Pharmacotherapies for Obesity: Past, Current, and Future Therapies

Table 4

Recent randomised controlled trials of weight loss therapies with 6-month followup.

Drug	No. subjects	Outcomes				Serious adverse events	Reference
		Absolute weight loss (kg) (95% CI)	≥5% weight loss	≥10% weight loss	Change in WC (cm)
Bupropion (400 mg) plus Naltrexone	Placebo-85	0.9±0.5	15%	2%	−0.9±0.9	Nausea: 3.5% P, 28.1% BN16, 39.7% BN32, 41% BN48	[22]
	N 48 mg-56 B-60	1.1±0.7	10%	2%	−3.8±1.2
	BN16 mg-64	2.6±0.6	26%	7%	−2.9±1.1
		5.1±0.6 𝑃<.05	52%, 𝑃<.05	17%, 𝑃<.05	−3.7±1.1, 𝑃<.05
	BN 32 mg-63	5.1±0.6 𝑃<.05	51%, 𝑃<.05	19%, 𝑃<.05	−4.6±1.0, 𝑃<.05
	BN 48 mg-61	4.0±0.6 𝑃<.05	39%, 𝑃<.05	15%, 𝑃<.05	−4.7±1.2, 𝑃<.05
Bupropion (120 mg/360 mg) + Zonisamide (360 mg/360 mg)	729 (total)	1.4^∧ P	15%^∧ P	4%^∧ P	NA	NA	[97]
		3.2^∧ Z120; 5.3^∧ Z360	27%^∧ Z120 44%^∧ Z360	9%^∧ Z120; 18%^∧ Z360
		2.3^∧ B360	21%^∧ B360	11%^∧ B360
		6.1^∧ ZB120 𝑃<.001; 7.5^∧ ZB360 𝑃<.001	47%^∧ ZB120 (𝑃<.05) 60%^∧ ZB360 (𝑃<.05)	25%^∧ ZB120 𝑃<.05; 32%^∧ ZB360 𝑃<.05
Rimonabant	P-417	0.5 (0.3, 1.3)	NR	NR	1.0 (−0.2, 1.9)	Psychiatric: 28.4% P, 43.4% R, 𝑃<.001	[98]
	R-422	4.3 (3.5, 5.1) 𝑃<.001			4.5 (−3.7, −5.4), 𝑃<.001	Severe psychiatric: 3.5% P, 4.8% R, 𝑃=.52
Rimonabant^∗	3165 (total)	Placebo 1.6; R 6.5	19.7%; 50.8%, 𝑃<.001	7.8%; 27%, 𝑃<.001	6.4; 2.5	Depression: 0.8% P, 1.9% R, NS Anxiety: 0.3 P, 1.0% R, NS	[96]
Tesofensine	Placebo-52	2.2 (0.9, 3.5)	13 (29%)	3 (7%)	−2.4 (0.7, 4.2)	Anger and hostility: 4% P, 14.3% T 1 mg, 𝑃=.018	[99]
	T 0.25 mg-52	6.7 (5.4, 8.0), 𝑃<.0001	29 (59%)	17 (35%)	−5.9 (4.0, 7.8), 𝑃=.007	Increased confusion: P-NA,
	T 0.5 mg-50	11.3 (9.9, 12.7), 𝑃<.0001	41 (87%)	25 (53%)	–9·4 (7.7, 11.0), 𝑃<.0001	T 0.5 mg 𝑃=.015,
	T 1.0 mg-49	12·8 (11.6, 14.1), 𝑃<.0001	42 (91%)	34 (74%)	–9·3 (7.6, 11.0), 𝑃<.0001	T 1 mg 𝑃=.0003

Absolute weight loss: weight loss from baseline; NS: not significant; NR: not recorded; WC: waist circumference; P: placebo; B: bupropion; N: naltrexone; Z: zonisamide; R: rimonabant; T: tesofensine; NA: not available; ^∗pooled non-diabetic patients; #mean ± standard deviation; ^∧estimated absolute weight based on mean baseline weight of 100 kg.