Drug combination found to reduce body weight
Monday August 2nd, 2010
A combination of two drugs may be an effective treatment for obesity, researchers have reported.
Professor Frank Greenway of Louisiana State University System, USA, and colleagues tested a treatment of sustained-release naltrexone plus bupropion, predicting it would "produce complementary actions in central nervous system pathways regulating bodyweight".
A total of 1,742 adults with a body mass index of 30 to 45 took part, mostly (85 per cent) women.
They randomly received either 32mg or 16mg of sustained-release naltrexone plus 360mg of sustained-release bupropion in one tablet per day, or placebo. All were prescribed a moderately reduced calorie diet and exercise.
Half the participants continued for 56 weeks. At this point, the average loss of bodyweight was six per cent on the higher dose, five per cent on the lower dose, and one per cent on placebo.
Common side-effects included nausea, headache, constipation, dizziness, vomiting, and dry mouth. Full results appear in the Lancet.
"A sustained-release combination of naltrexone plus bupropion could be a useful therapeutic option for treatment of obesity," report the team.
They write that a weight loss of five to ten per cent improved blood sugar control, and reduced the risk of abnormal blood fats and high blood pressure. "This combination improves control of eating and response to food cravings," they add.
But Professor Arne Astrup of the University of Copenhagen, Denmark, points out that the participants' blood pressure and cholesterol was not reduced as much as would be expected.
He writes: "More data are needed to get a better overall assessment of cardiovascular risk of this otherwise promising combination therapy for obesity."
Greenway, F. L. et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet, published online July 30, 2010.
Astrup, A. Is cardiometabolic risk improved by weight-loss drugs? The Lancet, published online July 30, 2010.
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