INTRODUCTION: Post-marketing data on weight-loss medications in free living population are a necessary adjunct to data from clinical trials. MATERIALS AND METHODS: We conducted a population-based analysis of first-time medication users based on HMO pharmacy purchasing data serving > one million adults. RESULTS: During 5 years, usage of orlistat and sibutramine more than doubled and rates were higher during the months May-Aug. As compared to non-users (n = 1,038,828), annual weight-loss drug users (n = 7175) had higher women proportion, body-mass-index (BMI), bariatric surgery history, and usage of diabetes, depression, and cardiovascular medications (p < 0.001 for all). Among users, men had higher BMI (34.4 kg/m(2) vs. 32.5 kg/m(2)), prevalence of diabetes (25.4% vs. 10.7%) and heart disease (14.2% vs. 3.5%) than women. Mean duration of purchasing weight-loss medications was 2.1 months for orlistat and 2.9 months for sibutramine. Fewer than 2% completed 12 months of weight-loss medication therapy. Among the 25% who continued to purchase at least 4 months, BMI (sub-group analysis) reduced from 33.02 kg/m(2) to 32.04 kg/m(2) (p < 0.001). In a multivariate model, long-term adherence (≥ 4 months) to weight-loss medications was associated with use of sibutramine vs. orlistat (OR = 2.08; 95%CI: 1.76-2.45), and prevalence of diabetes (OR = 1.20; 95%CI: 1.01-1.25). Age, gender, and baseline BMI were not associated with long-term adherence. CONCLUSIONS: Usage of weight-loss drugs is higher among diabetes patients. However, the poor adherence to therapy is substantially below levels reported in clinical trials.
INTRODUCTION: Post-marketing data on weight-loss medications in free living population are a necessary adjunct to data from clinical trials. MATERIALS AND METHODS: We conducted a population-based analysis of first-time medication users based on HMO pharmacy purchasing data serving > one million adults. RESULTS: During 5 years, usage of orlistat and sibutramine more than doubled and rates were higher during the months May-Aug. As compared to non-users (n = 1,038,828), annual weight-loss drug users (n = 7175) had higher women proportion, body-mass-index (BMI), bariatric surgery history, and usage of diabetes, depression, and cardiovascular medications (p < 0.001 for all). Among users, men had higher BMI (34.4 kg/m(2) vs. 32.5 kg/m(2)), prevalence of diabetes (25.4% vs. 10.7%) and heart disease (14.2% vs. 3.5%) than women. Mean duration of purchasing weight-loss medications was 2.1 months for orlistat and 2.9 months for sibutramine. Fewer than 2% completed 12 months of weight-loss medication therapy. Among the 25% who continued to purchase at least 4 months, BMI (sub-group analysis) reduced from 33.02 kg/m(2) to 32.04 kg/m(2) (p < 0.001). In a multivariate model, long-term adherence (≥ 4 months) to weight-loss medications was associated with use of sibutramine vs. orlistat (OR = 2.08; 95%CI: 1.76-2.45), and prevalence of diabetes (OR = 1.20; 95%CI: 1.01-1.25). Age, gender, and baseline BMI were not associated with long-term adherence. CONCLUSIONS: Usage of weight-loss drugs is higher among diabetespatients. However, the poor adherence to therapy is substantially below levels reported in clinical trials.
Authors: Clifford R Weiss; Godwin O Abiola; Aaron M Fischman; Lawrence J Cheskin; Jay Vairavamurthy; Brian P Holly; Olaguoke Akinwande; Franklin Nwoke; Kalyan Paudel; Stephen Belmustakov; Kelvin Hong; Rahul S Patel; Eun J Shin; Kimberley E Steele; Timothy H Moran; Richard E Thompson; Taylor Dunklin; Harvey Ziessman; Dara L Kraitchman; Aravind Arepally Journal: Radiology Date: 2019-04-02 Impact factor: 11.105
Authors: Charles Baum; Katherine Andino; Eric Wittbrodt; Shelley Stewart; Keith Szymanski; Robin Turpin Journal: Pharmacoeconomics Date: 2015-07 Impact factor: 4.981