Background Rimonabant, a selective cannabinoid-1 receptor (CB1)blocker, has been shown to reduce body weight and improve cardiovascularrisk factors in obese patients. The Rimonabant in Obesity–Lipids(RIO-Lipids) study examined the effects of rimonabant on metabolicrisk factors, including adiponectin levels, in high-risk patientswho are overweight or obese and have dyslipidemia.
Methods We randomly assigned 1036 overweight or obese patients(body-mass index [the weight in kilograms divided by the squareof the height in meters], 27 to 40) with untreated dyslipidemia(triglyceride levels >1.69 to 7.90 mmol per liter, or a ratioof cholesterol to high-density lipoprotein [HDL] cholesterolof >4.5 among women and >5 among men) to double-blindedtherapy with either placebo or rimonabant at a dose of 5 mgor 20 mg daily for 12 months in addition to a hypocaloric diet.
Results The rates of completion of the study were 62.6 percent,60.3 percent, and 63.9 percent in the placebo group, the groupreceiving 5 mg of rimonabant, and the group receiving 20 mgof rimonabant, respectively. The most frequent adverse eventsresulting in discontinuation of the drug were depression, anxiety,and nausea. As compared with placebo, rimonabant at a dose of20 mg was associated with a significant (P<0.001) mean weightloss (repeated-measures method, –6.7±0.5 kg, andlast-observation-carried-forward analyses, –5.4±0.4kg), reduction in waist circumference (repeated-measures method,–5.8±0.5 cm, and last-observation-carried-forwardanalyses, –4.7±0.5 cm), increase in HDL cholesterol(repeated-measures method, +10.0±1.6 percent, and last-observation-carried-forwardanalyses, +8.1±1.5 percent), and reduction in triglycerides(repeated-measures method, –13.0±3.5 percent, andlast-observation-carried-forward analyses, –12.4±3.2percent). Rimonabant at a dose of 20 mg also resulted in anincrease in plasma adiponectin levels (repeated-measures method,57.7 percent, and last-observation-carried-forward analyses,46.2 percent; P<0.001), for a change that was partly independentof weight loss alone.
Conclusions Selective CB1-receptor blockade with rimonabantsignificantly reduces body weight and waist circumference andimproves the profile of several metabolic risk factors in high-riskpatients who are overweight or obese and have an atherogenicdyslipidemia.
Source Information
From the Quebec Heart Institute, Laval Hospital Research Center, and the Division of Kinesiology, Department of Social and Preventive Medicine, Laval University, Ste.-Foy, Que., Canada (J.-P.D.); the Service of Therapeutic Education for Chronic Diseases, University Hospital Geneva, Geneva (A.G.); and the Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden (L.S.).
Address reprint requests to Dr. Després at the Quebec Heart Institute, Laval Hospital Research Center, Pavilion Marguerite-D'Youville, 4th Fl., 2725 Chemin Ste.-Foy, Ste.-Foy, QC G1V 4G5, Canada, or at jean-pierre.despres{at}crhl.ulaval.ca.
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