “dexfen-phen”) in the U.S.A. and other countries. They were withdrawn in September 1997 after case reports of cardiac valve abnormalities likely induced by these drugs. In many of these cases, the valvulopathies followed the long-term use, often for cosmetic purposes, even though the long-term safety was not established for these drugs. After the withdrawal, some observational studies, including an ad-hoc study of a clinical trial disrupted by safety concern, were conducted and many of them concluded that fenfluramine or dexfenfluramine increased the risk of cardiac valve abnormalities. In the study by Khan et al., the prevalence of valvulopathies was as high as 22.7% in the users of appetite suppressants compared with 1.3% in the control group, indicating that the withdrawal of fenfluramine and dexfenfluramine was the right decision. It is important to note that a serious non-rare adverse drug reaction like appetite suppressant-related valvulopathies may go unrecognized for more than 20 years. Post-marketing observational studies are valuable especially to evaluate administrative decisions, such as withdrawal, made sometimes without sufficient information.

収録刊行物

  • 臨床薬理

    臨床薬理 40 (1), 41-46, 2009

    一般社団法人 日本臨床薬理学会

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詳細情報 詳細情報について

  • CRID
    1390282680345645824
  • NII論文ID
    130004541288
  • DOI
    10.3999/jscpt.40.41
  • ISSN
    18828272
    03881601
  • 本文言語コード
    ja
  • データソース種別
    • JaLC
    • Crossref
    • CiNii Articles
  • 抄録ライセンスフラグ
    使用不可

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