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A systematic review and mixed treatment comparison of pharmacological interventions for the treatment of obesity.
Obes Rev. 2012 Jun; 13(6):483-98.OR

Abstract

The study aims to compare anti-obesity interventions in a single evidence synthesis framework. Electronic databases were searched for randomized controlled trials of orlistat, rimonabant or sibutramine reporting weight or body mass index (BMI) change from baseline at 3, 6 or 12 months. A mixed treatment comparison was used to combine direct and indirect trial evidence. Ninety-four studies involving 24,808 individuals were included; 83 trials included data on weight change and 41 on BMI change. All results are in comparison with placebo. The active drugs were all effective at reducing weight and BMI. At 3 months, orlistat reduced weight by -2.65 kg (95% credibility interval -4.00 kg, -1.31 kg). For sibutramine, 15 mg gave a greater reduction than 10 mg at 12 months, -6.35 kg versus -5.42 kg, respectively. Rimonabant reduced weight by -11.23 kg at 3 months and -4.55 kg at 12 months. Lifestyle advice alone also reduced weight at 6 and 12 months, but was less effective than the pharmacological interventions. In conclusion, modest weight reductions were seen for all pharmacological interventions. Those interventions which have now been withdrawn from use (sibutramine and rimonabant) seem to be the most effective, implying that there may be a place in clinical practice for similar drugs if side effects could be avoided.

Authors+Show Affiliations

Department of Health Sciences, University of Leicester, Leicester, UK. lg48@le.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

22288431

Citation

Gray, L J., et al. "A Systematic Review and Mixed Treatment Comparison of Pharmacological Interventions for the Treatment of Obesity." Obesity Reviews : an Official Journal of the International Association for the Study of Obesity, vol. 13, no. 6, 2012, pp. 483-98.
Gray LJ, Cooper N, Dunkley A, et al. A systematic review and mixed treatment comparison of pharmacological interventions for the treatment of obesity. Obes Rev. 2012;13(6):483-98.
Gray, L. J., Cooper, N., Dunkley, A., Warren, F. C., Ara, R., Abrams, K., Davies, M. J., Khunti, K., & Sutton, A. (2012). A systematic review and mixed treatment comparison of pharmacological interventions for the treatment of obesity. Obesity Reviews : an Official Journal of the International Association for the Study of Obesity, 13(6), 483-98. https://doi.org/10.1111/j.1467-789X.2011.00981.x
Gray LJ, et al. A Systematic Review and Mixed Treatment Comparison of Pharmacological Interventions for the Treatment of Obesity. Obes Rev. 2012;13(6):483-98. PubMed PMID: 22288431.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A systematic review and mixed treatment comparison of pharmacological interventions for the treatment of obesity. AU - Gray,L J, AU - Cooper,N, AU - Dunkley,A, AU - Warren,F C, AU - Ara,R, AU - Abrams,K, AU - Davies,M J, AU - Khunti,K, AU - Sutton,A, Y1 - 2012/01/30/ PY - 2012/2/1/entrez PY - 2012/2/1/pubmed PY - 2012/6/23/medline SP - 483 EP - 98 JF - Obesity reviews : an official journal of the International Association for the Study of Obesity JO - Obes Rev VL - 13 IS - 6 N2 - The study aims to compare anti-obesity interventions in a single evidence synthesis framework. Electronic databases were searched for randomized controlled trials of orlistat, rimonabant or sibutramine reporting weight or body mass index (BMI) change from baseline at 3, 6 or 12 months. A mixed treatment comparison was used to combine direct and indirect trial evidence. Ninety-four studies involving 24,808 individuals were included; 83 trials included data on weight change and 41 on BMI change. All results are in comparison with placebo. The active drugs were all effective at reducing weight and BMI. At 3 months, orlistat reduced weight by -2.65 kg (95% credibility interval -4.00 kg, -1.31 kg). For sibutramine, 15 mg gave a greater reduction than 10 mg at 12 months, -6.35 kg versus -5.42 kg, respectively. Rimonabant reduced weight by -11.23 kg at 3 months and -4.55 kg at 12 months. Lifestyle advice alone also reduced weight at 6 and 12 months, but was less effective than the pharmacological interventions. In conclusion, modest weight reductions were seen for all pharmacological interventions. Those interventions which have now been withdrawn from use (sibutramine and rimonabant) seem to be the most effective, implying that there may be a place in clinical practice for similar drugs if side effects could be avoided. SN - 1467-789X UR - https://www.unboundmedicine.com/medline/citation/22288431/A_systematic_review_and_mixed_treatment_comparison_of_pharmacological_interventions_for_the_treatment_of_obesity_ L2 - https://doi.org/10.1111/j.1467-789X.2011.00981.x DB - PRIME DP - Unbound Medicine ER -