Comparison of the effect of orlistat vs orlistat plus metformin on weight loss and insulin resistance in obese women

Sarı, Ramazan; Balcı, Mustafa Kemal; Çoban, Erkan; Yazicioglu, G.

doi:10.1038/sj.ijo.0802707

Cited by 19 publications

(16 citation statements)

References 31 publications

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“…However, significant difference was not noted between combination of sibutramine with orlistat and sibutramine alone [37]. Recently, we reported that the combination of metformin with orlistat did not induce further weight loss or reduction in HOMA-IR when compared to treatment of orlistat alone [38]. Similarly, combination of sibutramine and metformin therapy during the 12 months did not significantly induce greater weight loss, reduction in insulin resistance, serum leptin and serum hsCRP levels when compared to sibutramine alone in present study.…”

Section: Discussionmentioning

confidence: 93%

Comparison of the effects of sibutramine versus sibutramine plus metformin in obese women

et al. 2009

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Sibutramine and metformin are drugs commonly used to obtain weight loss. We aimed to compare the effects of sibutramine alone with that of sibutramine plus metformin combination on weight loss, insulin sensitivity, leptin and C reactive protein in obese women. Seventy obese women were included. After a diet period of month (baseline), each individual was randomly assigned to receive 15 mg sibutramine (sibutramine group; n = 36) or 15 mg sibutramine plus 1,700 mg metformin per day (sibutramine plus metformin group; n = 34) during the next 12 months. Body weight, insulin resistance by the homeostasis model assessment model (HOMA-IR), leptin and C reactive protein were measured at baseline, after 3 months and after 12 months. Mean weight losses in sibutramine and sibutramine plus metformin groups were 5.3 +/- 4.0% (P < 0.001) and 6.8 +/- 3.9% (P < 0.001) after 3 months, and 10.5 +/- 4.4% (P < 0.001) and 15.7 +/- 4.6% (P = 0.007) after 12 months, respectively. HOMA-IR value also decreased in both sibutramine (P = 0.045 and P = 0.002) and sibutramine plus metformin groups (P = 0.04 and P = 0.015) after 3 and 12 months, respectively. Similarly, serum leptin levels decreased in both sibutramine (P = 0.04, P = 0.01) and sibutramine plus metformin groups (P = 0.023, P = 0.025) after 3 and 12 months, respectively. There was also significant reductions in serum C reactive protein levels in both sibutramine (P = 0.045, P = 0.02) and sibutramine plus metformin groups (P = 0.007, P = 0.001) after 3 and 12 months, respectively. These decrements of body weight, HOMA-IR, serum leptin and C reactive protein levels were not statistical significance between these two groups both after 3 and 12 months (P > 0.05). Combination of sibutramine with metformin did not result in any further effects on weight loss, insulin resistance, leptin and C reactive protein levels when compared to sibutramine alone.

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Section: Discussionmentioning

confidence: 93%

Comparison of the effects of sibutramine versus sibutramine plus metformin in obese women

et al. 2009

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“…Orlistat, 360 mg/d, combined with metformin, 1,700 mg/d, was compared with orlistat, 360 mg/d, in a 57-subject trial over 12 weeks. There was no difference in weight loss between the groups [29].…”

Section: Orlistat and Metforminmentioning

confidence: 75%

Combination Drugs for Treating Obesity

Greenway

Bray

2010

Curr Diab Rep

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Although obesity is a chronic disease like hypertension and diabetes, obesity is not treated with drug combinations as are other chronic diseases. This is because orlistat and sibutramine, the two drugs approved for long-term treatment of obesity, do not result in additive weight loss when combined. This article discusses the history of combination drug therapy for treating obesity, the lessons learned from that experience, and describes the drug combinations now in development. One combination of two standardized dietary herbal supplements that result in clinically significant weight loss is also described. Obesity is poised to enter the era of combination drug therapy, as is now the routine in the treatment of other chronic diseases like hypertension and diabetes. The advent of combination drug therapy for obesity treatment offers hope for increasing the efficacy of obesity pharmacotherapy.

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“…In addition, a previous comparative study, in which was added during 4 months metformin tablets to half of the obese patients treated with orlistat capsules, showed that both therapies were well tolerated and no subject discontinued therapy since adverse events were mild and transient [30]. A 1-year multicenter trial tested placebo or orlistat in overweight and obese patients who are being treated with metformin, in that study, the placebo treatment evoked less adverse effects than orlistat treatment (4.6% vs. 9.8%, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…In a study carried out in metformin-treated type 2 diabetic patients was added orlistat or placebo, after 1 year of treatment, orlistat increases weight loss and improving glycemic control, serum lipid levels, and blood pressure in obese patients with type 2 diabetes who are being treated with metformin [22]. In addition, combination metforminorlistat seems to be safety in acute and chronic treatment [22,23]. Orlistat has a bioavailability less than 5% when administered orally and it is only detectable in plasma by liquid chromatography-mass spectrometry or gas chromatography-mass spectrometry with a low detection limit.…”

Section: Introductionmentioning

confidence: 99%

Comparative Pharmacokinetic Study between Metformin Alone and Combined with Orlistat in Healthy Mexican Volunteers

Santos-Caballero¹,

Flores‐Murrieta²

2012

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Traditional treatment of type 2 diabetes mellitus (T2DM) has focused on correcting hyperglycemia. However, T2DM is almost always accompanied by other conditions and risk factors that affect its morbidity and mortality. Obesity represents one of the main risk factors associated in the T2DM and a modest weight loss around 5% is linked with significant reduction in the blood glucose levels. The objective of this study was to compare the pharmacokinetic parameters between two formulations of metformin, alone or combined with orlistat, in healthy volunteers. A single-blinded, single dose, two-period, two-sequence, crossover, randomized and balanced study design with a 7-day washout period was performed in 26 Mexican volunteers. Plasma samples were collected over a 24-hour period after administration of 500 mg metformin alone or combined with 60 mg orlistat in each period. A validated high-performance liquid chromatography coupled with an ultraviolet detector was used to analyze metformin concentration in plasma. Bioequivalence between metformin alone and metformin combined with orlistat was determined when the ratio for the 90% confidence intervals (CI) of area under the curve (AUC 24h ) and maximum concentration (C max ) of the two formulations were within 80% and 125%. In the current study, the mean ± standard deviation (SD) of C max , AUC 24h and AUC ∞ of the formulation containing only metformin were 1.39 ± 0.44 µg/mL, 7.59 ± 3.17 µg·h/mL and 8.48 ± 4.13 µg·h/mL, respectively, while the mean ± SD of C max , AUC 24h and AUC ∞ of the formulation containing metformin and orlistat were 1.38 ± 0.48 µg/mL, 7.80 ± 2.83 µg·h/mL and 9.13 ± 4.29 µg·h/mL, respectively. The parametric 90% CI for C max and AUC 24h were 87.5 -109.3 and 88.7 -124.7, respectively. These results suggest that both formulations are bioequivalent and there is not pharmacokinetic interaction between metformin and orlistat.

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Comparison of the effect of orlistat vs orlistat plus metformin on weight loss and insulin resistance in obese women

Cited by 19 publications

References 31 publications

Comparison of the effects of sibutramine versus sibutramine plus metformin in obese women

Comparison of the effects of sibutramine versus sibutramine plus metformin in obese women

Combination Drugs for Treating Obesity

Comparative Pharmacokinetic Study between Metformin Alone and Combined with Orlistat in Healthy Mexican Volunteers

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