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Meta-Analysis
. 2006 Oct 18;2006(4):CD006162.
doi: 10.1002/14651858.CD006162.pub2.

Rimonabant for overweight or obesity

C Curioni  1 , C André
Affiliations
Meta-Analysis

Rimonabant for overweight or obesity

C Curioni et al. Cochrane Database Syst Rev. .

Abstract

Background: Worldwide, the prevalence of obesity and overweight in industrialized countries and in a substantial number of developing countries is increasing at an alarming rate. Rimonabant is a selective cannabinoid-1 receptor antagonist that has been investigated for its efficacy in reducing body weight and associated risk factors in obese people. Phase III trials are now under way to test the use of rimonabant for long-term weight-loss. Given the prevalence of overweight and obesity, it is important to establish the efficacy and safety of rimonabant.

Objectives: To assess the effects of rimonabant in overweight and obese people.

Search strategy: MEDLINE, EMBASE, The Cochrane Library, LILACS, databases of ongoing trials and reference lists were used to identify relevant trials. The last search was conducted in June 2006.

Selection criteria: Randomised controlled trials comparing rimonabant with placebo or other weight loss interventions in overweight or obese adults.

Data collection and analysis: Two reviewers independently assessed all potentially relevant citations for inclusion and methodological quality. The primary outcome measures were weight loss change, morbidity and adverse effects occurrence.

Main results: Four studies evaluating rimonabant 20 mg versus rimonabant 5 mg versus placebo in addition to a hypocaloric diet lasting at least one year were included. Compared with placebo, rimonabant 20 mg produced a 4.9 kg greater reduction in body weight in trials with one-year results. Improvements in waist circumference, high-density lipoprotein cholesterol, triglyceride levels and systolic and diastolic blood pressure were also seen. However, the results with rimonabant 5 mg demonstrated a weight reduction which was only 1.3 kg greater when compared with placebo. No clinically relevant effects on plasma lipids and blood pressure were found. Rimonabant 20 mg caused significant more adverse effects both of general and serious nature, especially of nervous system, psychiatric or gastro-intestinal origin. Attrition rates were approximately 40% at the end of one year.

Authors' conclusions: The use of rimonabant after one year produces modest weight loss of approximately 5%. Even modest amounts of weight loss may be potentially beneficial. The observed results should be interpreted with some caution, though, since the evaluated studies presented some deficiencies in methodological quality. Studies with longer follow-ups after the end of treatment and of more rigorous quality should be done before definitive recommendations can be made regarding the role of this new medication in the management of overweight or obese patients.

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Conflict of interest statement

None known

Figures

1
1
QUOROM (quality of reporting of meta‐analyses) flow chart for study selection
1.1
1.1. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 1 Weight [kg] change.
1.2
1.2. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 2 Waist circumference [cm] change.
1.3
1.3. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 3 Adverse effects (general).
1.4
1.4. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 4 Adverse effects (serious).
1.5
1.5. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 5 Systolic blood pressure [mmHg] change.
1.6
1.6. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 6 Diastolic blood pressure [mmHg] change.
1.7
1.7. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 7 Triglycerides levels [mg/dl] change.
1.8
1.8. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 8 High‐density lipoprotein [mg/dl] change.
1.9
1.9. Analysis
Comparison 1 Rimonabant 20 mg vs placebo (after one year), Outcome 9 Discontinuation due to adverse events.
2.1
2.1. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 1 Weight [kg] change.
2.2
2.2. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 2 Waist circumference [cm] change.
2.3
2.3. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 3 Adverse effects (general).
2.4
2.4. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 4 Adverse effects (serious).
2.5
2.5. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 5 Systolic blood pressure [mmHg] change.
2.6
2.6. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 6 Diastolic blood pressure [mmHg] change.
2.7
2.7. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 7 Triglycerides levels [mg/dl] change.
2.8
2.8. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 8 High‐density lipoprotein [mg/dl] change.
2.9
2.9. Analysis
Comparison 2 Rimonabant 5 mg vs placebo (after one year), Outcome 9 Discontinuation due to adverse events.
3.1
3.1. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 1 Weight [kg] change.
3.2
3.2. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 2 Waist circumference [kg] change.
3.3
3.3. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 3 Adverse effects (general).
3.4
3.4. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 4 Adverse effects (serious).
3.5
3.5. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 5 Systolic blood pressure [mmHg] change.
3.6
3.6. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 6 Diastolic blood pressure [mmHg] change.
3.7
3.7. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 7 Triglycerides levels [mg/dl] change.
3.8
3.8. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 8 High‐density lipoprotein [mg/dl] change.
3.9
3.9. Analysis
Comparison 3 Rimonabant 20 mg vs rimonabant 5 mg (after one year), Outcome 9 Discontinuation due to adverse events.
See this image and copyright information in PMC

Comment in

References

References to studies included in this review

RIO‐Diabetes {unpublished data only}
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RIO‐Europe {published data only}
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