Seyedeh Narjes Roudbaraki, Mostafa Salimi, Sina Esmailpour, Farzaneh Mohammadi
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A fixed-effects meta-analysis was performed.</p><p><strong>Results: </strong>Four RCTs (n = 444 participants) met inclusion criteria. Meta-analysis of three studies indicated NB did not significantly reduce binge eating frequency compared to controls (Mean Difference [MD] - 1.49, 95% CI - 3.63 to 0.64, p = 0.17). However, NB significantly reduced weight (MD -3.57 kg, 95% CI - 4.86 to - 2.27, p < 0.001) and BMI (MD - 1.24 kg/m<sup>2</sup>, 95% CI - 1.79 to - 0.70, p < 0.001). The certainty of evidence was assessed as moderate for binge frequency and low for weight and BMI outcomes.</p><p><strong>Conclusion: </strong>NB aids weight reduction in adults with BED, but current evidence is insufficient to confirm its efficacy for reducing binge eating frequency. 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引用次数: 0
摘要
目的：暴食症（BED）是一种普遍的疾病，但循证治疗方法有限。纳曲酮和安非他酮联合（NB）靶向与BED相关的神经生物学途径。本文的目的是通过系统回顾和荟萃分析来评估NB对成人BED的疗效。方法：根据PRISMA指南，我们检索了主要数据库和试验注册中心（截至2025年2月），以比较NB与安慰剂或常规治疗对成人BED的影响。主要结果是暴食频率；次要结果包括体重减轻和BMI。评估偏倚风险（ROB2）和证据确定性（GRADE）。进行固定效应荟萃分析。结果：4项rct （n = 444名受试者）符合纳入标准。三项研究的荟萃分析表明，与对照组相比，NB没有显著减少暴食频率（平均差异[MD] - 1.49, 95% CI - 3.63至0.64,p = 0.17）。然而，NB显著降低体重（MD -3.57 kg, 95% CI - 4.86至- 2.27,p = 2, 95% CI - 1.79至- 0.70,p）。结论：NB有助于减轻BED成人患者的体重，但目前的证据不足以证实其对减少暴食频率的有效性。进一步的高质量随机对照试验是必要的。证据等级：一级，系统评价和荟萃分析。
Efficacy of naltrexone and bupropion combination in patients with binge eating disorder: a systematic review and meta-analysis.
Purpose: Binge Eating Disorder (BED) is a prevalent condition with limited evidence-based treatments. Naltrexone and Bupropion Combination (NB) targets neurobiological pathways implicated in BED. The Objective of this paper is to evaluate the efficacy of NB for BED in adults through a systematic review and meta-analysis.
Methods: Following PRISMA guidelines, we searched major databases and trial registries (up to Feb 2025) for randomized controlled trials (RCTs) comparing NB to placebo or usual care in adults with BED. The primary outcome was binge eating frequency; secondary outcomes included weight loss and BMI. Risk of bias (ROB2) and certainty of evidence (GRADE) were assessed. A fixed-effects meta-analysis was performed.
Results: Four RCTs (n = 444 participants) met inclusion criteria. Meta-analysis of three studies indicated NB did not significantly reduce binge eating frequency compared to controls (Mean Difference [MD] - 1.49, 95% CI - 3.63 to 0.64, p = 0.17). However, NB significantly reduced weight (MD -3.57 kg, 95% CI - 4.86 to - 2.27, p < 0.001) and BMI (MD - 1.24 kg/m2, 95% CI - 1.79 to - 0.70, p < 0.001). The certainty of evidence was assessed as moderate for binge frequency and low for weight and BMI outcomes.
Conclusion: NB aids weight reduction in adults with BED, but current evidence is insufficient to confirm its efficacy for reducing binge eating frequency. Further high-quality RCTs are warranted.
Level of evidence: Level I, systematic reviews and meta-analyses.
期刊介绍：
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.
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