Rimonabant leads to modest weight loss, Cochrane review concludes
Use of rimonabant for one year could produce moderate weight loss of
about 5 per cent, according to a Cochrane review of the anti-obesity
drug, which was launched in the UK earlier this year (PJ, 1 July, p8).
However, the review, published online on 18 October,
concludes that more rigorous studies are needed to evaluate fully the
benefit/risk ratio of rimonabant.
The reviewers analysed four studies involving 6,625 overweight or obese
people who received either rimonabant 20mg (the licensed dose) or rimonabant
5mg or placebo, in combination with a low-calorie diet. Compared with
placebo, rimonabant 20mg produced a reduction in mean weight of 4.9kg
and a reduction in waist circumference of 3.8cm at one year (both P<0.0001).
Positive changes in high-density lipoprotein, triglycerides and blood
pressure were also seen. However, patients treated with rimonabant 20mg
had a 37 per cent increased likelihood of experiencing serious adverse
effects.
The lower dose of rimonabant produced a reduction in mean weight of 1.3kg
greater than placebo and a reduction in waist circumference of 1.2cm
(both P<0.0001). No clinically relevant effects on plasma lipids or
blood pressure were observed in patients who received rimonabant 5mg.
The reviewers detected deficiencies in the methodology of the studies
included in their review. There was a high drop-out rate of about 40
per cent in all studies, which may have led to considerable bias being
introduced into the results, they say. They also highlight that all studies
were sponsored by the manufacturer of the drug.
In conclusion, the reviewers acknowledge that even modest weight loss
may be beneficial, but suggest that studies with longer follow-up and
more rigour in the methodology should be done before definitive recommendations
can be made regarding the role of this medicine in the management of
obese patients. |
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