Dataset Information

Long term pharmacotherapy for obesity and overweight: updated meta-analysis.

ABSTRACT:

Objective

To summarise the long term efficacy of anti-obesity drugs in reducing weight and improving health status.

Design

Updated meta-analysis of randomised trials.

Data sources

Medline, Embase, the Cochrane controlled trials register, the Current Science meta-register of controlled trials, and reference lists of identified articles. All data sources were searched from December 2002 (end date of last search) to December 2006.

Studies reviewed

Double blind randomised placebo controlled trials of approved anti-obesity drugs used in adults (age over 18) for one year or longer.

Results

30 trials of one to four years' duration met the inclusion criteria: 16 orlistat (n=10 631 participants), 10 sibutramine (n=2623), and four rimonabant (n=6365). Of these, 14 trials were new and 16 had previously been identified. Attrition rates averaged 30-40%. Compared with placebo, orlistat reduced weight by 2.9 kg (95% confidence interval 2.5 kg to 3.2 kg), sibutramine by 4.2 kg (3.6 kg to 4.7 kg), and rimonabant by 4.7 kg (4.1 kg to 5.3 kg). Patients receiving active drug treatment were significantly more likely to achieve 5% and 10% weight loss thresholds. Orlistat reduced the incidence of diabetes and improved concentrations of total cholesterol and low density lipoprotein cholesterol, blood pressure, and glycaemic control in patients with diabetes but increased rates of gastrointestinal side effects and slightly lowered concentrations of high density lipoprotein. Sibutramine improved [corrected] concentrations of high density lipoprotein cholesterol and triglycerides [corrected] Rimonabant improved concentrations of high density lipoprotein cholesterol and triglycerides, blood pressure, and glycaemic control in patients with diabetes but increased the risk of mood disorders.

Conclusions

Orlistat, sibutramine, and rimonabant modestly reduce weight, have differing effects on cardiovascular risk profiles, and have specific adverse effects.

SUBMITTER: Rucker D

PROVIDER: S-EPMC2128668 | biostudies-literature | 2007 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Long term pharmacotherapy for obesity and overweight: updated meta-analysis.

Rucker Diana D Padwal Raj R Li Stephanie K SK Curioni Cintia C Lau David C W DC

BMJ (Clinical research ed.) 20071115 7631

<h4>Objective</h4>To summarise the long term efficacy of anti-obesity drugs in reducing weight and improving health status.<h4>Design</h4>Updated meta-analysis of randomised trials.<h4>Data sources</h4>Medline, Embase, the Cochrane controlled trials register, the Current Science meta-register of controlled trials, and reference lists of identified articles. All data sources were searched from December 2002 (end date of last search) to December 2006.<h4>Studies reviewed</h4>Double blind randomise ...[more]

PMID: 18006966

Similar Datasets

Project description:Background: Evidence for the efficacy of Pilates for the modulation of body weight and body composition is unclear. Objective: This meta-analysis aimed to evaluate the effects of Pilates on body weight and body composition in adults with overweight or obesity. Data Sources: The PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and EMBASE databases were systematically searched from the inception dates to 12 November 2020 for relevant randomized controlled trials (RCTs). Study Selection: Randomized controlled trials comparing Pilates with other physical exercises or without any intervention were included. Data Extraction and Synthesis: Three reviewers independently performed the data extraction and assessed study quality. The mean differences (MDs) and 95% confidence intervals (CIs) for pooled data were calculated. Main Outcomes and Measures: Outcome measures were body weight, body mass index (BMI), body fat percentage, lean body mass, and waist circumference. Results: Eleven RCTs with 393 subjects were included. This study revealed that Pilates dramatically reduces body weight (MD = -2.40, 95% CI: [-4.04, -0.77], P = 0.004, I 2 = 51%), BMI (MD = -1.17, 95% CI: [-1.85, -0.50], P = 0.0006, I 2 = 61%), and body fat percentage (MD = -4.22, 95% CI: [-6.44, -2.01], P = 0.0002, I 2 = 88%) in adults with overweight or obesity. The reduction in body weight and body fat percentage appears to be more pronounced in studies including participants with obesity only, and the efficacy of Pilates for the improvement of body weight and BMI appears to be more evident in longer intervention duration. However, Pilates has no significant effect on waist circumference (MD = -2.65, 95% CI: [-6.84, 1.55], P = 0.22, I 2 = 0%) and lean body mass (MD = -0.00, 95% CI: [-1.40, 1.40], P = 1.00, I 2 = 23%). Conclusions: Pilates dramatically reduces body weight, BMI, and body fat percentage in adults with overweight or obesity. Large-scale and well-designed RCTs with improved methodology and reporting are urgently needed to further confirm these results.

Project description:To examine the comparative efficacy and safety of different antiplatelet regimens in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack.Systematic review and network meta-analysis.As on 31 March 2015, all randomised controlled trials that investigated the effects of antiplatelet agents in the long-term (≥ 3 months) secondary prevention of non-cardioembolic transient ischaemic attack or ischaemic stroke were searched and identified.The primary outcome measure of efficacy was serious vascular events (non-fatal stroke, non-fatal myocardial infarction and vascular death). The outcome measure of safety was any bleeding.A total of 36 randomised controlled trials (82,144 patients) were included. Network meta-analysis showed that cilostazol was significantly more effective than clopidogrel (OR 0.77, 95% credible interval 0.60-0.98) and low-dose (75-162 mg daily) aspirin (0.69, 0.55-0.86) in the prevention of serious vascular events. Aspirin (50 mg daily) plus dipyridamole (400 mg daily) and clopidogrel reduced the risk of serious vascular events compared with low-dose aspirin; however, the difference was not statistically significant. Furthermore, low-dose aspirin was as effective as higher daily doses. Cilostazol was associated with a significantly lower bleeding risk than most of the other regimens. Moreover, aspirin plus clopidogrel was associated with significantly more haemorrhagic events than other regimens. Direct comparisons showed similar results as the network meta-analysis.Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75-162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups.

Dataset Information

Long term pharmacotherapy for obesity and overweight: updated meta-analysis.

Objective

Design

Data sources

Studies reviewed

Results

Conclusions

Publications

Long term pharmacotherapy for obesity and overweight: updated meta-analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets