Acomplia scientific update |
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Curr Atheroscler Rep. 2008 Apr;10(2):106-16.
Bourassa MG, Berry C.
Department of Medicine, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal, QC, Canada H1T 1C8.
Prevention and noninvasive management of coronary atherosclerosis in patients with diabetes.
Diabetes mellitus (DM) is a worldwide epidemic. Its prevalence is rapidly increasing in both developing and developed countries. Coronary heart disease (CHD) is highly prevalent and is the major cause of morbidity and mortality in patients with diabetes. Individuals with prediabetes states, with or without known CHD, should undergo lifestyle modifications aimed at preventing DM. In patients with CHD and DM, routine use of aspirin and an angiotensin-converting enzyme inhibitor, along with strict glycemic, blood pressure, and lipid control, is strongly recommended. Intense insulin therapy may be needed for glycemic control, and high-dose statin therapy may be needed for lipid control. For blood pressure control, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are considered first-line therapy. Noncompliance with medications and/or lifestyle measures and underprescription of evidence-based therapies remain important unsolved problems.
Eur Heart J. 2008 Jul;29(14):1761-71. Epub 2008 Apr 15.
Van Gaal LF, Scheen AJ, Rissanen AM, Rössner S, Hanotin C, Ziegler O; RIO-Europe Study Group.
Department of Diabetology, Metabolism, and Clinical Nutrition, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem-Antwerp, Belgium.
Long-term effect of CB1 blockade with rimonabant on cardiometabolic risk factors: two year results from the RIO-Europe Study.
AIMS: Rimonabant, the first selective cannabinoid type 1 receptor blocker, has been shown to produce weight loss and improvements in several cardiometabolic risk factors over 1 year. We report the 2 year efficacy and tolerability data of rimonabant. METHODS AND RESULTS: Patients with a body mass index > or =30 or >27 kg/m(2) with treated/untreated hypertension, dyslipidaemia, or both, were randomized to double-blind treatment with placebo, rimonabant 5 or 20 mg once daily plus a calorie-restricted diet for 2 years. Weight loss from baseline to 2 years in the intention-to-treat population was significantly greater with rimonabant 20 mg (mean +/- SD: -5.5 +/- 7.7 kg; P < 0.001) and 5 mg (-2.9 +/- 6.5 kg; P = 0.002) than placebo (-1.2 +/- 6.8 kg). Rimonabant 20 mg produced significantly greater improvements than placebo in waist circumference, high-density lipoprotein cholesterol, triglycerides, fasting glucose and insulin levels, insulin resistance, and metabolic syndrome prevalence. Rimonabant 20 mg produced clinically meaningful improvements in all Impact of Weight on Quality of Life-Lite questionnaire domain scores at 2 years. Rimonabant was generally well tolerated and rates of adverse events, including depressed mood disorders and disturbances were similar to placebo during year 2. Proportions of patients with clinically significant depression (Hospital Anxiety and Depression Scale score >11) were similar in all treatment groups. CONCLUSION: Rimonabant 20 mg over 2 years promoted clinically relevant and durable weight loss and improvements in cardiometabolic risk factors.
Med Monatsschr Pharm. 2008 Mar;31(3):107-8.
Picksak G, Stichtenoth DO.
Zentralapotheke, Medizinische Hochschule Hannover, 30623 Hannover.
[Prescription of rimonabant in the early stage of pregnancy?] [Article in German]
Rimonabant should not be prescribed in pregnancy because no sufficient data on the teratogenic/ embryotoxic risk are available. A preventive termination of pregnancy is not indicated. Women in childbearing age should take only low-risk drugs. Otherwise dedicated information, in doubt pregnancy test, and strict contraception is required.
Drugs. 2008;68(8):1067-88.
Buchhalter AR, Fant RV, Henningfield JE.
Pinney Associates, Bethesda, Maryland 20814, USA.
Novel pharmacological approaches for treating tobacco dependence and withdrawal: current status.
Increasing the diversity and availability of medications for the treatment of tobacco dependence and/or withdrawal, to aid in the achievement of smoking cessation, is crucial to meet the diverse needs of tobacco users. Despite a general awareness that smoking is harmful and widespread interest in smoking cessation, nearly 50 million adults in the US and 1.3 billion worldwide continue to smoke. Nicotine replacement therapies are effective in the treatment of tobacco dependence and withdrawal, but do not meet the needs of all tobacco users. Improvement of tobacco dependence and/or withdrawal treatments is likely to rely on novel pharmacological approaches that include new chemical entities and new formulations of current drugs. In addition, new indications for treating tobacco dependence and withdrawal show promise for reducing tobacco use and associated disease. This article focuses on a range of novel pharmacological approaches for the treatment of tobacco dependence and/or withdrawal, including oral and pulmonary nicotine delivery and the following non-nicotinic medications: antidepressants, an alpha4beta2 nicotine partial agonist, an alpha2-noradrenergic agonist, cytochrome P450 (CYP) 2A6 inhibitors, opioid antagonists and GABAergic medications. In addition to existing medications, this article addresses novel medications in the clinical development stage and those that have been evaluated previously. Novel medications in the clinical development stage include at least three nicotine vaccines and the cannabinoid receptor acting drug rimonabant. Medications evaluated previously include lobeline, mecamylamine and an anticholinergic drug regimen comprising atropine, scopolamine and chlorpromazine. Having not been approved by major drug regulatory authorities for the treatment of tobacco dependence and/or withdrawal, these medications have been evaluated in an experimental capacity.
