Experimental drug tackles cravings
An experimental drug that turns off cravings for tobacco and food may become a treatment for the nation’s leading causes of death: smoking and obesity.
Last week, researchers reported at the American College of Cardiology meeting in New Orleans on the dual punch of Rimonabant, the first in a new class of drugs that block the chemical system that gives marijuana users the munchies. In clinical trials, the drug helped overweight patients lose weight and reduce heart risks, and it nearly doubled the odds that smokers could quit -- without putting on pounds.
“That’s a huge advance for these patients,” said Dr. Gregg C. Fonarow, a UCLA professor of cardiovascular medicine who attended the meeting. “These are the big studies that will lead to FDA approval.”
Compared with weight-loss drugs that raise blood pressure, Sanofi-Synthelabo’s Rimonabant has only mild, transient side effects.
In the yearlong study of Rimonabant’s effect on obesity and cardiovascular risk, Jean-Pierre Despres, a researcher at Laval University in Quebec City, Canada, and colleagues divided 1,036 obese and overweight patients with high triglycerides and low high-density lipoprotein (HDL), or good cholesterol, into three groups. All dieted while getting either 5 milligrams of the drug, 20 milligrams of the drug or a placebo.
Higher-dose recipients lost almost 20 pounds (compared with 5 pounds in the placebo group) and trimmed 3.4 inches from their waists. Their HDL rose 23%, their triglycerides dropped 15% and their levels of C-reactive protein, a marker of inflammation, fell 27%, compared with 11% among placebo recipients.
The 20 milligrams also halved the number of patients with metabolic syndrome, a cluster of cardiovascular risks.
“Rimonabant appears to have a direct effect on fat cells, which may be contributing to the beneficial effects of this drug on abdominal obesity and associated risk factors,” Despres said.
Dr. Robert Anthenelli, a University of Cincinnati psychiatrist, reported on a 10-week study of 787 heavy smokers who had failed previous attempts to quit. They received either 5 milligrams or 20 milligrams of Rimonabant or a placebo; 36.2% of the high-dose group was smoke-free during the final four weeks, compared with about 20% of those in the 5-milligram or placebo groups.
