The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction

Hansen, Dorte L.; Toubro, Søren; Stock, Michael J.; Macdonald, I. A.; Astrup, Arne

doi:10.1038/sj.ijo.0801059

Cited by 143 publications

(121 citation statements)

References 25 publications

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“…The slight increase in systolic blood pressure (5 mmHg) and in diastolic blood pressure (5 mmHg) in the sibutramine group was corroborated by the literature [13][14][15] . The slight increase in blood pressure seems to be compensated by drug-induced weight loss 15 .…”

Section: Discussionsupporting

confidence: 72%

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Evaluation of efficacy, reliability, and tolerability of sibutramine in obese patients, with an echocardiographic study

et al. 2002

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This is a double-blind, placebo-controlled study of the efficacy, safety, and tolerability of sibutramine in the management of obese patients for a 6-month period.METHOD: Sixty-one obese patients (BMI >30, <40 kg/m2), aged 18-65 years were evaluated. In the first phase of the study (30 days), the patients were given a placebo. We monitored compliance with a low-calorie diet (1200 kcal/day) and to the placebo. In the next stage, the double-blind phase (6 months), we compared placebo and sibutramine (10 mg/day). The criteria for evaluating efficacy were weight loss, reduction in body mass index (BMI), and abdominal and hip circumferences. Tolerability was assessed based on reported side effects, variation in arterial blood pressure and heart rate, metabolic profile (fasting glucose, total cholesterol and its fractions, and triglycerides), laboratory tests (renal and hepatic functions), and flow Doppler echocardiogram. RESULTS:We observed a greater weight loss (7.3 kg, 8% vs 2.6 kg, 2.8%) and a reduction in body mass index (7.4% vs 2.1%) in the sibutramine group than in the placebo group. Classifying the patients into 4 subgroups according to weight loss (weight gain, loss <5%, loss of 5% to 9.9%, and loss >10%), we observed a weight loss of >5% in 40% of the patients on sibutramine compared with 12.9% in the placebo group. We also detected weight gain in 45.2% of the placebo group compared to 20% in the sibutramine group. The sibutramine group showed improvement in HDL-cholesterol values (increased by 17%) and triglyceride values (decreased by 12.8%). This group also showed an increase in systolic blood pressure (6.7%, 5 mmHg). There were no changes in echocardiograms comparing the beginning and end of follow-up, and side effects did not lead to discontinuation of treatment.DISCUSSION: Sibutramine proved to be effective for weight loss providing an 8% loss of the initial weight. Compliance to prolonged treatment was good, and side effects did not result in discontinuation of treatment. These data confirmed the good efficacy, tolerability, and safety profiles of sibutramine for treatment of obesity. DESCRIPTORS: Obesity. Weight loss. Sibutramine.

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Section: Discussionsupporting

confidence: 72%

“…Subsequent studies showed a significant effect of the drug on weight loss due to its satietogenic and calorigenic effects [13][14][15] .…”

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confidence: 99%

Evaluation of efficacy, reliability, and tolerability of sibutramine in obese patients, with an echocardiographic study

et al. 2002

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“…Part of the effects of sibutramine is due to the inhibition of noradrenaline reuptake with the resulting maintenance of adrenergic tonus in these patients, which can be beneficial for avoiding the drop in energy expenditure that follows weight loss according to the studies by Hansen et al 14 and Seagle et al 15 . This effect, however, could result in an elevation in blood pressure and a reduction in the antihypertensive benefits of weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…The use of sibutramine is associated with an increase in satiety scores and a lack of decline in 24-hour energy expenditure 14,15 , which make sibutramine efficient in inducing weight loss. Several studies show an adequate tolerability profile for the drug; however, aspects referring to hypertensive patients are still inconclusive, and the presence of higher adrenergic activity may interfere with the benefits resulting from weight loss.…”

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confidence: 99%

Effects of Sibutramine on the Treatment of Obesity in Patients with Arterial Hypertension

Faria¹,

Filho²,

Lerario³

et al. 2002

Arq. Bras. Cardiol.

