Lorcaserin facilitates weight loss despite presence of obstructive sleep apnea
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Adults with overweight or obesity and obstructive sleep apnea assigned to the serotonin receptor agonist lorcaserin lost weight at a rate similar to those without obstructive sleep apnea, with 47% experiencing at least 5% weight loss and 22.2% experiencing at least 10% weight loss at 1 year, according to findings from a retrospective analysis published in Obesity Science & Practice.
“Obstructive sleep apnea is very common among patients that struggle with weight,” Ken Fujioka, MD, director of the Center for Weight Management and director of the Nutrition and Metabolic Research Center at Scripps Clinic San Diego, told Endocrine Today. “It is felt by many that patients with untreated obstructive sleep apnea may have a hard time losing weight because of the hormonal changes that go on with the condition, especially if not treated. This study demonstrates that patients with obstructive sleep apnea can lose weight just like any other patient that struggles with weight. Weight loss is an excellent treatment for obstructive sleep apnea, especially if it is mild or moderate.”
Fujioka and colleagues analyzed data from 336 participants with self-reported obstructive sleep apnea identified from a pooled population of participants in three randomized controlled trials (BLOOM, BLOSSOM and BLOOM-DM) assessing the efficacy and safety of lorcaserin (Belviq, Eisai) in adults with overweight or obesity. Researchers randomly assigned participants in the three studies to receive 10 mg lorcaserin twice per day (n = 176; mean age, 51 years; 44.3% women) or placebo (n = 160; mean age, 52 years; 36.9% women) along with diet and exercise. Researchers evaluated weight loss data through week 52, including overall weight change at year 1 and the proportion of participants with at least 5% and 10% weight loss from baseline. Changes in heart rate and blood pressure were also evaluated.
At year 1, 47.2% of participants assigned to lorcaserin and 25.6% of participants assigned to placebo lost at least 5% of baseline body weight (P < .0001), whereas 22.2% of participants in the lorcaserin group and 13.1% of participants in the placebo group lost at least 10% of baseline body weight (P < .0354). Participants in the lorcaserin group overall lost approximately twice as much weight at year 1 compared with participants in the placebo group (mean, 6.4 kg vs. 3.5 kg; P < .0001), according to researchers.
Weight loss for participants with obstructive sleep apnea was similar when compared with participants without obstructive sleep apnea across the three studies. Lorcaserin was also associated with improvements in BP and heart rate in participants with obstructive sleep apnea when compared with placebo, according to researchers.
“These results may be more significant considering report of recently reviewed evidence suggesting that [obstructive sleep apnea] leads to weight gain by causing changes that adversely impact the balance intake and expenditure of energy,” the researchers wrote. “A weight loss of 5% to 10% is meaningful for patients and is associated with beneficial effects in a number of conditions, including sleep apnea, hypertension, diabetes, dyslipidemia and arthritis.” – by Regina Schaffer
Disclosures: Fujioka reports he has served as a paid consultant for Ambra, Eisai, Gelesis, KVK Tech, Nazura, Novo Nordisk, Orexigen and Zafgen and received research funding from Eisai, EnteroMedics, Novo Nordisk, Orexigen and Shire and speaking fees from Novo Nordisk, Orexigen and Shire. Two other authors report they are employees of Eisai.