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MORE ON DIET PILLS AND VALVULAR DISEASE.

The August 1, 1997 Journal Watch included a prepublication report of a study on valvular heart disease associated with the diet drugs fenfluramine and phentermine. The original article appears in the August 28, 1997 New England Journal of Medicine, along with the following three related reports.

A letter to the editor describes 28 additional cases reported to the FDA during the past two months. These patients took fenfluramine-phentermine for an average of 10 months before the diagnosis of cardiac valvular disease. Most patients developed symptomatic congestive heart failure and had two or more affected valves (usually the mitral and aortic). Another letter describes a 32-year old woman who developed symptomatic mitral, aortic, and tricuspid regurgitation after taking dexfenfluramine for 10 months. And finally, an article reports on a 29-year old woman who developed fatal primary pulmonary hypertension after taking fenfluramine-phentermine for only 23 days.

Comment: These cases add to the evidence that anorectic drugs are associated with serious cardiovascular disease. Although the incidence of these complications is unclear, an editorialist argues that we should "demand a moratorium on the use of anorectic drugs for the purpose of cosmetic weight loss."

— AS Brett

Published in Journal Watch General Medicine September 5, 1997

Citation(s):

Connolly HM et al. Valvular heart disease associated with fenfluramine-phentermine. N Engl J Med 1997 Aug 28 337 581-588.

• Original article (Subscription may be required)
• Medline abstract (Free)

Graham DJ and Green L. Further cases of valvular heart disease associated with fenfluramine-phentermine (letter). N Engl J Med 1997 Aug 28 337 635-635.

• Original article (Subscription may be required)
• Medline abstract (Free)

Cannistra LB et al. Valvular heart disease associated with dexfenfluramine (letter). N Engl J Med 1997 Aug 28 337 636-636.

• Original article (Subscription may be required)
• Medline abstract (Free)

Mark EJ et al. Fatal pulmonary hypertension associated with short-term use of fenfluramine and phentermine. N Engl J Med 1997 Aug 28 337 602-606.

• Original article (Subscription may be required)
• Medline abstract (Free)

Curfman GD. Diet pills redux. N Engl J Med 1997 Aug 28 337 629-630.

• Original article (Subscription may be required)
• Medline abstract (Free)