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CB1 receptor blockade and its impact on cardiometabolic risk factors: overview of the RIO programme with rimonabant.
J Neuroendocrinol. 2008 May; 20 Suppl 1:139-46.JN

Abstract

Rimonabant, the first selective CB(1) receptor antagonist in clinical use, has been extensively investigated in the Rimonabant in Obesity (RIO) programme, comprising four 1-2 year placebo-controlled randomised clinical trials recruiting more than 6600 overweight/obese patients with or without co-morbidities. Rimonabant 20 mg daily consistently reduced body weight, waist circumference, triglycerides, blood pressure, insulin resistance and C-reactive protein levels, and increased HDL cholesterol concentrations in both non-diabetic and type-2 diabetic overweight/obese patients. Adiponectin levels were increased, an effect that correlated with HDL cholesterol augmentation, while small dense LDL cholesterol levels were decreased in patients receiving rimonabant 20 mg compared with those receiving placebo in RIO Lipids. Furthermore, in RIO Diabetes, a 0.7% reduction in glycated haemoglobin (HbA1c) levels was observed in metformin- or sulphonylurea-treated patients with type-2 diabetes, an effect recently confirmed in the 6-month SERENADE (Study Evaluating Rimonabant Efficacy in drug-NAive DiabEtic patients) trial in drug-naive diabetic patients. Almost half of metabolic changes occurred beyond weight loss, in agreement with direct peripheral effects. The positive effects observed after 1 year were maintained after 2 years. Rimonabant was generally well-tolerated, but with a slightly higher incidence of depressed mood disorders, anxiety, nausea and dizziness compared with placebo. In clinical practice, rimonabant has to be prescribed to the right patient, i.e. overweight/obese subjects with cardiometabolic risk factors and with no major depressive illness and/or ongoing antidepressive treatment, in order to both maximise efficacy and minimise safety issues. New trials are supposed to confirm the potential role of rimonabant in patients with abdominal adiposity, atherogenic dyslipidaemia and/or type-2 diabetes, i.e. at high cardiometabolic risk.

Authors+Show Affiliations

Division of Diabetes, Nutrition and Metabolic Disorders and Clinical Pharmacology Unit, CHU Sart Tilman, University of Liege, Liege, Belgium. andre.scheen@chu.ulg.ac.be

Pub Type(s)

Evaluation Study
Journal Article
Review

Language

eng

PubMed ID

18426513

Citation

Scheen, A J.. "CB1 Receptor Blockade and Its Impact On Cardiometabolic Risk Factors: Overview of the RIO Programme With Rimonabant." Journal of Neuroendocrinology, vol. 20 Suppl 1, 2008, pp. 139-46.
Scheen AJ. CB1 receptor blockade and its impact on cardiometabolic risk factors: overview of the RIO programme with rimonabant. J Neuroendocrinol. 2008;20 Suppl 1:139-46.
Scheen, A. J. (2008). CB1 receptor blockade and its impact on cardiometabolic risk factors: overview of the RIO programme with rimonabant. Journal of Neuroendocrinology, 20 Suppl 1, 139-46. https://doi.org/10.1111/j.1365-2826.2008.01681.x
Scheen AJ. CB1 Receptor Blockade and Its Impact On Cardiometabolic Risk Factors: Overview of the RIO Programme With Rimonabant. J Neuroendocrinol. 2008;20 Suppl 1:139-46. PubMed PMID: 18426513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CB1 receptor blockade and its impact on cardiometabolic risk factors: overview of the RIO programme with rimonabant. A1 - Scheen,A J, PY - 2008/5/9/pubmed PY - 2008/7/19/medline PY - 2008/5/9/entrez SP - 139 EP - 46 JF - Journal of neuroendocrinology JO - J. Neuroendocrinol. VL - 20 Suppl 1 N2 - Rimonabant, the first selective CB(1) receptor antagonist in clinical use, has been extensively investigated in the Rimonabant in Obesity (RIO) programme, comprising four 1-2 year placebo-controlled randomised clinical trials recruiting more than 6600 overweight/obese patients with or without co-morbidities. Rimonabant 20 mg daily consistently reduced body weight, waist circumference, triglycerides, blood pressure, insulin resistance and C-reactive protein levels, and increased HDL cholesterol concentrations in both non-diabetic and type-2 diabetic overweight/obese patients. Adiponectin levels were increased, an effect that correlated with HDL cholesterol augmentation, while small dense LDL cholesterol levels were decreased in patients receiving rimonabant 20 mg compared with those receiving placebo in RIO Lipids. Furthermore, in RIO Diabetes, a 0.7% reduction in glycated haemoglobin (HbA1c) levels was observed in metformin- or sulphonylurea-treated patients with type-2 diabetes, an effect recently confirmed in the 6-month SERENADE (Study Evaluating Rimonabant Efficacy in drug-NAive DiabEtic patients) trial in drug-naive diabetic patients. Almost half of metabolic changes occurred beyond weight loss, in agreement with direct peripheral effects. The positive effects observed after 1 year were maintained after 2 years. Rimonabant was generally well-tolerated, but with a slightly higher incidence of depressed mood disorders, anxiety, nausea and dizziness compared with placebo. In clinical practice, rimonabant has to be prescribed to the right patient, i.e. overweight/obese subjects with cardiometabolic risk factors and with no major depressive illness and/or ongoing antidepressive treatment, in order to both maximise efficacy and minimise safety issues. New trials are supposed to confirm the potential role of rimonabant in patients with abdominal adiposity, atherogenic dyslipidaemia and/or type-2 diabetes, i.e. at high cardiometabolic risk. SN - 1365-2826 UR - https://www.unboundmedicine.com/medline/citation/18426513/CB1_receptor_blockade_and_its_impact_on_cardiometabolic_risk_factors:_overview_of_the_RIO_programme_with_rimonabant_ L2 - https://doi.org/10.1111/j.1365-2826.2008.01681.x DB - PRIME DP - Unbound Medicine ER -