 |
|
The Efficacy and Safety of Sibutramine for Weight Loss
A Systematic Review
David E. Arterburn, MD, MPH;
Paul K. Crane, MD, MPH;
David L. Veenstra, PharmD, PhD
Arch Intern Med. 2004;164:994-1003.
Background The primary goal of weight loss is to prevent or reduce obesity-associated morbidity and mortality by improving cardiovascular and metabolic risk factors. We conducted a systematic review to assess the efficacy and safety of sibutramine hydrochloride for weight loss.
Methods In April 2002, we searched MEDLINE, EMBASE, the Cochrane Library, and 7 other computerized bibliographic search tools using the keywords "sibutramine," "Meridia," and "Reductil" (in all languages and all available years). The authors and the manufacturer were contacted. We reviewed randomized placebo-controlled trials of sibutramine, 10 to 20 mg/d, in obese adults. Methodological quality was assessed.
Results A total of 29 trials had sufficient data for analysis after including unpublished data from 10 authors. The summary mean differences in weight loss, sibutramine minus placebo, for the 3-month and 1-year trials were –2.78 kg (95% confidence interval, –2.26 to –3.29 kg) and –4.45 kg (95% confidence interval, –3.62 to –5.29 kg), respectively. The 6-month trials were statistically heterogeneous, and evidence of publication bias was found. One trial found that sibutramine maintains weight loss better than placebo at 2 years. Weight loss with sibutramine was associated with modest increases in heart rate and blood pressure, small improvements in high-density lipoprotein cholesterol and triglycerides levels, and, among diabetic patients, small improvements in glycemic control. There was no direct evidence that sibutramine reduces obesity-associated morbidity or mortality.
Conclusions Sibutramine is effective in promoting weight loss. Weight loss with sibutramine is associated with both positive and negative changes in cardiovascular and metabolic risk factors. There is insufficient evidence to accurately determine the long-term risk-benefit profile for sibutramine.
From the Department of Veterans Affairs, Puget Sound Health Care System, Seattle, Wash (Dr Arterburn); and the Department of Medicine, School of Medicine (Dr Crane) and the Pharmaceutical Outcomes Research and Policy Program, School of Pharmacy (Dr Veenstra), University of Washington, Seattle. The authors have no relevant financial interest in this article. Dr Arterburn is now with the Health Services Research and Development Service, Cincinnati Veterans Affairs Medical Center and the Department of Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Triple Uptake Inhibitor (1R,5S)-(+)-1-(3,4-Dichlorophenyl)-3-azabicyclo[3.1.0] Hexane Hydrochloride (DOV 21947) Reduces Body Weight and Plasma Triglycerides in Rodent Models of Diet-Induced Obesity
Tizzano et al.
J. Pharmacol. Exp. Ther. 2008;324:1111-1126.
ABSTRACT
| FULL TEXT
Efficacy of Sibutramine for the Treatment of Binge Eating Disorder: A Randomized Multicenter Placebo-Controlled Double-Blind Study
Wilfley et al.
Am. J. Psychiatry 2008;165:51-58.
ABSTRACT
| FULL TEXT
Sibutramine in cardiovascular disease: is SCOUT the new STORM on the horizon?
von Haehling et al.
Eur Heart J 2007;28:2830-2831.
FULL TEXT
Medical Weight Loss Treatment Options in Obese Solid-Organ Transplant Candidates
DiCecco
Nutr Clin Pract 2007;22:505-511.
ABSTRACT
| FULL TEXT
National trends in the use and costs of anti-obesity medications in England 1998-2005
Srishanmuganathan et al.
J Public Health (Oxf) 2007;29:199-202.
ABSTRACT
| FULL TEXT
Effect of Orlistat on Weight Regain and Cardiovascular Risk Factors Following a Very-Low-Energy Diet in Abdominally Obese Patients: A 3-year randomized, placebo-controlled study
Richelsen et al.
Diabetes Care 2007;30:27-32.
ABSTRACT
| FULL TEXT
The effectiveness of screening for obesity in primary care: weighing the evidence.
Wilson and McAlpine
Med Care Res Rev 2006;63:570-598.
ABSTRACT
Cannabinoid-1 Receptor Antagonist, Rimonabant, for Management of Obesity and Related Risks
Gadde and Allison
Circulation 2006;114:974-984.
FULL TEXT
Metabolic Syndrome: Connecting and Reconciling Cardiovascular and Diabetes Worlds
Grundy
J Am Coll Cardiol 2006;47:1093-1100.
ABSTRACT
| FULL TEXT
Treatment and prevention of obesity--are there critical periods for intervention?
Lawlor and Chaturvedi
Int J Epidemiol 2006;35:3-9.
FULL TEXT
Randomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity
Wadden et al.
NEJM 2005;353:2111-2120.
ABSTRACT
| FULL TEXT
Obstructive sleep apnea: Diagnosis, medical management and dental implications
MAGLIOCCA and HELMAN
Journal of the American Dental Association 2005;136:1121-1129.
ABSTRACT
| FULL TEXT
Pharmacologic and Surgical Management of Obesity in Primary Care: A Clinical Practice Guideline from the American College of Physicians
Snow et al.
ANN INTERN MED 2005;142:525-531.
ABSTRACT
| FULL TEXT
Meta-Analysis: Pharmacologic Treatment of Obesity
Li et al.
ANN INTERN MED 2005;142:532-546.
ABSTRACT
| FULL TEXT
|
