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Article: Rise in antiobesity drug prescribing for children and adolescents in the UK: A population-based study

TitleRise in antiobesity drug prescribing for children and adolescents in the UK: A population-based study
Authors
Issue Date2009
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/BJCP
Citation
British Journal Of Clinical Pharmacology, 2009, v. 68 n. 6, p. 844-851 How to Cite?
AbstractWhat is already known about this subject • The antiobesity drugs sibutramine and orlistat are not licensed for use in children and adolescents in the UK or USA. • Clinical trials suggest antiobesity drugs are effective and well-tolerated in obese adolescents. What this study adds • Prescribing of unlicensed antiobesity drugs in children and adolescents has increased significantly in the past 8 years. • Most prescribed antiobesity drugs in children and adolescents are rapidly discontinued before patients can see clinical benefit, suggesting they are poorly tolerated or poorly efficacious. Aims The international childhood obesity epidemic has driven increased use of unlicensed antiobesity drugs, whose efficacy and safety are poorly studied in children and adolescents. We investigated the use of unlicensed antiobesity drugs (orlistat, sibutramine and rimonabant) in children and adolescents (0-18 years) in the UK. Methods Population-based prescribing data from the UK General Practice Research Database between 1 January 1999 and 31 December 2006. Results A total of 452 subjects received 1334 prescriptions during the study period. The annual prevalence of antiobesity drug prescriptions rose significantly from 0.006 per 1000 [95% confidence interval (CI) 0.0007, 0.0113] in 1999 to 0.091 per 1000 (95% CI 0.07, 0.11) in 2006, a 15-fold increase, with similar increases seen in both genders. The majority of prescriptions were made to those ≥14 years old, although 25 prescriptions were made for children <12 years old. Orlistat accounted for 78.4% of all prescriptions; only one patient was prescribed rimonabant. However, approximately 45% of the patients ceased orlistat and 25% ceased sibutramine after only 1 month. The estimated mean treatment durations for orlistat and sibutramine were 3 and 4 months, respectively. Conclusions Prescribing of unlicensed antiobesity drugs in children and adolescents has dramatically increased in the past 8 years. The majority are rapidly discontinued before patients can see weight benefit, suggesting they are poorly tolerated or poorly efficacious when used in the general population. Further research into the effectiveness and safety of antiobesity drugs in clinical populations of children and adolescents is needed. © 2009 The British Pharmacological Society.
Persistent Identifierhttp://hdl.handle.net/10722/171387
ISSN
2015 Impact Factor: 3.83
2015 SCImago Journal Rankings: 1.486
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorViner, RMen_US
dc.contributor.authorHsia, Yen_US
dc.contributor.authorNeubert, Aen_US
dc.contributor.authorWong, ICKen_US
dc.date.accessioned2012-10-30T06:13:47Z-
dc.date.available2012-10-30T06:13:47Z-
dc.date.issued2009en_US
dc.identifier.citationBritish Journal Of Clinical Pharmacology, 2009, v. 68 n. 6, p. 844-851en_US
dc.identifier.issn0306-5251en_US
dc.identifier.urihttp://hdl.handle.net/10722/171387-
dc.description.abstractWhat is already known about this subject • The antiobesity drugs sibutramine and orlistat are not licensed for use in children and adolescents in the UK or USA. • Clinical trials suggest antiobesity drugs are effective and well-tolerated in obese adolescents. What this study adds • Prescribing of unlicensed antiobesity drugs in children and adolescents has increased significantly in the past 8 years. • Most prescribed antiobesity drugs in children and adolescents are rapidly discontinued before patients can see clinical benefit, suggesting they are poorly tolerated or poorly efficacious. Aims The international childhood obesity epidemic has driven increased use of unlicensed antiobesity drugs, whose efficacy and safety are poorly studied in children and adolescents. We investigated the use of unlicensed antiobesity drugs (orlistat, sibutramine and rimonabant) in children and adolescents (0-18 years) in the UK. Methods Population-based prescribing data from the UK General Practice Research Database between 1 January 1999 and 31 December 2006. Results A total of 452 subjects received 1334 prescriptions during the study period. The annual prevalence of antiobesity drug prescriptions rose significantly from 0.006 per 1000 [95% confidence interval (CI) 0.0007, 0.0113] in 1999 to 0.091 per 1000 (95% CI 0.07, 0.11) in 2006, a 15-fold increase, with similar increases seen in both genders. The majority of prescriptions were made to those ≥14 years old, although 25 prescriptions were made for children <12 years old. Orlistat accounted for 78.4% of all prescriptions; only one patient was prescribed rimonabant. However, approximately 45% of the patients ceased orlistat and 25% ceased sibutramine after only 1 month. The estimated mean treatment durations for orlistat and sibutramine were 3 and 4 months, respectively. Conclusions Prescribing of unlicensed antiobesity drugs in children and adolescents has dramatically increased in the past 8 years. The majority are rapidly discontinued before patients can see weight benefit, suggesting they are poorly tolerated or poorly efficacious when used in the general population. Further research into the effectiveness and safety of antiobesity drugs in clinical populations of children and adolescents is needed. © 2009 The British Pharmacological Society.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/BJCPen_US
dc.relation.ispartofBritish Journal of Clinical Pharmacologyen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAge Distributionen_US
dc.subject.meshAnti-Obesity Agents - Therapeutic Useen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCyclobutanes - Therapeutic Useen_US
dc.subject.meshDrug Prescriptions - Statistics & Numerical Dataen_US
dc.subject.meshDrug Utilization - Legislation & Jurisprudence - Trendsen_US
dc.subject.meshDrugs, Investigational - Therapeutic Useen_US
dc.subject.meshFemaleen_US
dc.subject.meshGreat Britain - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshLactones - Therapeutic Useen_US
dc.subject.meshLegislation, Drug - Statistics & Numerical Dataen_US
dc.subject.meshMaleen_US
dc.subject.meshObesity - Drug Therapy - Epidemiologyen_US
dc.subject.meshPhysician's Practice Patterns - Legislation & Jurisprudence - Statistics & Numerical Data - Trendsen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleRise in antiobesity drug prescribing for children and adolescents in the UK: A population-based studyen_US
dc.typeArticleen_US
dc.identifier.emailWong, ICK:wongick@hku.hken_US
dc.identifier.authorityWong, ICK=rp01480en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1365-2125.2009.03528.xen_US
dc.identifier.pmid20002078-
dc.identifier.scopuseid_2-s2.0-70350167188en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-70350167188&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume68en_US
dc.identifier.issue6en_US
dc.identifier.spage844en_US
dc.identifier.epage851en_US
dc.identifier.isiWOS:000272171000005-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridViner, RM=7005899067en_US
dc.identifier.scopusauthoridHsia, Y=35068032100en_US
dc.identifier.scopusauthoridNeubert, A=7003774960en_US
dc.identifier.scopusauthoridWong, ICK=7102513915en_US
dc.identifier.citeulike6253408-

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