Evidence map›Paper›PMID 27894343›Full record

SynthesisBMC medicine2016

Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.

Igho J Onakpoya, Carl J Heneghan, Jeffrey K Aronson

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
73citing papers in PubMed, 2 pooled it
14.4field-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

73 citing papers in PubMed, 2 syntheses or guidelines pooled it, 167 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Survodutide for Obesity in Chinese Adults: Phase 3 Randomized Trial Design and Baseline Characteristics (SYNCHRONIZE™-CN).Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
    Article
  5. Review
  6. Observational
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Evolving Approaches for Pharmacological Therapy of Obesity.Annual review of pharmacology and toxicology · 2025
    Review
  16. Article
  17. Article
  18. In Vitro Models for Peripheral Nerve Regeneration.Advanced healthcare materials · 2024
    Review
  19. Article
  20. Article

13 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

3 authors at 1 institution in 1 country.

Igho J OnakpoyaNuffield Department of Primary Care Health Sciences, University of Oxford, Centre for Evidence-Based Medicine, Gibson Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK. igho.onakpoya@kellogg.ox.ac.uk.
Carl J HeneghanNuffield Department of Primary Care Health Sciences, University of Oxford, Centre for Evidence-Based Medicine, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford, UK.
Jeffrey K AronsonNuffield Department of Primary Care Health Sciences, University of Oxford, Centre for Evidence-Based Medicine, Gibson Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK.
University of Oxford · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundWe identified anti-obesity medications withdrawn since 1950 because of adverse drug reactions after regulatory approval, and examined the evidence used to support such withdrawals, investigated the mechanisms of the adverse reactions, and explored the trends over time.

methodsWe conducted searches in PubMed, the World Health Organization database of drugs, the websites of drug regulatory authorities, and selected full texts, and we hand searched references in retrieved documents. We included anti-obesity medications that were withdrawn between 1950 and December 2015 and assessed the levels of evidence used for making withdrawal decisions using the Oxford Centre for Evidence-Based Medicine criteria.

resultsWe identified 25 anti-obesity medications withdrawn between 1964 and 2009; 23 of these were centrally acting, via monoamine neurotransmitters. Case reports were cited as evidence for withdrawal in 80% of instances. Psychiatric disturbances, cardiotoxicity (mainly attributable to re-uptake inhibitors), and drug abuse or dependence (mainly attributable to neurotransmitter releasing agents) together accounted for 83% of withdrawals. Deaths were reportedly associated with seven products (28%). In almost half of the cases, the withdrawals occurred within 2 years of the first report of an adverse reaction.

conclusionsMost of the drugs that affect monoamine neurotransmitters licensed for the treatment of obesity over the past 65 years have been withdrawn because of adverse reactions. The reasons for withdrawal raise concerns about the wisdom of using pharmacological agents that target monoamine neurotransmitters in managing obesity. Greater transparency in the assessment of harms from anti-obesity medications is therefore warranted.

Indexed as

Drug-Related Side Effects and Adverse ReactionsHumansObesityProduct Surveillance, PostmarketingSafety-Based Drug WithdrawalsAdverse drug reactionDrug withdrawalObesitySystematic review

Identifiers

PMID27894343
PMCPMC5126837
OpenAlexW2551793627

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.