Orlistat Most Effective Antiobesity Drug for Reducing Blood Pressure and Cholesterol Levels: Presented at ECO

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Title: Orlistat Most Effective Antiobesity Drug for Reducing Blood Pressure and Cholesterol Levels: Presented at ECO
URL: http://www.pslgroup.com/dg/221C9A.htm
Doctor's Guide
May 22, 2008

By Timothy A. O'Leary

GENEVA -- May 22, 2008 -- The antiobesity drug orlistat reduces blood pressure, total cholesterol, and low-density lipoprotein (LDL) cholesterol more effectively than rimonabant, sibutramine, or placebo, according to research presented here at the 16th European Congress on Obesity (ECO).

The findings were presented on May 16 by lead author Diego Bellido Guerrero, MD, Researcher, Department of Endocrinology and Nutrition, Architect Marcide Hospital, La Coruña, Spain.

High blood pressure and high cholesterol frequently accompany obesity and are major risk factors for cardiovascular disease.

All 3 drugs were effective at reducing weight, but orlistat was superior at reducing blood pressure. Sibutramine caused blood pressure to increase, while rimonabant caused total cholesterol and LDL cholesterol to increase.

"Orlistat 120 mg reduces arterial pressure more effectively than rimonabant and sibutramine in obese patients," Dr. Bellindo Guerrero said.

"Orlistat was [also] associated with greater reductions in total and LDL cholesterol levels," he added.

Dr. Bellido Guerrero and colleagues conducted a comparative meta-analysis to evaluate the effects of orlistat 120 mg, rimonabant, and sibutramine on systolic and diastolic blood pressure and cholesterol levels in obese patients.

For their analysis, the researchers chose 27 double-blind, randomised, placebo-controlled trials. All of the trials had lasted 1 year or longer, had been conducted within the last 5 years, and were considered to be of good quality.

Patients had to have been treated with orlistat 120 mg, rimonabant, sibutramine, or placebo, to be aged 18 years or older, to have a body mass index (BMI) of 30 kg/m² or greater, or have a BMI of 27 kg/m² or greater with 1 or 2 of the comorbidities associated with obesity.

Orlistant 120 mg reduced mean systolic blood pressure compared with placebo (-1.79 vs -0.66 mm Hg) and mean diastolic blood pressure compared with placebo (-2.81 vs 1.03 mm Hg). Rimonabant reduced both mean systolic and mean diastolic blood pressure less effectively against placebo (-0.61 vs -0.21 mm Hg and -0.93 vs -0.30 mm Hg, respectively). Finally, sibutramine actually increased mean systolic and diastolic blood pressure levels compared with placebo (+ 4.35 vs -0.15 mm Hg and +1.64 vs -0.48 mm Hg, respectively).

"Orlistat 120 mg reduces arterial blood pressure to a greater extent than rimonabant or sibutramine in obese patients," the researchers declared in their poster presentation. "These results suggest that, in addition to reducing weight, orlistat 120 mg may decrease the risk of developing hypertension."

The researchers also determined that orlistat reduced total cholesterol by 32.84 mg/dL and LDL cholesterol by 30.61 mg/dL (both P < .001 vs placebo).

Sibutramine was found to reduce total cholesterol by 3.87 mg/dL and LDL cholesterol by 3.36 mg/dL. Rimonabant increased total cholesterol by 3.09 mg/dL and LDL cholesterol by 1.90 mg/dL.

On the other hand, high-density lipoprotein (HDL) levels increased 8.22 mg/dL with rimonabant and 5.25 mg/dL with sibutramine (both P < .001 vs placebo). With orlistat, HDL cholesterol levels were fairly stable, falling marginally by 0.63 mg/dL.

Of the trials that the researchers chose for their analysis, 44% were focused on orlistat, 30% focused on rimonabant, and 26% focused on sibutramine.

This analysis was funded by F. Hoffmann-La Roche Ltd.

[Presentation title: Comparative Meta-Analysis to Evaluate Systolic and Diastolic Blood Pressure in Obese Patients Treated With Orlistat 120 mg, Rimonabant, Sibutramine, or Placebo. Abstract T2:PS:118. Comparative Study of Cholesterol Reduction Between Orlistat 120 mg-Placebo, Rimonabant-Placebo and Sibutramine-Placebo Through a Meta-Analysis. Abstract T2:PS:119]

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