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Setmelanotide (Imcivree°) in certain, very rare, genetic forms of obesity: possibly helpful

  Marketing Authorisations  Evaluation of setmelanotide in the very rare patients with obesity due to POMC, PCSK1 or LEPR mutations is only based on two non-comparative trials, in a total of 30 patients treated for one year. These trials suggest that daily subcutaneous injections of setmelanotide help patients feel less hungry, and consequently lose weight, especially those with POMC deficiency.
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  • Biallelic POMC, PCSK1 or LEPR deficiency (i.e. due to mutations in both alleles of the gene in question) leads to insufficient MC4R activation, resulting in unrelenting hunger, hyperphagia and a constant urge to seek out food.
     
  • Setmelanotide is an MC4R agonist. According to the limited data available in mid-2022, setmelanotide's main adverse effects are skin hyperpigmentation, injection-site reactions, gastrointestinal and sexual disorders, and depression.

©Prescrire 1 January 2023

Source: "Setmelanotide (Imcivree°) in certain, very rare, genetic forms of obesity" Prescrire International 2023; 32 (244): 9-11. Subscribers only.

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