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Rimonabant found beneficial for CVD risk reduction
New RIO: North America Study found that rimonabant can improve HDL cholesterol, triglycerides and insulin sensitivity.
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Treatment with rimonabant may offer significant weight loss benefits for patients who are overweight or obese, according to recent results from the RIO: North America Study.
The study, led by F. Xavier Pi-Sunyer, MD, chief of the division of endocrinology at the Saint Luke’s–Roosevelt Hospital Center of Columbia University, demonstrated that rimonabant (Acomplia, Sanofi Aventis) may offer benefits for both weight loss and other cardiovascular risk factors.
Patients treated with a once-daily dose of rimonabant 20 mg experienced significant reduction of their waist circumference and body weight, as well as improvements in multiple cardiometabolic risk factors, including HDL cholesterol, triglycerides and an estimate of insulin sensitivity.
Two-year evaluation
The study involved a two-year evaluation of 3,045 patients at 64 American and eight Canadian sites. All patients included in the study were overweight or obese and had hypertension or dyslipidemia.
After a four-week run-in period that involved placebo plus reduced-caloric diet, patients were randomized to receive placebo, rimonabant at a daily dose of 5 mg or rimonabant at a daily dose of 20 mg for one year.
After one year, all patients treated with rimonabant were randomized once again to receive placebo or to continue to receive the same rimonabant dose for a second year. During this second year, the placebo group continued to receive the placebo.
20-mg dose most effective
At the end of the first year, patients in the 20 mg of rimonabant group showed the most significant improvements. Compared with the placebo group, this group had greater mean reductions in weight and waist circumference. The 20 mg of rimonabant group lost an average of 6.3 kg; average weight loss was 1.6 kg for the placebo group during the same time.
Waist circumference decreased 6.1 cm for the 20 mg of rimonabant group and 2.5 cm for the placebo group. Triglyceride levels and HDL cholesterol also improved more significantly among patients who took 20 mg of rimonabant.
Patients who were switched from the 20 mg rimonabant group to the placebo group during the second year experienced weight regain while those who continued to receive 20 mg of rimonabant maintained their weight loss and favorable changes in cardiometabolic risk factors.
The researchers noted that rimonabant was generally well tolerated; a small percentage of patients experienced nausea.
“The RIO-North America trial results indicate that rimonabant at a daily dose of 20 mg produced sustained, clinically meaningful weight loss and improvements in associated risk factors during two years of treatment,” Pi-Sunyer said in a press release.
“The sustained improvements we see in several risk factors were beyond what was expected from the observed weight loss and suggests that rimonabant represents an exciting breakthrough in our quest to improve the multiple cardiometabolic risk factors contributing to increased risk for diabetes and heart disease in patients who have abdominal obesity.”
For more information:
- Pi-Sunyer FX, Aronne L, Heshmati H, et al. Effect of rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients. JAMA. 2006;295:761-775.