Effect of Rimonabant, a Cannabinoid-1 Receptor Blocker, on Weight and Cardiometabolic Risk Factors in Overweight or Obese Patients

Pi-Sunyer, F. Xavier; Aronne, Louis J.; Heshmati, Hassan M.; Devin, Jeanne; Rosenstock, Julio
February 2006
JAMA: Journal of the American Medical Association;2/15/2006, Vol. 295 Issue 7, p761
Academic Journal
Context Rimonabant, a selective cannabinoid-1 receptor blocker, may reduce body weight and improve cardiometabolic risk factors in patients who are overweight or obese. Objective To compare the efficacy and safety of rimonabant with placebo each in conjunction with diet and exercise for sustained changes in weight and cardiometabolic risk factors over 2 years. Design, Setting, and Participants Randomized, double-blind, placebo-controlled trial of 3045 obese (body mass index ≥30) or overweight (body mass index >27 and treated or untreated hypertension or dyslipidemia) adult patients at 64 US and 8 Canadian clinical research centers from August 2001 to April 2004. Intervention After a 4-week single-blind placebo plus diet (600 kcal/d deficit) run-in period, patients were randomized to receive placebo, 5 mg/d of rimonabant, or 20 mg/d of rimonabant for 1 year. Rimonabant-treated patients were rerandomized to receive placebo or continued to receive the same rimonabant dose while the placebo group continued to receive placebo during year 2. Main Outcome Measures Body weight change over year 1 and prevention of weight regain during year 2. Additional efficacy measures included changes in waist circumference, plasma lipid levels, and other cardiometabolic risk factors. Results At year 1, the completion rate was 309 (51%) patients in the placebo group, 620 (51%) patients in the 5 mg of rimonabant group, and 673 (55%) patients in the 20 mg of rimonabant group. Compared with the placebo group, the 20 mg of rimonabant group produced greater mean (SEM) reductions in weight (-6.3 [0.2] kg vs -1.6 [0.2] kg; P<.001), waist circumference (-6.1 [0.2] cm vs -2.5 [0.3] cm; P<.001), and level of triglycerides (percentage change, -5.3 [1.2] vs 7.9 [2.0]; P<.001) and a greater increase in level of high-density lipoprotein cholesterol (percentage change, 12.6 [0.5] vs 5.4 [0.7]; P<.001). Patients who were switched from the 20 mg of rimonabant group to the placebo group during year 2 experienced weight regain while those who continued to receive 20 mg of rimonabant maintained their weight loss and favorable changes in cardiometabolic risk factors. Use of different imputation methods to account for the high rate of dropouts in all 3 groups yielded similar results. Rimonabant was generally well tolerated; the most common drug-related adverse event was nausea (11.2% for the 20 mg of rimonabant group vs 5.8% for the placebo group). Conclusions In this multicenter trial, treatment with 20 mg/d of rimonabant plus diet for 2 years promoted modest but sustained reductions in weight and waist circumference and favorable changes in cardiometabolic risk factors. However, the trial was limited by a high drop-out rate and longer-term effects of the drug require further study. Clinical Trials Registration ClinicalTrials.gov Identifier: NCT00029861


Related Articles

  • Phone and e-mail counselling are effective for weight management in an overweight working population: a randomized controlled trial. van Wier, Marieke F.; Ariëns, Geertje A. M.; Dekkers, J. Caroline; Hendriksen, Ingrid J. M.; Smid, Tjabe; van Mechelen, Willem // BMC Public Health;2009, Vol. 9 Issue 1, p1 

    Background: The work setting provides an opportunity to introduce overweight (i.e., Body Mass Index ≥ 25 kg/ m2) adults to a weight management programme, but new approaches are needed in this setting. The main purpose of this study was to investigate the effectiveness of lifestyle...

  • Noni-based nutritional supplementation and exercise interventions influence body composition. Palu, Afa K.; West, Brett J.; Jensen, Jarakae // North American Journal of Medical Sciences;Dec2011, Vol. 3 Issue 12, p552 

    Background: The prevalence of obesity and overweight in the Unites States has reached unprecedented levels, and so has the need for effective exercise and nutritional programs for prevention of unhealthy weight gain or safe weight loss. Aims: The present study was conducted in overweight men and...

  • A STUDY ON PEAKING OF BODY FAT AND AGE RELATED CHANGES IN HUMAN BODY COMPOSITION. D. V., Muralidhara // Malaysian Journal of Medical Sciences;Jul2008 Supplement, p46 

    Introduction: Ageing is associated with increase in body mass, total body fat, loss of fat mass, central adiposity (redistribution body fat) and reduction in basal metabolic rate. In most men, gains in body weight occur between 29 and 35 years of age and in women between 45 and 49 years of age....

  • Parental Preferences on Addressing Weight-Related Issues in Children. Eneli, Ihuoma U.; Kalogiros, Ioanna D.; McDonald, Kaitlin A.; Todem, David // Clinical Pediatrics;Sep2007, Vol. 46 Issue 7, p612 

    Little is known about parental preferences on how providers should approach or manage weight-related concerns. A cross-sectional survey was conducted of 292 parents in a pediatric primary care faculty group practice. Of the 292 respondents, 90% were women, 45% had a child on Medicaid, and 53%...

  • MAILBAG. Kegan, K.; Jake, H.; Andy, C. // Weekly Reader News - Edition 4;4/27/2007, Vol. 88 Issue 24, p2 

    The article presents various opinions of readers about the effectiveness of obesity report cards in controlling weight gain in the U.S. One said that it is useful to people who are conscious about their weight. Another reader thinks that Body Mass Index (BMI) reports should be sent out to solve...

  • Composition (lean and fat tissue) of weight changes in adult Danes. Heitmann, Berit Lilienthal; Garby, Lars // American Journal of Clinical Nutrition;May2002, Vol. 75 Issue 5, p840 

    Background: Weight loss may be associated with unfavorable changes in body composition not compensated for by subsequent weight gain. Objective: We examined the composition of weight change in relation to obesity, previous weight changes, weight-loss attempts, and physical activity. Design: Part...

  • Adult obesity management: who, when and how to treat. Srikugan, L.; Loganayagam, A. // Update;Aug2007, Vol. 75 Issue 2, p23 

    The article focuses on adult obesity management, and assessment and treatment of overweight patients. Obesity management involves exploring the patients' own ideas about their weight and possible consequences. Drugs licensed for use by NICE Co. in helping weight loss can be considered in...

  • Prevalence of Unhealthy Lifestyle Patterns Among Overweight and Obese Adults. Kushner, Robert F.; Choi, Seung W. // Obesity (19307381);Jun2010, Vol. 18 Issue 6, p1160 

    This study determined the prevalence of unhealthy eating, exercise, and coping pattern traits among a large sample of overweight and obese adults. We analyzed responses to a 53-item lifestyle pattern questionnaire posted on a commercial weight loss program Web site collected from 2004 through...

  • Use of a Weight Loss Index for Evaluating Weight Management in Adults. Miller, Wayne C.; Henricson, Hilary L.; Moreland, Megan M. // Journal of Nutrition Education & Behavior;Jan/Feb2007, Vol. 39 Issue 1, p13 

    Objective: A quantitative method for evaluating weight loss using the body mass index (BMI) standard 25, during part or the entire weight loss continuum, was designed and tested. Design: Weight Loss Index (WLI) represents the area under tile curve of the graphical representation of the weight...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics