Rimonabant
Obesity
is now the most common nutritional disorder in industrialised countries.
Defined as a body mass index of greater than 30, obesity arises from
the accumulation of excess fat in the body from over consumption of
fatty foods. Prevalence of obesity in the Europe and USA has reached
epidemic levels. The french company Sanofi-Aventis had invented a revolutionary
medication that helps overweight and obese people to change their life.
What
is Rimonabant?
Rimonabant
is the first of a new class of drugs that block the cannabinoid receptor
1 (CB1). The CB1 receptor is thought to play an important role in certain
aspects of human behavior and metabolism - specifically, it is thought
to play a role in obesity, smoking habits, and lipid and glucose metabolism
How
Rimonabant really works?
Rimonabant
works by blocking endogenous cannabinoid binding to neuronal CB1 receptors.
Activation of these receptors by endoegenous cannabinoids, such as anadamide,
increases appetite. It is the most advanced endocannabinoid receptor
antagonist in clinical development and offers a novel therapeutic approach
to appetite control and weight reduction. This amazing medication also
has potential as a treatment for smoking cessation because the endocannabinoid
system is involved in the body's response to tobacco dependence.
Rimonabant
has been available in Europe since the middle of 2006, following regulatory
approval by the EMEA in June 2006 for its use as an adjunct to diet
and exercise for obese patients with associated risk factors, such as
type 2 diabetes or dyslipidaeamia. However, it has had a less easy passage
through the US regulatory system.
What
is Rimonabant used for?
.Rimonabant
emerged from this screening process as a potent CB1 receptor antagonist.
Preclinical animal studies subsequently showed that it could reduce
consumption of fats and sugars, which contribute to weight gain. Two-year
data from the phase III multicentre Rimonabant In Obesity (RIO) trials,
which compared rimonabant at doses of 5mg and 20mg with placebo with
respect to weight reduction and prevention of weight gain, showed that
the positive results seen after a year's treatment were sustained over
the full two-year trial period.
Rimonabant pills is recommended for patients with large waist circumference
(defined as 102 cm/ 40 inches in men and 88 cm/ 35 inches in women)
and they will mostly benefit from taking this revolutionary medication.
Recommended
Acomplia dosage
The company Sanofi-Aventis recommend to take a 20mg Rimonabant tablet
daily . It is also recommended to consult a doctor.
Acomplia
Overdose
In cases
of Rmonabant overdose the following symptoms were reported; headache,
fatigue and insomnia. If an overdose is suspected ensure that airways
are kept clear, monitor heart activity and contact a health profesional
immediately.
Rimonabant
side effects .
Side effects
in the trial on Rimonabant in obesity were vomiting and nausea, dizziness,
diareea, and anxiety forcing about 21 percent of people to leave the
trial versus 15 percent of those who took placebo. However, these side
effects of rimonabant vary for different individuals.
Recomandation
for Rimonabant
Because
the slimmimg pills contain lactose, people with certain types of lactose
intolerance, particularly intolerance for galactose, should not use
it. Also people with kidney or liver diseases should not use Rimonabant
.
News
on Rimonabant
At the
American College of Cardiology Scientific Sessions in Orlando, data
was presented describing the two-year results with rimonabant in the
RIO-Europe trial. Rimonabant, an investigational drug from the french
company Sanofi-Aventis, is aimed at helping patients lose weight and
possible quit smoking. Early trials with rimonabant have been promising,
but many have cautioned that it's way too early to get very excited
about this amazing medication.
The RIO-Europe
trial enrolled and randomized 1507 overweight and obese patients to
receive either placebo or rimonabant (either 5 mg or 20 mg.) Two years
after enrollment, patients taking 20 mg of rimonabant maintained significant
reductions in both weight and waist size.
The average weight loss in patients still taking rimonabant was between
15 - 20 pounds (compared to approximately 5 pounds on placebo,) and
waist size was reduced by 7.5 cm (compared to 3.4 cm.) Further, obese
people taking 20 mg of rimonabant after two years had nearly a 30% increase
in HDL cholesterol, and a 9% reduction in triglycerides. Anyway most
impressive, the proportion of patients with metabolic syndrome was reduced
by 50% in patients on 20 mg of rimonabant. Results on the 5 mg dose
also moved things in the right direction, but to a lesser extent.
Rimonabant side effects were described as minor and temporary, the most
frequent being diarrhea, nausea, vomiting and dizziness. More severe
anticipated side effects, especially depression, did not materialize.
Only about
50% of the remarkable metabolic improvement seen among rimonabant patients
could be accounted for by the weight loss itself. Investigators conclude
that rimonabant must have a direct favorable effect on lipid metabolism.
In any
case, the data that the french company released on rimonabant is impressive.
In the first study, designed to measure the drug's ability to induce
weight loss, 44% of patients who took rimonabant for 1 year lost more
than 10% of their body weight.
And in
the second study, looking at the drug's ability to help with smoking
cessation, 36% of patients who stayed on the drug for 10 weeks had complete
smoking abstinence during the final 4 weeks of the study.
Furthermore,
patients treated with rimonabant pills tended to have increased HDL
cholesterol levels (i.e., the "good" cholesterol) and reduced
triglyceride levels.
The FDA
and Sanofi-Aventis have to be thinking of all this as they decide what
to do with rimonabant. The demand for this drug is immense; and contrary
to what you might think, especially in the current atmosphere, this
huge demand will make both the regulators and the parent pharmaceutical
company extremely hesitant about unleashing this medication pills to
the marketplace. Even very rare side effects will show up (and will
be made by the media and the legal profession to look common) when tens
of thousands begin using the drug - especially when, one can easily
predict, patients anxious to lose even more weight will not use the
drug quite as prescribed. If the FDA and the company Sanofi-Aventis
have brains in their heads, this revolutionary slimming pills will initially
be approved only for relatively small numbers of patients who are at
the highest risk.
. The weight
loss achieved with rimonabant pills is highly significant, statistically.
But in magnitude, it's just not that great. The patients enrolled in
this study were fat. A 20 pound weight loss (and 3 inches off the waist)
after two years might not even be particularly noticeable in many of
them. This medication simply does not take obese people and make them
svelte; that's not what it does. It helps - but most of the real help
appears to be metabolic. The metabolic improvement is very important.
But this stuff won't make you skinny.
