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Fenfluramine-Phentermine is Associated with an Increase in Cellular Proliferation Ex Vivo and In Vitro.
J Heart Valve Dis
July 2017
Division of Biochemistry and Molecular Biology, Mayo Clinic and Mayo Foundation, Rochester, MN, USA.
Background And Aim Of The Study: Fenfluraminephentermine (FenPhen) has been implicated in accelerated valvular heart disease, characterized by valvular regurgitation and thickening, and resembling the histopathologic lesions found in carcinoid. The study aim was to determine whether cellular proliferation is present in FenPhen-exposed valves, by utilizing an in-vitro model to test whether FenPhen has a direct mitogenic effect on cardiac valvular cells, as compared to serotonin.
Methods: Ex-vivo valves were tested for proliferation in surgically removed FenPhen-exposed valves (n = 10) and compared to proliferation levels in normal human cardiac valves removed at autopsy (n = 10).
Diet medications and valvular heart disease: the current evidence.
Spec Care Dentist
December 2002
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.
Since 1997, the appetite suppressant drugs fenfluramine-phentermine (fen-phen) and dexfenfluramine have been associated with the development of valvular heart disease. As a result, the drugs have been withdrawn from the market and interim recommendations for evaluation and treatment of exposed patients were issued. However, subsequent studies showed lower prevalence rates for valve abnormalities than were initially reported, and the possibility of such drug-induced lesions resolving has been raised.
View Article and Find Full Text PDFDose and duration of fenfluramine-phentermine therapy impacts the risk of significant valvular heart disease.
Am J Cardiol
July 2000
Heart Center of Los Angeles, Los Angeles, California, USA.
Characterization of phentermine and related compounds as monoamine oxidase (MAO) inhibitors.
Biochem Pharmacol
June 2000
Department of Pharmacology and Clinical Pharmacology, Uludag University Medical School, Bursa, Turkey.
Phentermine was shown in the 1970s to inhibit the metabolism of serotonin by monoamine oxidase (MAO), but never was labeled as an MAO inhibitor; hence, it was widely used in combination with fenfluramine, and continues to be used, in violation of their labels, with other serotonin uptake blockers. We examined the effects of phentermine and several other unlabeled MAO inhibitors on MAO activities in rat lung, brain, and liver, and also the interactions of such drugs when administered together. Rat tissues were assayed for MAO-A and -B, using serotonin and beta-phenylethylamine as substrates.
View Article and Find Full Text PDFDose-effect of fenfluramine use on the severity of valvular heart disease among fen-phen patients with valvulopathy.
Int J Obes Relat Metab Disord
September 1999
Epidemic Intelligence Service, Epidemiology Program Office and Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.
Objective: To determine whether the severity of valvulopathy was associated with the dosage of fenfluramine taken by fenfluramine-phentermine users with valvulopathy.
Design: Out of 105 suspected valvulopathy case reports received by the US Food and Drug Administration (FDA) among fenfluramine-phentermine users, 74 patients meeting FDA case definition for valvulopathy were included in this study. Patients with severe valvulopathy were classified as those either undergoing valve replacement surgery or having severe aortic or mitral regurgitation; all other patients were considered to have less severe valvulopathy.
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