Menopause Int. 2008 Jun;14(2):57-62.
Samat A, Rahim A, Barnett A.
Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK.
Pharmacotherapy for obesity in menopausal women.
Weight gain, during and after the menopause is common. Contributing factors include ethnicity, reduced physical activity, reduced lean mass, reduced resting metabolic rate and treatment with certain drugs, e.g. steroids, insulin, glitazones. Excess body weight increases the risk of medical conditions including type 2 diabetes, hypertension, osteoarthritis, certain cancers and is associated with increased mortality. This review examines pharmacological approaches to promote weight loss. Pharmacological therapy should be considered as an adjunct to diet and lifestyle changes. The licensed drugs orlistat, sibutramine and rimonabant are discussed. Obesity increases the risk of type 2 diabetes. Thus, the effects of metformin and exenatide are examined.
Fortschr Neurol Psychiatr. 2008 Jul;76(7):421-8.
Heberlein A, Bleich S, Kornhuber J, Hillemacher T.
Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, Erlangen.
[Pharmacological treatment options for prevention of alcohol relapse] [Article in German]
Many studies address the neurobiological mechanisms of alcohol craving. The study results obtained so far show that there may be at least three subtypes of craving, which may be linked to changes in different neurotransmitter systems. Actually in Germany acamprosate and disulfiram are approved for clinical use for the prevention of alcohol relapse. Also off-label therapy with naltrexone is possible. However studies show that these substances are not effective in all patients. In the light of hypothetical changes in different neurotransmitter systems, subtype specific therapy may be necessary for successful prevention of alcohol relapse. Therefore new therapy options are needed in order to treat alcohol dependent persons. Substances that seem to have efficacy in preclinical or preliminary clinical studies are baclofen, topiramate, odansetron, rimonabant and memantine.
Diabetes Care. 2008 Aug 4.
Rosenstock J, Hollander P, Chevalier S, Iranmanesh A; for the SERENADE study group.
Dallas Diabetes and Endocrine Center, TX, USA.
The SERENADE Trial: Effects of Monotherapy with Rimonabant, the First Selective CB1 Receptor Antagonist, on Glycemic Control, Body Weight and Lipid Profile in Drug-naive Type 2 Diabetes.
Objective To assess the glucose-lowering efficacy and safety of rimonabant monotherapy in drug-naïve, type 2 diabetes (T2DM) patients. Research design and methods SERENADE was a 6-month, randomized, double-blind, placebo-controlled trial of rimonabant 20 mg/day in drug-naïve patients with T2DM (HbA(1c) 7-10%). Primary endpoint was HbA(1c) change from baseline; secondary endpoints included body weight, waist circumference and lipid profile changes. Results 281 patients were randomized, 278 were exposed to treatment, and 236 (84.9%) completed the study. Baseline HbA(1c) (7.9%) was reduced by -0.8% with rimonabant versus -0.3% with placebo (Delta HbA(1c) -0.51%; P = 0.0002), with a larger rimonabant effect in patients with baseline HbA(1c) >/=8.5% (Delta HbA(1c) -1.25%; P = 0.0009). Weight loss from baseline was -6.7 kg with rimonabant versus -2.8 kg with placebo (Delta weight -3.8 kg; P < 0.0001). Rimonabant induced improvements from baseline in waist circumference (-6 vs. -2 cm; P < 0.0001), fasting plasma glucose (-0.9 vs. -0.1 mmol/L; P = 0.0012), triglycerides (-16.3% vs. +4.4%; P = 0.0031) and HDL-cholesterol (+10.1% vs. +3.2%; P < 0.0001). Adverse events of interest that occurred more frequently with rimonabant versus placebo: dizziness (10.9% vs. 2.1%), nausea (8.7% vs. 3.6%), anxiety (5.8% vs. 3.6%), depressed mood (5.8% vs. 0.7%) and paresthesia (2.9% vs.1.4%). Conclusions Rimonabant monotherapy resulted in meaningful improvements in glycemic control, body weight and lipid profile in drug-naïve T2DM patients. Further ongoing studies will better establish the benefit:risk profile of rimonabant and define its place in T2DM management.
Dev Disabil Res Rev. 2008;14(2):158-64.
Halford JC, Harrold JA.
Kissileff Laboratory for the Study of Human Ingestive Behaviour, School of Psychology, University of Liverpool, Liverpool, United Kingdom.
Neuropharmacology of human appetite expression.
The regulation of appetite relies on the integration of numerous episodic (meal) and tonic (energy storage) generated signals in energy regulatory centres within the central nervous system (CNS). These centers provide the pharmacological potential to modify human appetite (hunger and satiety) to increase or decrease caloric intake, or to normalize aberrant eating behavior. With regard to obesity, the satiety enhancing anti-obesity drug sibutramine has proved effective at reducing body weight. Additionally, the endocannabinoid CB(1) antagonist rimonabant has recently been approved for use in Europe (but not in the US). A 5-HT(2C) agonist lorcaserin is also currently undergoing large-scale clinical trials, but the effect of the drug on human appetite is unknown as yet. Appetite enhancing drugs such as magestrol acetate and dronabiol are currently used to promote weight gain. Finally, sibutramine, selective serotonergic reuptake inhibitors such as fluoxetine and some anti-epileptic drugs have all been used to normalise aberrant eating behaviour. All these drugs act by modifying the expression of human appetite. An assessment of a drug's effects on caloric intake and feelings of hunger and satiety is necessary before they can be considered for clinical use.
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Drug category:Weight loss and gaining agents
 Acomplia scientific update
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