Rimonabant available as Acomplia in the UK

News Update

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Due to reports of some serious psychiatric problems and even suicide among patients taking Rimonabant (Acomplia), the European Medicines Agency recommended the suspension of prescribing this drug to obese people. Weight Loss Resources would always recommend calorie counting for weight loss and that, should you decide on using pills, that you investigate the possible side effects thoroughly.

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Rimonabant, a new weight loss drug to be marketed under the name Acomplia, has recently been approved by the EU and is available to patients in the UK as of 28th June 2006. The United Kingdom is, in fact, the very first place that Acomplia will be available, though it is likely to be a couple of years before the drug is available on the NHS.

Who is Acomplia For?

Clinical trials have found that Rimonabant can help overweight and obese people to lose weight. It was also found that the drug could reduce the risk of cardiovascular heart disease and diabetes, and be of help to people who are trying to stop smoking.

As of June 28th, Acomplia is available only to private patients with prescription, as the drug is currently awaiting approval of the National Institute for Health and Clinical Excellence (NICE) which is expected to take two years. If Acomplia is approved it is likely that obese (BMI over 30) patients, and overweight (BMI over 25) patients considered to be at high risk of type 2 diabetes or cardiovascular disease, could be offered the tablets.

However it has been noted that this weight loss treatment could cost the NHS billions, with each Acomplia tablet costing £1.97 - £55.20 per patient per month.

How Does Rimonabant Work?

Rimonabant targets an area in the brain called the Endocannabinoid System. It blocks the receptors in this area, meaning that Cannabinoids (chemical compounds containing ‘hungry’ messages) cannot reach the system. This lowers the intake of food, resulting in weight loss.

The Endocannabinoid system affects the regulation of energy use, the breaking down of sugars, lipids and of the regulation of body weight and metabolism.

Rimonabant targets visceral fat, a layer of fat which forms around internal organs. Reducing this layer of fat has been found to stem the production of harmful substances (such as cholesterol), which prevent the body responding to insulin. This effectively means that Rimonabant can lower the risk of diabetes and cardiovascular heart disease.

Is it Effective?

Trials of Rimonabant over the last few years have shown it to be an effective weight loss aid for some people. It was found that, of those taking 20mg tablets of Rimonabant, a third lost over 10% of their initial body weight, while over 60% lost over 5%. Average waist measurements are reported to have reduced by between 6 and 9 cm (3-4 inches).

Patients followed a low calorie diet while taking the drug, and achieved better results than a control group following a low calorie diet and taking a placebo.

Participants in these trials also showed improved glucose control, cholesterol and triglyceride measurements from blood fats. These results show improvements of beyond what is expected from normal weight loss. For this reason, Rimonabant is believed to have positive effects on these measures. High-Density lipoprotein cholesterol (The good cholesterol) measures had also improved beyond expected levels.

Side Effects and Maintenance

Side effects of this drug are known to include diarrhoea, nausea and anxiety, this provoked a 15% drop out rate among participants in the trial.

For most patients Rimonabant only remained effective for weight loss for up to about 34 weeks, though continuous use of the drug has been shown to maintain the weight loss.

After ending their use of Rimonabant, most patients regained most of the weight they had lost.

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Further Information

Dietitian Juliette Kellow reports on Rimonabant

WLR’s John Litchfield with an update on Rimonabant trials

For a Summary of the research evidence from the BMJ see www.besttreatments.co.uk

For an NHS evaluation of the evidence see www.nelh.nhs.uk/hth/obesity_pill.asp

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