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Rimonabant: endocannabinoid inhibition for the metabolic syndrome.
Int J Clin Pract. 2006 Dec; 60(12):1697-706.IJ

Abstract

Rimonabant is the first drug to target the endocannabinoid (CB) pathway by inhibiting the actions of anandamide and 2-archidonyl-glycerol on CB1 receptors. This review gives an overview of rimonabant and the CB system and how this system relates to obesity. Rimonabant blocks the central effects of this neurotransmitter pathway involved in obesity and weight control and also blocks the direct effects of CBs on adipocyte and hepatocyte metabolism. Blockade of CB1 receptors leads to a decrease in appetite and also has direct actions in adipose tissue and the liver to improve glucose, fat and cholesterol metabolism so improving insulin resistance, triglycerides and high-density lipoprotein cholesterol (HDL-C) and in some patients, blood pressure. The Rimonabant in Obesity (RIO) trials have shown that rimonabant induces weight loss > 5% in 30-40% of patients and > 10% in 10-20% above both a dietary run-in and long-term hypocaloric management over a 2 year period with a low level of drug-related side effects. Rimonabant therapy is associated with an extra 8-10% increase in HDL-C and a 10-30% reduction in triglycerides and improvements in insulin resistance, glycaemic control in patients with diabetes and also adipokines and cytokines including C-reactive protein over hypocaloric diet therapy. In addition rimonabant abolishes the weight gain associated with smoking cessation and improves the chances of quitting smoking. Thus rimonabant has major effects on both the metabolic syndrome and cardiovascular risk factors thus has the potential to reduce the risks of type 2 diabetes and cardiovascular disease associated with the cardiometabolic phenotype.

Authors+Show Affiliations

Lipid Unit, St. Thomas' Hospital, London, UK. anthony.wierzbicki@kcl.ac.uk

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17109677

Citation

Wierzbicki, A S.. "Rimonabant: Endocannabinoid Inhibition for the Metabolic Syndrome." International Journal of Clinical Practice, vol. 60, no. 12, 2006, pp. 1697-706.
Wierzbicki AS. Rimonabant: endocannabinoid inhibition for the metabolic syndrome. Int J Clin Pract. 2006;60(12):1697-706.
Wierzbicki, A. S. (2006). Rimonabant: endocannabinoid inhibition for the metabolic syndrome. International Journal of Clinical Practice, 60(12), 1697-706.
Wierzbicki AS. Rimonabant: Endocannabinoid Inhibition for the Metabolic Syndrome. Int J Clin Pract. 2006;60(12):1697-706. PubMed PMID: 17109677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rimonabant: endocannabinoid inhibition for the metabolic syndrome. A1 - Wierzbicki,A S, PY - 2006/11/18/pubmed PY - 2007/8/24/medline PY - 2006/11/18/entrez SP - 1697 EP - 706 JF - International journal of clinical practice JO - Int J Clin Pract VL - 60 IS - 12 N2 - Rimonabant is the first drug to target the endocannabinoid (CB) pathway by inhibiting the actions of anandamide and 2-archidonyl-glycerol on CB1 receptors. This review gives an overview of rimonabant and the CB system and how this system relates to obesity. Rimonabant blocks the central effects of this neurotransmitter pathway involved in obesity and weight control and also blocks the direct effects of CBs on adipocyte and hepatocyte metabolism. Blockade of CB1 receptors leads to a decrease in appetite and also has direct actions in adipose tissue and the liver to improve glucose, fat and cholesterol metabolism so improving insulin resistance, triglycerides and high-density lipoprotein cholesterol (HDL-C) and in some patients, blood pressure. The Rimonabant in Obesity (RIO) trials have shown that rimonabant induces weight loss > 5% in 30-40% of patients and > 10% in 10-20% above both a dietary run-in and long-term hypocaloric management over a 2 year period with a low level of drug-related side effects. Rimonabant therapy is associated with an extra 8-10% increase in HDL-C and a 10-30% reduction in triglycerides and improvements in insulin resistance, glycaemic control in patients with diabetes and also adipokines and cytokines including C-reactive protein over hypocaloric diet therapy. In addition rimonabant abolishes the weight gain associated with smoking cessation and improves the chances of quitting smoking. Thus rimonabant has major effects on both the metabolic syndrome and cardiovascular risk factors thus has the potential to reduce the risks of type 2 diabetes and cardiovascular disease associated with the cardiometabolic phenotype. SN - 1368-5031 UR - https://www.unboundmedicine.com/medline/citation/17109677/Rimonabant:_endocannabinoid_inhibition_for_the_metabolic_syndrome_ L2 - https://doi.org/10.1111/j.1742-1241.2006.01210.x DB - PRIME DP - Unbound Medicine ER -