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Table 2 Summary comparison of post-marketing withdrawal patterns of centrally acting anti-obesity medicinal products

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

Primary mode of action at receptor ending

Primary reason for withdrawal

Median interval between launch and first ADR report

Median interval between first ADR report and withdrawal

Statistical comparisonsa

Neurotransmitter re-uptake inhibition (n = 8)

Cardiotoxicity: n = 7

Drug misuse: n = 1

5.5 years (IQR = 1.3 to 13.3 years

1 year (IQR = 0 to 12 years)

Withdrawal due to cardiotoxicity significantly more likely vs neurotransmitter releasers (P = 0.0004)

Neurotransmitter release (n = 14)

Cardiotoxicity: n = 1

Drug abuse or dependence: n = 12

Hemorrhagic stroke: n = 1

17.5 years (IQR = 5.8 to 28 years)

5 years (IQR = 2 to 16.3 years)

Withdrawal due to drug misuse significantly more likely vs neurotransmitter re-uptake inhibitors (P = 0.002)

  1. One centrally acting product, rimonabant, has been excluded from the comparisons because it is an antagonist and inverse agonist at cannabinoid C1 receptors
  2. aUsing Fisher’s exact test; there was no significant difference between groups for proportion of psychiatric disturbances (P = 1.000)
  3. ADR adverse drug reaction, IQR interquartile range