催产素鼻喷雾剂治疗暴食症和肥胖症:一项先导、随机、双盲试验

R. Agabio, Anna Maria Giulia Farci, Olga Curreli, Raffaele Deidda, S. Mercuro, Romina Naitana, A. Restivo, E. Tronci, G. Gessa, M. R. Melis
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引用次数: 12

摘要

临床前研究表明,神经肽催产素可以减少食物摄入和体重,但只有少数临床研究调查了这些发现在人类中的可翻译性。本研究探讨了催产素鼻喷雾剂对暴饮暴食症和肥胖症患者的安全性和有效性。方法17例暴食症合并肥胖症门诊患者参加为期8周的双盲试验,并给予催产素治疗(n=8;24 IU,一天四次,每餐前20分钟,睡前服用)或安慰剂(n=9)搭配能量限制饮食。主要结局包括不良事件和每周暴食发作次数。次要测量包括体重、身体质量指数、BED的严重程度、对食物的渴望、睡眠质量、生活质量、焦虑和抑郁症状。结果1例催产素组患者在第一次随机化后疗效测量前提前终止试验。在其他16名参与者中,13名(81.2%)完成了试验,3名(18.8%)停止了试验[催产素组3名;安慰剂组为0 (p=0.0625, Fisher精确检验)。在评估的任何结果中,两组间均未发现显著差异。在一些次要结果中,安慰剂组患者的表现略好于催产素组患者,但这些差异并不显著。结论催产素鼻喷雾剂对育龄妇女是安全的,但对患有暴食症和肥胖症的门诊患者每周暴食发作次数没有显著减少。这些发现是根据人类催产素文献进行讨论的。
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Oxytocin Nasal Spray in the Treatment of Binge Eating Disorder and Obesity: A Pilot, Randomized, Double-Blind Trial
Background Preclinical studies suggest that the neuropeptide oxytocin reduces food intake and body weight, but only a few clinical studies have investigated the translatability of these findings in humans. The present study investigated the safety and efficacy of oxytocin nasal spray in patients affected by binge eating disorder and obesity. Methods Seventeen outpatients affected by binge eating disorder and obesity participated in a 8 week double-blind trial and received oxytocin (n=8; 24 IU, four times a day, 20 min before each of three meals and before going to bed) or placebo (n=9) with an energy-restricted diet. Primary outcomes included adverse events and the number of binge eating episodes per week. Secondary measures included body weight, BMI, severity of BED, craving for food, quality of sleep, quality of life, anxiety, and depressive symptoms. Results One patient of oxytocin group discontinued prematurely the trial before the first post-randomization efficacy measure. Among the other 16 participants, 13 (81.2%) completed the trial, and 3 (18.8%) discontinued [3 in the oxytocin group; 0 in the placebo group (p=0.0625, Fisher’s exact test)]. No significant difference between groups was found in any outcome evaluated. Patients of the placebo group performed slightly better than patients of the oxytocin group in some secondary outcomes, but these differences were not significant. Conclusion Oxytocin nasal spray resulted to be safe, including in women of childbearing age but did not significantly reduce the number of binge eating episodes per week in outpatients affected by binge eating disorder and obesity. These findings are discussed in light of the human oxytocin literature.
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