Call: FDA panel endorses another weight loss drug
Posted: May 12 in Medical Weight Loss News by Dr. Lazarus
Shortly after recommending approval of Qnexa (Phentermine / Topiramate), the FDA advisory panel this week also voted to approve Arena Pharmaceuticals weight loss drug, Lorgess (Lorcacerin). This medication has been in clinical trials over the past several years and works through the 5HT2c sub-type Seratonin receptor in the brain.
Why is this important? What is 5HT2c? Well, Lorgess is a seratonin agonist – that means it triggers the release of seratonin. Sound familiar? The big hit weight loss drug of the 90’s, Fenfluramine worked as a seratonin agonist as well. That was when it was discovered that we had seratonin receptors in lots of places, not just our brains. In fact, we have a seratonin receptor in heart valves. That’s why Fenfluramine caused heart valve damage.
Fast forward to 2012. We now have the technology to target specific seratonin receptors. By targeting the 5HT2c receptor, Arena Pharmaceuticals has been able to develop a medication that targets only the brain, with little to no activity in the heart. They have done careful safety studies, and have proven that their new obesity drug is both safe and effective.
The FDA panel is scheduled to vote on Qnexa on July 17th, and on Lorgess on June 27th, but they are under no obligations to follow their advisory panel’s advice.
So, will 2012 be the first year in 13 years that we get a new obesity treatment? Stay tuned…
Several years ago I was a client of CNC…the program worked great for me! Last year I was diagnosed with papillary cancer of the thyriod. After the thyroidectomy they discovered I had both papillary and medullary cancer. Since then I have been diagnosed with subclinical cushings syndrome caused by the medullary cancer that is still present in my neck…just too small to be seen by imaging at this time. Currently I am on synthroid 125 mcg and ketaconazole 1200 mg…my question is would the newer weight loss drugs work for me…i.e., can I take them with the “issues” I told you about. I would like to lose 15-18 lbs.
Thank you,
Betty
Hi Betty –
There would be no contraindication to using Phentermine, Topiramate, Wellbutrin, Naltrexone, Tenuate or Lorgess for an individual who has been through what you have and is on your medications. There is a ‘relative’ contraindication with using the stimulants in conjunction with Synthroid; however, we commonly do this with specific instruction and monitoring. Keep in mind that Lorgess, QNexa and Contrave have not yet been approved; however, we can continue to use Phentermine, Tenuate, or other combinations with great results.
The medication class that is not safe which is being studied for weight loss are the incretin mimetics – these include Victoza, Byetta and Bydureon – this class of drugs is absolutely contraindicated with a history of thyroid cancer.
Look forward to hearing from you!
I am a 71 year old, female, medullary, thyroid, cancer survivor, and invasive Laub Euler breast cancer survivor. Since my mastectomies and being on the estrogen, inhibitor, my weight has gone up 60 pounds. I am so wanting to get rid of this weight but because of my medical history with medullary thyroid cancer, my options are limited. I am most interested to learn what new drugs are on the horizon, that would be compatible with my medical history.
Well, h/o MTC means the new GLP-1 medications are contra-indicated and cannot be prescribed (Wegovy, Saxenda, Mounjaro, Ozempic, Rybelsus). However, still a good candidate for all of the FDA-approved oral therapies – why not set up a visit with an ABOM – certified obesity medicine physician to review these options? Further, assuming on Medicare, Medicare does not allow use of medications for weight loss, so you are on your own with regards to cost – this makes the oral options appealing as they are very affordable. You could ask your doctor if your are a good fit for phentermine, tenuate (diethylpropion), Qsymia, or Contrave.