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作为一种大麻素-1受体阻断剂的里莫纳班特对超重或肥胖患者体重和心脏代谢风险因素的影响:RIO-北美:随机对照试验.

F Xavier Pi-Sunyer1, Louis J Aronne, Hassan M Heshmati

  • 1Obesity Research Center, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA. fxp1@columbia.edu

JAMA
|February 16, 2006
PubMed
概括

里莫纳班 (一种大麻素-1受体阻塞剂) 在两年内显著降低了超重/肥胖患者的体重,并改善了心脏代谢因素. 然而,高退学率限制了长期结论.

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科学领域:

  • 药理学 药理学是指药理学的学科.
  • 代谢医学是一种代谢医学.
  • 肥胖问题研究研究

背景情况:

  • 作为一种选择性大麻素-1受体阻断剂的里莫纳班,正在研究其降低体重并改善超重和肥胖个体的心脏代谢风险因素的潜力.
  • 肥胖和相关的心脏代谢风险构成重大公共卫生挑战,需要有效的治疗干预措施.

研究的目的:

  • 为了比较利莫纳班特与安慰剂的疗效和安全性,当与饮食和运动相结合时,在两年内对体重和心脏代谢风险因素的持续变化进行比较.
  • 评估里莫纳班特对超重和肥胖成年人群的体重管理和代谢健康的长期影响.

主要方法:

  • 一项随机,双盲,安慰剂对照试验,涉及3045名肥胖或超重的成年人在美国和加拿大的72个临床研究中心.
  • 参与者接受了为期4周的安慰剂运行与卡路里限制饮食,随后随机分配到安慰剂,5毫克/天或20毫克/天的里莫纳班特一年,第二年延长阶段涉及剂量调整或安慰剂.
  • 主要的疗效指标包括体重和腰围的变化,次要指标集中在血脂水平和其他心脏代谢风险因素上.

主要成果:

  • 20毫克/天里莫纳班特组在一年后 (P<.001) 与安慰剂 (-1.6千克,-2.5厘米) 相比,体重 (-6.3千克) 和腰围 (-6.1厘米) 的平均减少显著增加 (P<.001).
  • 里莫纳班特治疗也导致了脂质特征的有利变化,包括降低甘油三和增加高密度脂蛋白胆固醇.
  • 在第二年继续服用里莫纳班的患者保持体重减轻和心脏代谢改善,而转换为安慰剂的患者体重恢复;恶心是最常见的不良事件.

结论:

  • 与饮食相结合的20毫克/天里莫纳班特治疗,在两年内导致体重,腰围和心脏代谢风险因素的缓慢但持续下降,以及心脏代谢风险因素的改善.
  • 这项试验受到高退学率的限制,需要进一步调查才能充分了解里莫纳班特的长期影响和安全性.
  • 这些发现表明,里莫纳班特作为肥胖和超重个体体重管理的辅助疗法具有潜力,但需要仔细考虑其风险益处概况.