Orlistat or sibutramines
effectiveness over time averages less then 5% weight loss
Long-term treatment with orlistat or sibutramine results in
weight loss averaging less than 5% of body weight, according to research
presented at the 2003 Annual Meeting of the Society for Clinical Pharmacology
and Therapeutics.
Dr. Raj Padwal from
University of Toronto, Ontario, Canada and colleagues undertook a systematic
review to examine the effectiveness and safety of orlistat and sibutramine for
long-term promotion of weight loss.
In 8 controlled trials
lasting 12 months or more, orlistat produced a mean incremental weight loss
(compared with placebo) of 2.7 kg, the investigators report, or 2.9% of the
initial body weight.
Similarly, in 3
controlled trials, sibutramine provided a 4.3-kg (or 4.6% of baseline body
weight) greater weight loss than did placebo after a year of treatment.
With both drugs, the
percentage of patients achieving < 10% better weight loss than achieved with
placebo was small, the researchers indicate--3% with orlistat and 15% with
sibutramine.
High attrition rates
(33% in the orlistat studies and 48% in the sibutramine studies) hampered the
study quality for both agents, the results indicate.
Dr. Padwal stated that
GI side effects were more common with orlistat treatment, whereas sibutramine
use was associated with small but significant increases in systolic blood
pressure (mean increase, 0.8 mm Hg) and diastolic blood pressure (2.2 mm Hg).
"This is of special concern," he said, "because we would expect blood pressure
to fall with weight loss and because increased blood pressure is what you would
hope to avoid as another cardiovascular risk factor."
Dr. Padwal said that,
given the choice, "I would favor orlistat over sibutramine because of the side
effect profiles. But neither treatment provides impressive weight loss."
Source: Diabetes In Control Dot Com.
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