Weight Loss Drugs Review - Orlistat &
Sibutramine
Weight management and current options in
pharmacotherapy: orlistat and sibutramine.
Chronic obesity is associated with various
cardiovascular disorders, including diabetes, dyslipidemia, and hypertension.
Pharmacotherapy with antiobesity agents is an important management strategy
in conjunction with lifestyle interventions.
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Orlistat & Sibutramine
This article describes the pharmacologic management of obesity,
concentrating on orlistat and sibutramine. Relevant articles were
identified through a MEDLINE search (1966-February 2002) using the
terms obesity, overweight, weight loss, antiobesity drugs, orlistat,
and sibutramine. The search for efficacy trials was limited to randomized
controlled studies of >6 months' duration. Also included in the
review were relevant references cited in the bibliographies of identified
articles, news reports, and the authors' own data.
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Weight Loss Drugs Review - Results
Orlistat reduces fat absorption by inhibiting gastrointestinal lipases.
In randomized, controlled trials of up to 2 years' duration, orlistat
plus a hypocaloric diet produced significantly greater weight loss than
placebo (P < 0.001). In the maintenance phase, patients taking orlistat
had less weight regain than did placebo recipients. The weight reduction
with orlistat was also associated with a significant improvement in control
of cardiovascular risk factors (P < 0.05). Unlike orlistat, sibutramine
works by suppressing appetite; its efficacy, however, was similar to that
of orlistat in the identified clinical trials. Orlistat was associated
primarily with gastrointestinal side effects. Use of orlistat was associated
with minimal drug interactions, except with cyclosporine, with which it
should not be taken. Sibutramine was also well tolerated, although it
may cause dry mouth, anorexia, and insomnia, and should be used with caution
in patients at risk for cardiovascular disease.
Weight Loss Drugs Review Conclusions
Orlistat and sibutramine demonstrated a favorable efficacy and safety
profile in randomized controlled trials. Current evidence supports their
use as adjuncts to lifestyle modifications in the treatment of obesity.
Source: Leung WY, Neil Thomas G, Chan JC,
Tomlinson B. Department of Medicine and Therapeutics, Division of Clinical
Pharmacology, The Chinese University of Hong Kong, The Prince of Wales
Hospital, Shatin, Hong Kong. 2003
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