COMPARISON OF EFFICACY AND SAFETY OF RIMONABANT WITH ORLISTAT IN OBESE AND OVERWEIGHT PATIENTS

Abstract

Introduction- Rapidly rising prevalence of obesity is alarming. Obesity predisposes to co-morbidities like
hypertension, Type 2 Diabetes Mellitus, dyslipidemias thus substantially rising health care expenditure. Lifestyle
modifications alone have very limited success; necessitate the addition of pharmacotherapy to it.
Objective- Present study was carried out to compare efficacy and safety of new drug Rimonabant with Orlistat
Methodology- 90 obese (BMI>30) or overweight (BMI >27) with co-morbidity patients after initial screening for
common endocrinological causes were randomized into either Rimonabant 20mg once a day or Orlistat 120mg
three times a day or Placebo group. Weight, waist circumference, total cholesterol, triglycerides, HDL, LDL
were recorded at baseline and then at 2nd,4th & 6th month. ADR reported by patients were recorded. For safety
evaluation various hematological & biochemical parameters were assessed. Originally planned duration of 12
months was reduced to 6 months after Rimonabant was banned.
Results- Compared to placebo Rimonabant caused significant reduction in weight (5.4±0.5 kg), waist
circumference (4.7±0.5 cm), triglyceride (8.6±3.2 %), and increase in HDL (18±4.1 %). Orlistat caused
significant reduction in weight (4.9±0.8 kg), waist circumference (4.0 ± 0.6 cm), total cholesterol (6.13±1.4 %),
LDL (7.93±1.3 %). Orlistat caused GIT side effects while Rimonabant caused nausea, URTI, diarrhea.
Conclusion- Rimonabant has a similar weight loss efficacy to Orlistat but different effect on lipid profile with a
substantially low cost 5-8 Rs/day Vs 120/day for Orlistat. Rimonabant was banned because of severe
psychiatric side effects.