Xenical Publication Review 19-20

Pol Arch Med Wewn. 2004 Dec;112(6):1415-23.
[Effect of orlistat therapy on carbohydrate, lipid, vitamin and hormone plasma levels in obese subjects]

[Article in Polish]

Czerwienska B, Kokot F, Franek E, Irzyniec T, Wiecek A.

Katedra i Klinika Nefrologii, Endokrynologii i Chorób Przemiany Materii Sl. AM w Katowicach.

Orlistat is an inhibitor of lipase which splits triglycerides into free fatty acides and glycerol. This drug, by inhibiting hydrolysis of triglycerides, is the cause of significant loss of fat in the faeces. 13 obese and 15 nonobese subjects were examined. Obese subjects received orlistat (Xenical, F. Hoffmann La Roche Ltd, Switzerland) 3 x 120 mg/d. Treatment with orlistat for 16 weeks was followed by a significant fall of BMI and MAP, insulinemia, insulin/glucose ratio, leptinemia, serum total cholesterol, triglycerides, HDL-cholesterol and 25-OH-D concentration respectively. Orlistat did not influence significantly serum LDL-cholesterol concentration but unexpectedly increased plasma levels of folic acid, vitamin B12 and NPY. CONCLUSIONS: (1) Monitoring of plasma 25-OH-D levels in obese patients on orlistat therapy seems to be mandatory. (2) In spite of significant changes (in opposite direction) in leptinemia and serum NPY level observed in obese subjects treated with orlistat, presence of a functional relationship between these hormones could not be confirmed.

PMID: 15962606 [PubMed - indexed for MEDLINE]

Therapie. 2005 Jan-Feb;60(1):17-24.
[Results from the observational study EPIGRAM: management of excess weight in general practice and follow-up of patients treated with orlistat]

[Article in French]

Vray M, Joubert JM, Eschwège E, Liard F, Fagnani F, Montestruc F, Fages S, Bégaud B.

Institut Pasteur, Bâtiment Laveran, Paris, France. vray@pasteur.fr

The EPIGRAM pharmacoepidemiological study was conducted in general practitioners (GPs) prescribing orlistat (Xenical) in order to describe, under real clinical conditions, the management of obese or overweight patients, as well as a 1-year follow-up of a patient cohort treated with orlistat. A total of 714 GPs participated in this study and recruited a total of 6801 patients. Forty percent were treated with orlistat, 76% were women and 63% presented with a comorbidity. With a mean body mass index of 33.1+/-5.1 kg/m2, 85% of the patients treated with orlistat were in agreement with the indications of this drug. Comparison of patients treated and not treated with orlistat did not allow identification of any key factor able to predict prescription of the treatment. Patients treated with orlistat on inclusion and reviewed at least once by their doctor were followed up for an average of 11 months and a maximum of 23 months. Between 64% and 77% of patients stopped treatment with orlistat during the follow-up period. The treatment cost was the main reason for definitive treatment discontinuation for more than 50% of the patients. The average weight loss was 5% and 9% after 3 and 12 months of treatment, respectively.

PMID: 15929469 [PubMed - indexed for MEDLINE]