Key result
Orlistat reduces weight by ~2.4 kg and modestly improves cardiovascular risk factors versus placebo.
Why the study?
Although anti-obesity drugs are widely used to prevent the complications of obesity, their effects on cardiovascular risk factors were unclear.
Do anti-obesity drugs (orlistat, sibutramine, rimonabant) improve cardiovascular risk factors compared to placebo?
Meta-Analysis
Do anti-obesity drugs (orlistat, sibutramine, rimonabant) improve cardiovascular risk factors compared to placebo?
Anti-obesity therapy decreases weight regardless of drug type, with orlistat and rimonabant improving multiple cardiovascular risk factors while sibutramine only significantly reduces weight and triglycerides.
Background Anti-obesity drugs are widely used to prevent the complications of obesity, however, the effects of anti-obesity drugs on cardiovascular risk factors are unclear at the present time. We carried out a comprehensively systematic review and meta-analysis to assess the effects of anti-obesity drugs on cardiovascular risk factors. Methodology and Principal Findings We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles and proceedings of major meetings for relevant literatures. We included randomized placebo-controlled trials that reported the effects of anti-obesity drugs on cardiovascular risk factors compared to placebo. Overall, orlistat produced a reduction of 2.39 kg (95%CI-3.34 to −1.45) for weight, a reduction of 0.27 mmol/L (95%CI: −0.36 to −0.17) for total cholesterol, a reduction of 0.21 mmol/L (95%CI: −0.30 to −0.12) for LDL, a reduction of 0.12 mmol/L (95%CI: −0.20 to −0.04) for fasting glucose, 1.85 mmHg reduction (95%CI: −3.30 to −0.40) for SBP, and a reduction of 1.49 mmHg (95%CI: −2.39 to −0.58) for DBP. Sibutramine only showed effects on weight loss and triglycerides reduction with statistical significances. Rimonabant was associated with statistically significant effects on weight loss, SBP reduction and DBP reduction. No other significantly different effects were identified between anti-obesity therapy and placebo. Conclusion/Significance We identified that anti-obesity therapy was associated with a decrease of weight regardless of the type of the drug. Orlistat and rimonabant could lead to an improvement on cardiovascular risk factors. However, Sibutramine may have a direct effect on cardiovascular risk factors.
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Zhou et al. (2012) conducted a meta-analysis in Obesity. Anti-obesity drugs (orlistat, sibutramine, rimonabant) vs. Placebo was evaluated on Weight and cardiovascular risk factors (total cholesterol, LDL, fasting glucose, SBP, DBP, triglycerides) (MD -2.39 kg (orlistat weight reduction), 95% CI -3.34 to -1.45). Orlistat reduced weight by 2.39 kg (95% CI -3.34 to -1.45), LDL by 0.21 mmol/L, and SBP by 1.85 mmHg vs placebo, improving cardiovascular risk factors.
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