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20 February 2001 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue is available on the Internet at on January 16, 2001.

What Happened After Patients Stopped Taking Fen-Phen?

Two studies find that after patients stopped taking various combinations of the appetite suppressants dexfenfluramine and phentermine, most heart valve abnormalities that may have developed do not get worse and some improve. Researchers studied 50 patients who had taken various combinations of fenfluramine, dexfenfluramine and phentermine for a mean of 64 weeks and were found to have heart valve regurgitation, or leaking valves (Article, p. 261). At least 100 days after therapy ended, the diseased valves in most patients had improved or remained stable.

Another study comparing overweight people who had taken dexfenfluramine alone for two or three months found that one year after stopping the diet drugs, in some patients with leaking valves, regurgitation diminished and in no cases did it become more serious (Article, p. 267).

An editorial says that these findings are important for physicians considering valve surgery for some patients (Editorial, p. 335). The editorial says that even though large studies, particularly of patients who took the diet drugs for a long time, have not yet been done, the two studies in today’s Annals clarify two important issues: progressive valve disease is uncommon and valve regurgitation may heal itself after the diet drugs are stopped.

Use of Prescription Diet Drugs Widespread and Often Inappropriate

A large survey found that two out of every 100 respondents (2.5 percent) or approximately 4.6 million U.S. adults had taken prescription weight loss pills in 1996 to 1998 (Brief Communication, p. 282). Women, white respondents and Hispanic respondents reported most use. Nearly one quarter of the people who used diet pills were not overweight.

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