Literature DB >> 19758358

Weight and blood pressure response to weight management and sibutramine in diabetic and non-diabetic high-risk patients: an analysis from the 6-week lead-in period of the sibutramine cardiovascular outcomes (SCOUT) trial.

L F Van Gaal1, I D Caterson, W Coutinho, N Finer, A P Maggioni, A M Sharma, C Torp-Pedersen, H Ge, S A Moran, G M Shepherd, W P T James.   

Abstract

OBJECTIVE: To assess treatment responses to sibutramine and weight management in diabetic patients during the lead-in period of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial.
METHODS: SCOUT is an ongoing, prospective, randomized, double-blind, placebo-controlled outcome trial in cardiovascular high-risk overweight/obese patients. A total of 10 742 patients received single-blind sibutramine and individualized weight management during the 6-week lead-in period; 84% had a history of type 2 diabetes mellitus and additional co-morbidities. Post-hoc analyses assessed anthropomorphic and vital sign responses between patients with and without diabetes.
RESULTS: Concomitant antidiabetic medication use was reported by 86% of the diabetic patients (approximately 30% required insulin-alone or in combination). Body weight and waist circumference decreased in diabetic patients: median 2.1 kg; 2.0 cm (both men and women); for those on insulin: 1.9 kg; 1.5/2.0 cm (men/women); without insulin: 2.3 kg; 2.0 cm (both men and women); blood pressure (BP) was also reduced (median systolic/diastolic 3.5/1.0 mmHg) with larger reductions in diabetic patients who were hypertensive and/or lost the most weight (>5%). In diabetic patients who entered with BP at target (<130/<85 mmHg) but did not lose weight (N = 245), increases of 3.5/2.0 mmHg were observed. Non-diabetic patients had greater weight losses (2.5 kg) but smaller reductions in BP (systolic/diastolic -2.5/-0.5 mmHg). Pulse rate increases were less in diabetic vs. non-diabetic patients (1.5 vs. 2.0 bpm).
CONCLUSION: In these high-risk diabetic patients, sibutramine and lifestyle modifications for 6 weeks resulted in small, but clinically relevant, median reductions in body weight, waist circumference and BP. A small median increase in pulse rate was recorded.

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Year:  2009        PMID: 19758358     DOI: 10.1111/j.1463-1326.2009.01090.x

Source DB:  PubMed          Journal:  Diabetes Obes Metab        ISSN: 1462-8902            Impact factor:   6.577


  5 in total

Review 1.  Assessment of potential cardiovascular risks of methylphenidate in comparison with sibutramine: do we need a SCOUT (trial)?

Authors:  Jochen Antel; Özgür Albayrak; Gerd Heusch; Tobias Banaschewski; Johannes Hebebrand
Journal:  Eur Arch Psychiatry Clin Neurosci       Date:  2014-08-23       Impact factor: 5.270

Review 2.  Sibutramine on cardiovascular outcome.

Authors:  André J Scheen
Journal:  Diabetes Care       Date:  2011-05       Impact factor: 19.112

3.  Pharmacotherapies for obesity: past, current, and future therapies.

Authors:  Lisa L Ioannides-Demos; Loretta Piccenna; John J McNeil
Journal:  J Obes       Date:  2010-12-12

4.  No compelling evidence that sibutramine prolongs life in rodents despite providing a dose-dependent reduction in body weight.

Authors:  D L Smith; H T Robertson; R A Desmond; T R Nagy; D B Allison
Journal:  Int J Obes (Lond)       Date:  2010-11-16       Impact factor: 5.095

5.  Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With US Food and Drug Administration Warnings.

Authors:  Jenna Tucker; Tessa Fischer; Laurence Upjohn; David Mazzera; Madhur Kumar
Journal:  JAMA Netw Open       Date:  2018-10-05
  5 in total

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