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

Abstract

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.

Effects of Lifestyle Measures, Antiobesity Agents, and Bariatric Surgery on Serological Markers of Inflammation in Obese Patients

“…Sibutramine lowers body weight by increasing satiety and by reducing appetite through the selective inhibition of the neuronal reuptake of serotonin and noradrenaline within the hypothalamus [ 130 , 131 ]. In studies lasting more than 1 year, sibutramine reduced body weight by approximately 4.2 kg (95% CI 3.6–4.7 kg) compared with placebo [ 120 , 130 ]. Sibutramine also lowers triglyceride (TG) levels but increases BP and pulse rate [ 120 , 130 ].…”

“…In studies lasting more than 1 year, sibutramine reduced body weight by approximately 4.2 kg (95% CI 3.6–4.7 kg) compared with placebo [ 120 , 130 ]. Sibutramine also lowers triglyceride (TG) levels but increases BP and pulse rate [ 120 , 130 ].…”

Comparative effects of sibutramine and orlistat on weight loss, glucose metabolism and leptin levels in non-diabetic obese patients: A prospective study

“…[ 1 2 ] In terms of BP, sibutramine may be associated with an increase or no effect at all. [ 3 ] A meta-analysis has reported that 1-year treatment with orlistat is associated with a mild decrease in BP and pulse rate. [ 4 ] In our study, orlistat exerted a trend towards more favourable effects on lipid levels.…”

Pharmacological Approaches for Management of Child and Adolescent Obesity

“…So there is emerging evidence that sibutramine can be a valid therapeutic option for obese adolescents. The only caveat being regular monitoring of blood pressure and pulse rates, though preliminary trials are reporting its safety and tolerability [ 10 , 11 ]. In a double-blind placebo-controlled cross-over study conducted among children diagnosed with hypothalamic obesity, sibutramine was found to be efficacious [ 12 ].…”

“…Various studies discussing the role of sibutramine along with behavior therapy have shown successful results in obesity reduction [ 11 ]. As safety issues related to sibutramine therapy are still under investigation, trials conducted using intermittent therapies versus continuous therapy have a special role in obesity management.…”