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Clinical Question
Is lorcaserin a safe and effective aid to weight loss for obese patients?
Bottom line
Lorcaserin 10 mg twice daily helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10), and appears to be safe in terms of cardiovascular events. 1b
Reference
Study design: Randomized controlled trial (double-blinded)
Funding: Industry
Setting: Outpatient (any)
Synopsis
Although lorcaserin has been approved for treatment of obesity by the FDA, they required a postmarketing randomized trial to assure cardiovascular safety. In this study, patients (N = 12,000) with a body mass index (BMI) of 27 kg/m2 or higher who had heart disease or multiple cardiovascular risk factors were randomized to receive lorcaserin 10 mg twice daily or matching placebo. All patients had access to a study nurse by phone. The groups were balanced at the start of the study, with a mean age of 64 years and a mean BMI of 35 kg/m2; 90% were hypertensive and 57% had diabetes mellitus. Approximately one-third of patients in each group stopped taking the study drug or placebo during the median 3.3-year follow-up period. Lorcaserin had a modest effect on weight: patients who took the drug lost a mean of 2.8 kg (~ 6 pounds) more than those who took the placebo. More patients in the lorcaserin group lost at least 10% of their body weight (14.6% vs 4.8%; P < .001; NNT = 10). There was no difference in the likelihood of cardiovascular events between the 2 groups (6.1% for lorcaserin vs 6.2% for placebo). There was also no difference in serious adverse events between groups. Patients randomized to receive lorcaserin were more likely to experience an adverse event that led to the discontinuation of the drug (7.2% vs 3.7%; P < .05; number needed to treat to harm = 29), mostly dizziness, fatigue, and headache. The overall rates of these events were low, with absolute risk increases of only 0.4% to 1.1%.
Reviewer
Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA
Comments
don't use in my practice
The challenge of obesity and the many ramifications of this condition are overwhelming and anything that may help is a very important topic
Another industry funded study with little benefit and likely covert delayed problems. Good to discount
Wouldn’t their resources have been better spent on a personal trainer?
Good poem
Excellent