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Obesity Drug Shows Mixed Success Against Atherosclerosis


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Not for lack of effort, researchers have yet to happen on a "magic" treatment for obesity and its attendant problems.

One drug that has shown some promise, Acomplia (rimonabant), has been approved for use in Europe but not in the United States. Last June, the U.S. Food and Drug Administration did not recommend approval of the drug, pending more information on psychiatric side effects.

The drug works by inhibiting the cannabinoid type 1(CB1) receptors, which are involved in regulating food ingestion.

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For the new study, 839 patients at 112 centers in Australia, Europe and North America were randomly selected to receive either Acomplia or a placebo. All participants, who also had coronary disease, received dietary counseling as well.

Coronary intravascular ultrasonography (IVUS) at the end of 18 months revealed a 0.25 percent increase in percent atheroma volume (PAV) in those taking rimonabant, compared to 0.51 percent in the placebo group. And change in normalized total atheroma volume (TAV) decreased in the Acomplia group but increased in the placebo group. PAV and TAV are basically two ways to measure how clogged an artery is.

Those taking Acomplia also saw other benefits: They lost more weight (9.5 pounds versus 1.1 pounds in the placebo group); their waist circumference went down more (1.77 inches versus 0.39 inches); their HDL or "good" cholesterol increased more (22.4 percent versus 6.9 percent) and triglyceride levels went down further (20.5 percent versus 6.2 percent). But LDL or "bad" cholesterol levels and blood pressure stayed about the same in both groups.

More worrisome, 43.4 percent of those in the Acomplia group experienced psychiatric problems, most notably anxiety and depression, compared to 28.4 percent in the placebo group.

More information

The U.S. Centers for Disease Control and Prevention has more on overweight and obesity.

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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 4/1/2008

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SOURCES: Suzanne Steinbaum, D.O., director, Women and Heart Disease, Lenox Hill Hospital, New York City; April 2, 2008, Journal of the American Medical Association; April 1, 2008, presentation, American College of Cardiology annual meeting, Chicago


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