Dr Diana Rucker and colleagues from Canada summarized the long term efficacy of anti-obesity drugs in reducing weight and improving health status.
The team identified trials from Medline, Embase, the Cochrane controlled trials register, the Current Science meta-register of controlled trials, and reference lists of identified articles.
|Rimonabant reduced weight by 5 kg|
|British Medical Journal |
The team searched all data sources from 2002 to 2006.
The team reviewed double blind randomized placebo controlled trials of approved anti-obesity dugs used in adults for 1 year or longer.
The team found 30 trials of 1 to 4 years' duration that met the inclusion criteria.
Of these, 16 trials assessed orlistat in 10,631 participants, 10 assessed the use of sibutramine in 2623 participants, and 4 evaluated rimonabant in 6365 participants.
The team reported that 14 trials were new, and 16 had previously been identified.
Attrition rates averaged between 30% and 40%.
The team noted that, compared with placebo, orlistat reduced weight by 3 kg, sibutramine by 4 kg, and rimonabant by 5 kg.
Patients receiving active drug treatment were significantly more likely to achieve 5% and 10% weight loss thresholds.
The researchers found that orlistat reduced the incidence of diabetes.
Orlistat improved concentrations of total cholesterol and low density lipoprotein cholesterol, blood pressure, and glycemic control in patients with diabetes.
However, the team observed that orlistat increased rates of gastrointestinal side effects. and slightly lowered concentrations of high density lipoprotein.
Sibutramine lowered concentrations of high density lipoprotein cholesterol and triglycerides but raised blood pressure and pulse rate.
The researchers found that rimonabant improved concentrations of high density lipoprotein cholesterol and triglycerides, blood pressure, and glycemic control in patients with diabetes but increased the risk of mood disorders.
Dr Rucker's team concluded, "Orlistat, sibutramine, and rimonabant modestly reduce weight, have differing effects on cardiovascular risk profiles, and have specific adverse effects."