Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled

André J Scheen1, Nick Finer, Priscilla Hollander

  • 1Division of Diabetes, Nutrition and Metabolic Disorders, CHU Sart Tilman, University of Liege, Liege, Belgium. andre.scheen@chu.ulg.ac.be

Lancet (London, England)
|November 14, 2006
PubMed
Abstract

Insights

Rimonabant significantly reduced bodyweight in overweight or obese patients with type 2 diabetes. The 20 mg/day dose improved glycemic control and metabolic risk factors when combined with diet and exercise.

Area of Science:

  • Metabolic disease research
  • Pharmacological interventions
  • Diabetes management

Background:

  • Rimonabant, a cannabinoid type 1 receptor blocker, has shown efficacy in reducing bodyweight and improving metabolic profiles in non-diabetic individuals.
  • Type 2 diabetes often coexists with obesity, necessitating effective weight management strategies to improve glycemic control and reduce cardiovascular risk.

Purpose of the Study:

  • To evaluate the efficacy and safety of rimonabant in overweight or obese patients with type 2 diabetes.
  • To assess rimonabant's impact on bodyweight, glycemic control (HbA1c), and cardiovascular risk factors in this patient population.

Main Methods:

  • A 1-year, double-blind, randomized controlled trial involving 1047 overweight or obese type 2 diabetes patients inadequately controlled on metformin or sulphonylureas.
  • Participants received a hypocaloric diet, increased physical activity, and were randomly assigned to placebo, 5 mg/day rimonabant, or 20 mg/day rimonabant.
  • The primary endpoint was weight change from baseline after 1 year, with intention-to-treat analysis.

Main Results:

  • Weight loss was significantly greater in both rimonabant groups compared to placebo after 1 year (20 mg/day: -5.3 kg).
  • Rimonabant was generally well-tolerated, although adverse events leading to discontinuation were slightly higher in the 20 mg/day group (mood disorders, nausea, dizziness).

Conclusions:

  • 20 mg/day rimonabant, combined with lifestyle interventions, offers a clinically meaningful reduction in bodyweight for overweight or obese type 2 diabetes patients.
  • This treatment approach also demonstrates improvements in HbA1c and key cardiovascular and metabolic risk factors.

Related Concept Videos

Carbohydrate Metabolism01:36

Carbohydrate Metabolism

Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...