Evidence map›Paper›PMID 22448619›Full record

ReviewClinical pharmacokinetics2012

Impact of obesity on drug metabolism and elimination in adults and children.

Margreke J E Brill, Jeroen Diepstraten, Anne van Rongen, Simone van Kralingen, John N van den Anker, Catherijne A J Knibbe

Abstract readReview
PubMed Publisher
In one paragraph

Review in Clinical pharmacokinetics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 178 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
178citing papers in PubMed, 7 pooled it
27.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

178 citing papers in PubMed, 7 syntheses or guidelines pooled it, 371 citations in OpenAlex.

  1. Therapeutic Enoxaparin Dosing in Obesity.The Annals of pharmacotherapy · 2025
    Pooled it
  2. Updated antimicrobial dosing recommendations for obese patients.Antimicrobial agents and chemotherapy · 2024
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Trial
  9. Trial
  10. Visceral Adiposity and Progression of ADPKD: A Cohort Study of Patients From the TEMPO 3:4 Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024
    Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Implications for IV posaconazole dosing in the era of obesity.The Journal of antimicrobial chemotherapy · 2020
    Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

118 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Margreke J E BrillDepartment of Clinical Pharmacy, St Antonius Hospital, Nieuwegein, the Netherlands.
Jeroen Diepstraten
Anne van Rongen
Simone van Kralingen
John N van den Anker
Catherijne A J Knibbe
St. Antonius Ziekenhuis · NLCentre for Human Drug Research · NLErasmus MC - Sophia Children’s Hospital · NLSint Lucas Andreas Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The prevalence of obesity in adults and children is rapidly increasing across the world. Several general (patho)physiological alterations associated with obesity have been described, but the specific impact of these alterations on drug metabolism and elimination and its consequences for drug dosing remains largely unknown. In order to broaden our knowledge of this area, we have reviewed and summarized clinical studies that reported clearance values of drugs in both obese and non-obese patients. Studies were classified according to their most important metabolic or elimination pathway. This resulted in a structured review of the impact of obesity on metabolic and elimination processes, including phase I metabolism, phase II metabolism, liver blood flow, glomerular filtration and tubular processes. This literature study shows that the influence of obesity on drug metabolism and elimination greatly differs per specific metabolic or elimination pathway. Clearance of cytochrome P450 (CYP) 3A4 substrates is lower in obese as compared with non-obese patients. In contrast, clearance of drugs primarily metabolized by uridine diphosphate glucuronosyltransferase (UGT), glomerular filtration and/or tubular-mediated mechanisms, xanthine oxidase, N-acetyltransferase or CYP2E1 appears higher in obese versus non-obese patients. Additionally, in obese patients, trends indicating higher clearance values were seen for drugs metabolized via CYP1A2, CYP2C9, CYP2C19 and CYP2D6, while studies on high-extraction-ratio drugs showed somewhat inconclusive results. Very limited information is available in obese children, which prevents a direct comparison between data obtained in obese children and obese adults. Future clinical studies, especially in children, adolescents and morbidly obese individuals, are needed to extend our knowledge in this clinically important area of adult and paediatric clinical pharmacology.

Indexed as

PharmacokineticsAdolescentAdultAge FactorsChildClinical Trials as TopicCytochrome P-450 Enzyme SystemGlomerular Filtration RateHumansLiverObesityPharmaceutical PreparationsCytochrome P-450 Enzyme SystemPharmaceutical Preparations

Identifiers

PMID22448619
OpenAlexW2158282974

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.