Lorcaserin: A Review of its Use in Chronic Weight Management

Abstract

Oral lorcaserin (BELVIQ(®)), a selective serotonin 5-HT2C receptor agonist, is indicated in the US as an adjunct to diet and exercise in the chronic weight management of obese adults, or overweight adults with at least one weight-related comorbidity (e.g. dyslipidaemia, hypertension, type 2 diabetes). This article reviews the pharmacological properties, therapeutic efficacy and tolerability of oral lorcaserin in this patient population. In three large randomized, double-blind, multicentre studies, oral lorcaserin was more effective than placebo in the management of obese and overweight adults with or without type 2 diabetes mellitus. Following 12 months' therapy, significantly higher proportions of lorcaserin than placebo recipients achieved a ≥5 and ≥10 % reduction from baseline in their bodyweight and a significant between-group difference favouring lorcaserin over placebo was observed for the change from baseline in bodyweight. Moreover, among patients who had achieved a ≥5 % reduction in their bodyweight after 12 months' therapy with lorcaserin, a significantly higher proportion who received lorcaserin for a further 12 months than those who switched to placebo maintained ≥5 % weight loss at 24 months. In general, oral lorcaserin was well tolerated in clinical studies, with hypoglycaemia and headache the most frequently reported adverse events in those with or without type 2 diabetes, respectively. According to a pooled analysis, the risk of US-FDA-defined valvulopathy with lorcaserin is generally low and not statistically significantly different from placebo. From these and other data, the FDA has concluded that lorcaserin is unlikely to elevate the risk of valvulopathy.

Khat (<b><i>Catha edulis</i></b>) and Obesity: A Scoping Review of Animal and Human Studies

“…The BLOOM-DM study (behavioural modification and lorcaserin for obesity and overweight management in diabetes mellitus), which was a one-year clinical trial study, reported that lorcaserin was an effective drug for obesity and is associated with better glycaemic control in diabetic patients [54] . The main adverse effect of lorcaserin as reported by the 3 clinical trials was headache, while the risk of valvulopathy was comparable to that of the placebo [55] .…”

Perinatal selective serotonin reuptake inhibitor (SSRI) effects on body weight at birth and beyond: A review of animal and human studies

“…Serotonin (5-HT) is directly involved in the regulation of eating behavior [109] and reductions in 5-HT function have been associated with negative mood, an increased urge for binge eating [110], and increased consumption of high-fat sweet foods [111,112]. Conversely, increasing 5-HT through pharmacological intervention has been used for obesity treatment [113], but this SSRI intervention has been associated with increased risk of depression, suicide, and cardiac complication. In addition to 5HT in the brain and peripheral nervous system affecting mood and feeding behavior, the majority of 5HT circulates in the blood, often termed "peripheral 5HT".…”

Novel Oral Anti-Obesity Agents: New Perspectives with Lorcaserin?

“…The approval has been based on a clinical study programme with lorcaserin that includes studies with a duration of 2 years. A comprehensive overview of this agent, including its clinical profile regarding efficacy and safety is given in the article by Hoy in this issue [17].The efficacy and safety of lorcaserin was investigated in large clinical trials , BLOSSOM [13] and BLOOM [18]), using doses of 10 mg lorcaserin twice daily in a randomized, multicentre, placebo-controlled, double-blind fashion. Significantly more patients receiving lorcaserin achieved a bodyweight reduction from baseline of C5 % and C10 % compared with the placebo group after 12 months.…”

“…The approval has been based on a clinical study programme with lorcaserin that includes studies with a duration of 2 years. A comprehensive overview of this agent, including its clinical profile regarding efficacy and safety is given in the article by Hoy in this issue [17].…”