In 2013 the American Medical Association recognized obesity as a disease state with multiple pathophysiological aspects that require a variety of interventions to advance treatment and prevention 3 and today, this is considered a chronic disease.

According to the World Health Organization, in 2016 alone, more than 1.9 billion adults aged 18 years and older were overweight, of which, more than 650 million were obese, resulting in 39% of men and 40% of women being overweight and 11% of men and 15% of women being obese.

In El Salvador alone, 37.9% of people nationwide are overweight and 27.3% are obese, according to the National Survey of Chronic Non-Communicable Diseases.

New treatment for El Salvador

In view of this panorama and in order to try to lower the high percentages of obesity and overweight, and at the same time continue promoting a healthy life, with a balanced diet, good nutrition, hand in hand with exercise, ISTARIL, the new drug, distributed by Asofarma, arrives in the country, which works as an auxiliary of a reduced calorie diet with increased physical activity for chronic weight management in adult patients.

"The difference between wanting to lose weight and being able to do so lies in people's willpower, and that is why it is extremely important for us to announce that salvadorans now have a new treatment to combat this disease. ISTARIL is aimed at adults who have an initial body mass index of 30 kg/m2 or more (obesity), or 27 kg/m2 or more (overweight) in the presence of at least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus or dyslipidemia", said Dr. Herald Manrique, endocrinologist.

This drug has Phentermine-Topiramate. Phentermine is a sympathomimetic amine with pharmacological activity similar to the prototypical drugs of this class used in obesity, such as amphetamine (d- and d/l-amphetamine). The effect of phentermine on chronic weight management is probably mediated by the release of catecholamines in the hypothalamus, resulting in reduced appetite and decreased food intake, but other metabolic effects may also be involved.

Topiramate, which functions as an appetite suppressant and satiety potentiation, induced by a combination of pharmacological effects including increased gamma-aminobutyric neurotransmitter activity, modulation of voltage-operated ion channels, inhibition of excitatory AMPA/kainite glutamate receptors or inhibition of carbonic anhydrase.

The Phentermine/Topiramate combination has been studied for long-term use.

Dose

According to the specialist, it is recommended to take one tablet in the morning with or without food intake and dosing at night should be avoided due to the possibility of insomnia. "Start treatment with 3.75 mg/23 mg of Phentermine - Topiramate daily for 14 days; then increase to the recommended dosage of 7.5 mg/46 mg of Phentermine Topiramate once daily."

Weight loss evaluation

This assessment should be made after 12 weeks of treatment, as all patients should lose at least 3% of baseline body weight.11 "If the patient has not lost 3% in the 12 weeks, the use of Phentermine-Topiramate should be discontinued or the dose escalated, as clinically significant weight loss is unlikely to be achieved and sustained at the 7.5 mg/46 mg dose of Phentermine-Topiramate.

In addition, when the dose has already been increased, weight loss should be assessed after 12 weeks of additional treatment. If a patient has not lost at least 5% of baseline body weight with 15 mg/92 mg of Phentermine-Topiramate, discontinue the use of Phentermine", concluded Dr. Manrique.

Translated by: A.M