Acomplia: to be used complementary to diet and exercise to treat obese or overweight

Acomplia (rimonabant) is the first in a new class of drugs that target certain receptors on the surface of brain cells that are part of the endocannabinoid system, which helps regulate food intake and energy expenditure. Its specific action is to block the cannabinoid type 1 receptor, which is the same receptor that is active when people are hungry. In fact, people who overeat are believed to have an overactive cannabinoid system, which is active also in cocaine use and smoking. Cannabinoid type 1 receptors are found not only in the brain, but also on the surface of fat cells.

Is it necessary?

Although many people may think that marketing this kind of drug would mean some great money expenditure for regular citizens, obesity is now considered a health condition that may lead to some predisposes to many serious illnesses; so there might be a chance of getting it paid by insurance.

Many statistics reveals some alarming numbers that give an idea about the reach of obesity. By the moment, in some parts of Europe over 70% of men aged 55-64 years are clinically obese or overweight -Body Mass Index higher than 25; while one in five of all Americans are obese and one in three overweight. So even if slimming pills have had a questioned history, due to its relative effectiveness and adverse side effects, when these kinds of statistics are analyzed, experts seem themselves urged to find a reliable help for those who are struggling to lose weight, in order to put their health on safe.

At the moment, many drug companies are developing their own compounds that work on the same brain receptors, but Sanofi-Aventis is the first in doing clinical trials.

Trials

– Stratus-US study: It evaluated the drug’s effect on smoking cessation. 787 smokers with an average of nearly 23 cigarettes per day were randomized to receive either placebo, or rimonabant in doses of either 5 mg or 20 mg per day during 10 weeks. For the first 2 weeks, they were permitted to continue smoking, though they were instructed to attempt to quit smoking on Day 15. The number of patients who had not smoked during the last 4 weeks of the 10-week period was tabulated. The final results were that 36% from patients who received 20 mg of rimonabant had quit smoking, while from patients who took either placebo or 5 mg rimonabant, only 20% successfully quit.

However, experts have also taken advantage of this trial in order to analyze the drug effects over fat loss. So they have seen that of those patients who quit smoking, the ones taking either placebo or 5 mg rimonabant gained 84%, which is more weight than those taking 20 mg rimonabant. In their case, they have seen a significant increase in the rate of successfully quitting smoking, and also greatly reduced post-smoking-cessation weight gain.

– RIO-Lipids study: 1036 overweight or obese patients who had blood lipid disorders were also randomized to one of three groups described on the other trial -placebo vs. 5 mg/day or 20 mg/day rimonabant- for one year. Besides, 50% of them suffered also from metabolic syndrome X –a constellation of metabolic disorders that all result from the primary disorder of insulin resistance.

By the end of the trial period patients receiving 20 mg rimonabant lost an average of about 20 pounds of weight, compared to 5 pounds for patients on placebo. Moreover, in comparison to placebo, patients receiving 20 mg rimonabant had significant improvements in waist circumference, HDL levels, triglyceride levels, CRP levels, and insulin sensitivity. Regarding the ones who suffered metabolic syndrome X, half of those taking 20 mg rimonabant no had longer this disease at the end of the study.

Final words

There is still a lot to research about rimonabant, so further studies will be required before the drug is released. But in case it turns out to be as effective and as safe as these –and some other- studies suggest, its uptake once released has the potential to be explosive.

If we take into account the quantity of victims that obesity has gained, not only in Europe or the USA, but also around the world, literally millions of patients may be receiving it within a short period of time.

All these facts give the organizations on whose its approval depends on –like the FDA- many reasons to be cautious and deeply analyze all possible side effects, in order to guarantee that Acomplia will be a reliable and safe drug in every sense of the word, before putting it on circulation.