Effects of Sibutramine Plus Orlistat in Obese Women Following 1 Year of Treatment by Sibutramine Alone: A Placebo‐Controlled Trial

Wadden, Thomas A.; Berkowitz, Robert I.; Womble, Leslie G.; Sarwer, David B.; Arnold, M; Steinberg, Carrie

doi:10.1038/oby.2000.53

Cited by 113 publications

(59 citation statements)

References 17 publications

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“…phentermine, diethylpropion, phendimetrazine), a combined adrenergic-serotonergic agent (sibutramine), and a malabsorptive agent (orlistat). There are very limited data on the subject, but combinations of either sibutramine and orlistat 43 or phentermine and orlistat 44 do not appear to increase weight loss over the use of single drugs. Thus, there are no accepted or commonly used combinations of obesity drugs at this time.…”

Section: Discussionmentioning

confidence: 99%

Comparison of combinations of drugs for treatment of obesity: body weight and echocardiographic status

et al. 2006

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Background: Obesity treatment with single drugs produces weight losses of about 8-10% of initial body weight. Few studies of combinations of drugs for treating obesity have been published. The combination of phentermine, an adrenergic agent, and fenfluramine, a serotonergic agent, (phen-fen) produced weight losses of about 15% of initial body weight. Fenfluramine is no longer available because it was associated with cardiac valve lesions. Phentermine-fluoxetine (phen-flu) has been proposed as an alternative for phen-fen. Objective: To compare the efficacy of treatment and prevalence of cardiac valve abnormalities on phen-flu vs phen-fen. Design: Retrospective chart review of all patients treated for at least 3 months with phen-flu (N ¼ 97) to a random sample of patients treated with phen-fen (N ¼ 98) in the Clinical Nutrition Clinic at the University of Wisconsin. Comparison of echocardiograms in all patients treated solely with phen-flu (N ¼ 21) to a random sample of patients treated with phen-fen (N ¼ 47), and to a group of subjects never treated with obesity drugs (N ¼ 26). Results: With last observation carried forward analysis (LOCF), at 6 months of treatment the phen-fen patients lost 12.670.6% of baseline weight and phen-flu patients lost 9.070.6% (Po0.001). With completers analysis, there were no significant differences in weight loss as a percent of baseline weight at 6 months (14.470.6 vs 13.370.9%). LOCF decreases in body mass index (BMI) at 6 months were À5.3 and À3.6 kg/m 2 for phen-fen and phen-flu, respectively (Po0.001), and 6.270.3 vs 5.470.4 kg/m 2 , respectively, for the completers analysis (P -NS). Dropout rate at 6 months was higher in phen-flu subjects (44 vs 28%). In subjects without atherosclerosis of valves (presumably pre-existing), cardiac valve lesions occurred in eight of 38 phen-fen subjects and in none of 15 phen-flu subjects or 25 control subjects who had not been treated with drugs. Conclusions: The combination of phentermine and fluoxetine was not as effective as phen-fen, but was not associated with cardiac valve lesions. Longer term, larger scale studies of phen-flu are warranted.

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Section: Discussionmentioning

confidence: 99%

Comparison of combinations of drugs for treatment of obesity: body weight and echocardiographic status

et al. 2006

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“…Recently, Wadden et al 32 reported that the addition of orlistat to sibutramine did not induce further weight loss as compared to treatment by sibutramine alone. However, their results should be interpreted with caution, because of the study that did not include combination therapy initially.…”

Section: Discussionmentioning

confidence: 99%

“…33 After 3-month metformin therapy, no significant change occurred in any lipid parameter in some reports. 27,32 The beneficial effects of metformin on serum lipids have been shown to be dose dependent. 34 We have not noted any significant change in total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride levels in the two groups.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2004

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BACKGROUND AND AIM:Orlistat and metformin are the currently used drugs for weight loss. We aimed to compare the effect of orlistat and orlistat plus metformin combination therapy on weight loss and insulin resistance in obese women. PATIENTS AND METHODS:In all, 57 obese women (body mass index Z30 kg/m 2 and normal glucose tolerance) were included. All subjects took the same content and caloric diet therapy during the study. After a month of diet period, each individual was randomly assigned to receive 360 mg orlistat per day (group 1; n ¼ 30) or 360 mg orlistat plus 1700 mg metformin per day (group 2; n ¼ 27) during the next 3 months. Body weight and insulin resistance by the homeostasis model assessment model (HOMA-IR) was measured at baseline, first month and fourth month. RESULTS: The mean weight loss in groups 1 and 2 was 1.3670.8 kg (1.470.7%) and 1.1170.7 kg (1.170.7%) from baseline to first month; 4.872.9 kg (5.2873.0%) and 5.7772.5 kg (6.1772.9%) from first month to fourth month. Body weight was decreased in groups 1 (Po 0.001) and 2 (Po 0.001), but there was no statistically significant difference between groups. Change of HOMA-IR in groups 1 and 2 was 0.4170.4 (14.9710.1%) and 0.2370.7 (8.16712.3%) from baseline to first month; 0.4970.77 (22.0726%) and 0.9570.88 (34.8729.1%) from first month to fourth month. HOMA-IR value was decreased in groups 1 (Po 0.001) and 2 (Po 0.001) but was not different between groups during the study period. CONCLUSIONS: Combination of orlistat with metformin did not result in an additional effect on weight loss and insulin resistance when compared to orlistat alone in our study. However, new studies which have more sample sizes and the longer study period are necessary for this purpose.

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“…133,134 Interestingly, a small study in 34 women who had received sibutramine for one year showed that adding orlistat to sibutramine for 16 weeks did not induce further weight loss. 141 In another study in 198 obese patients, combining sibutramine with an experimental selective antagonist of the receptor 5 of the orexigenic neuropeptide Y did not result …”

Section: Comparative Studies With Other Antiobesity Agentsmentioning

confidence: 99%

The use of sibutramine in the management of obesity and related disorders: An update

Tzotzas¹,

Krassas²,

Τζιόμαλος³

et al. 2009

VHRM

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Aims:To review the major trials that evaluated the efficacy and safety of the use of sibutramine for weight loss and the impact of this agent on obesity-related disorders. Methods and results:The most important articles on sibutramine up to January 2009 were located by a PubMed and Medline search. Sibutramine reduces food intake and body weight more than placebo and has positive effects on the lipid profile (mainly triglycerides and high density lipoprotein cholesterol), glycemic control and inflammatory markers in studies for up to one year. Preliminary studies showed that sibutramine may also improve other obesityassociated disorders such as polycystic ovary syndrome, left ventricular hypertrophy, binge eating disorder and adolescent obesity. The high discontinuation rates and some safety issues mainly due to the increase in blood pressure and pulse rate have to be considered. Additionally, it has not yet been established that treatment with sibutramine will reduce cardiovascular events and total mortality. Conclusions: Sibutramine, in conjunction with lifestyle measures, is a useful drug for reducing body weight and improving associated cardiometabolic risk factors and obesity-related disorders. Studies of longer duration are required to determine the precise indications of the drug, to evaluate safety issues and to assess its efficacy on cardiovascular mortality.

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Effects of Sibutramine Plus Orlistat in Obese Women Following 1 Year of Treatment by Sibutramine Alone: A Placebo‐Controlled Trial

Cited by 113 publications

References 17 publications

Comparison of combinations of drugs for treatment of obesity: body weight and echocardiographic status

Comparison of combinations of drugs for treatment of obesity: body weight and echocardiographic status

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

The use of sibutramine in the management of obesity and related disorders: An update

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