Rimonabant Synopsis of RIO-Lipids Reprint Publication Information Title: Effects of Rimonabant on Metabolic Risk Factors in Overweight Patients with Dyslipidemia Authors: Després J-P, Golay A, Sjöström L, for the Rimonabant in Obesity-Lipids Study Group Journal: N Engl J Med 2005;353:2121-34 Objective
To study the effects of rimonabant on metabolic risk factors, including adiponectin levels, in high-risk patients
who are overweight or obese and have untreated dyslipidemia
Design
Randomized, double-blind, placebo-controlled, multicenter study
Patients randomized to receive placebo, rimonabant 5 mg, or rimonabant 20 mg (1:1:1 ratio,
Single blind, 4-week placebo run-in period with mildly hypocaloric diet (600 kcal/day deficit) that
Patient Population
Presence of untreated dyslipidemia: triglycerides > 150-700 mg/dL (1.69-7.90 mmol/L), or ratio
of cholesterol to high-density lipoprotein cholesterol (HDL-C) of > 4.5 in women and > 5 in men
Endpoints
Primary: Change in body weight
Secondary: Changes in levels of HDL-C, triglycerides, glucose, insulin (during an oral glucose
tolerance test), metabolic syndrome, waist circumference, leptin, adiponectin, and relevant biochemical cardiovascular markers (for example, C-reactive protein); and assessment of safety
Results
Weight change: Rimonabant 20 mg induced significant weight loss compared with placebo: -19 lb
(-8.6 kg) rimonabant 20 mg vs. -5.1 lb (-2.3 kg) placebo using the repeated-measures (RM) model for completers (which provided a better estimate of the true effect of the drug than last observation carried forward [LOCF]); with the LOCF analysis, weight loss was -15.2 lb (-6.9 kg) rimonabant 20 mg vs. -3.3 lb (-1.5 kg) placebo (P < 0.001)
FOR SALES EDUCATION ONLY. NOT FOR PROMOTIONAL USE. DO NOT DUPLICATE, DISTRIBUTE, OR USE IN DETAILING. Rimonabant
Waist circumference: Rimonabant 20 mg induced a significant decrease in waist circumference
compared with placebo: -9.1 cm with rimonabant 20 mg vs. -3.4 cm with placebo (P < 0.001) using RM; and -7.1 cm vs. -2.4 cm using LOCF
Triglycerides: Levels decreased -15.8% with rimonabant 20 mg vs. -3.6% with placebo (P <
0.001) using RM; -12.6 vs. -0.2 using LOCF
HDL-C: Levels increased 23.4% with rimonabant 20 mg vs. 12.2% with placebo (P < 0.001) using
Plasma adiponectin: Levels of plasma adiponectin increased by 57.7% with rimonabant 20 mg
using RM and 46.2% using LOCF (P < 0.001), a change that was partly independent of weight loss
Other factors: Rimonabant 20 mg also showed significant improvement over placebo in changes
in low-density lipoprotein particle size, glucose tolerance, fasting and post-challenge insulin levels, C-reactive protein levels, and the proportion of patients with metabolic syndrome
Safety profile: The rates of completion for the study were similar among those receiving placebo
and rimonabant 5 mg and 20 mg. The most frequent adverse events causing discontinuation were depression, anxiety, and nausea
Conclusions
CB1-receptor blockade with rimonabant significantly reduces body weight and waist circumference
and improves a number of metabolic risk factors in overweight or obese patients who have atherogenic dyslipidemia
The adverse-event profile in this study was similar to that in the RIO-Europe study
The weight-loss-independent effect of rimonabant on plasma adiponectin levels is consistent with
rimonabant's in vitro effect on adiponectin production by adipocytes
FOR SALES EDUCATION ONLY. NOT FOR PROMOTIONAL USE. DO NOT DUPLICATE, DISTRIBUTE, OR USE IN DETAILING.
Pain Medicine 2011; 12: 459–465Wiley Periodicals, Inc. NEUROPATHIC PAIN SECTION Original Research Article The Lack of Efficacy of Different Infusion Rates of Intrathecal Baclofen in Complex Regional Pain Syndrome: A Randomized, Double-Blind, Crossover Studypme_1065459.465 Anton Adriaan van der Plas, MD,* Johan Marinus, Results. There were no significant differences PhD,* Sa
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