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Objective - Effects of Sibutramine on the Treatment of Obesity in Patients with Arterial Hypertension Artigo OriginalThe prevalence of obesity and its associated morbidities has increased in several countries worldwide, including Brazil 1,2 . The increase in body mass index has proved to be a determinant factor for elevation of blood pressure, both for obese and nonobese children and adults 3,4 . In addition, the presence of obesity is related to a 2.5 higher risk of arterial hypertension, mainly in patients with central body fat distribution 5 . Several hypotheses exist for the pathophysiology of arterial hypertension in this obese population. The first and more accepted hypothesis proposes that hyperinsulinemia secondary to insulin resistance existing in these patients leads to greater sympathetic activity and to renal sodium retention, which would account for the increase in pressure levels [6][7][8] . The second hypothesis associates the arterial hypertension existing in these patients with the mechanical compression of renal parenchyma by visceral fat. This leads to hyperactivation of the renin-angiotensinaldosterone system (RAAS), higher sodium reabsorption, and a subsequent elevation in blood pressure by a mechanism independent from insulinemia 9,10 .Even though we have not reached a consensus about the causes of arterial hypertension in the obese, several clinical studies confirm the importance of weight loss to better control blood pressure levels 11,12 .The great challenge has been to find effective clinical treatments, which do not impair blood pressure control, to induce weight loss in hypertensive patients. Of the several treatments available for weight control, we can count on appetite suppressing drugs, which comprise a generic class of drugs derived from amphetamines that act through adrenergic receptors, and, therefore, may aggravate hypertension. More recently, other options include orlistat that inhibits gastrointestinal fat absorption, and sibutramine, an appetite suppressant that blocks serotonin, dopamine, and noradrenaline reuptake 13 .The use of sibutramine is associated with an increase in satiety scores and a lack of decline in 24-hour energy

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“…11,12 Controlled clinical studies have shown that sibutramine produces dose-related weight reduction in obese subjects, as early as 2 weeks after initiation of treatment. 13 However, the norepinephrine activation induced by sibutramine administration could lead to an increase in arterial blood pressure and elevation of heart rate in some patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of sibutramine in 2225 subjects with cardiovascular risk factors: short-term, open-label, observational study

Gaciong

Placha

2005

J Hum Hypertens

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This study aims to determine the efficacy and tolerability of sibutramine hydrochloride in overweight and obese patients with cardiovascular risk factors. This was a 12-week, open-label, observational trial carried out in primary care settings. Patients' data were obtained from questionnaires received from 153 physicians. A total of 2225 overweight and obese (BMIX27 kg/m 2 ) patients received sibutramine in single daily doses of 10 and/or 15 mg. The study population included patients in general good health and with controlled hypertension (41.2%), type II diabetes mellitus (15.6%), hyperlipidaemia (45.5%), and who were chronic tobacco users (smokers) (37.0%). The main outcome measures were changes in body weight, blood pressure and heart rate, and evaluation of reported adverse events. Reduction of body weight of at least 45% from baseline to week 12 was achieved in 2030 (91%) patients and 410% was achieved in 987 (44%) patients. Baseline differences in the percentages of male and female patients, presence or absence of hyperlipidaemia or smoking status did not appear to affect the rate of weight change. Weight loss was less in patients with type II diabetes mellitus and/or controlled systolic hypertension at baseline compared to those patients without these conditions. Mean systolic and diastolic blood pressure and heart rate decreased from baseline to week 12. Overall, sibutramine was well tolerated. In conclusions, treatment with sibutramine resulted in clinically significant weight loss during short-term therapy in obese adults with a range of cardiovascular risk factors.

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The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction

Cited by 143 publications

References 25 publications

Evaluation of efficacy, reliability, and tolerability of sibutramine in obese patients, with an echocardiographic study

Evaluation of efficacy, reliability, and tolerability of sibutramine in obese patients, with an echocardiographic study

Effects of Sibutramine on the Treatment of Obesity in Patients with Arterial Hypertension

Efficacy and safety of sibutramine in 2225 subjects with cardiovascular risk factors: short-term, open-label, observational study

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