title: Orlistat treatment is safe in overweight and obese liver transplant recipients: a prospective, open label trial.
abstract: Obesity is a frequent complication following liver transplantation and is insufficiently responsive to dietary and life style advice. We studied the safety of orlistat treatment in obese and overweight liver transplant recipients (n = 15) on a stable tacrolimus-based immunosuppressive regimen. For safety reasons, the treatment period was restricted (6 months 120 mg t.i.d., 3 months 120 mg daily). Three patients dropped out, tacrolimus dose was adjusted in six of 12 remaining patients (dose reduction in 4, increase in 2, P = N.S.). All dose adjustments occurred during the 6 months of orlistat 120 mg t.i.d. therapy. No drug intolerance, adverse events or episodes of rejection occurred during the study. Efficacy of orlistat treatment in this population could not be shown, because a formal control population was not included in this safety trial. Moreover, only a significant decrease of waist circumference (P < 0.01 versus start of the study), but not of weight or body mass index, was achieved in the treated group. Orlistat treatment is well tolerated in liver transplant recipients and can be started safely, provided immunosuppressive drug levels and dietary adherence are closely monitored.
authors.affiliation: Department of Hepatology, University Hospital Gasthuisberg, University of Leuven, Belgium. david.cassiman@med.kuleuven.be
authors.forename: David
authors.initials: D
authors.lastname: Cassiman
authors.forename: Mieke
authors.initials: M
authors.lastname: Roelants
authors.forename: Gerda
authors.initials: G
authors.lastname: Vandenplas
authors.forename: Schalk W
authors.initials: SW
authors.lastname: Van der Merwe
authors.forename: Ann
authors.initials: A
authors.lastname: Mertens
authors.forename: Louis
authors.initials: L
authors.lastname: Libbrecht
authors.forename: Chris
authors.initials: C
authors.lastname: Verslype
authors.forename: Johan
authors.initials: J
authors.lastname: Fevery
authors.forename: Raymond
authors.initials: R
authors.lastname: Aerts
authors.forename: Jacques
authors.initials: J
authors.lastname: Pirenne
authors.forename: Erik
authors.initials: E
authors.lastname: Muls
authors.forename: Frederik
authors.initials: F
authors.lastname: Nevens
mesh_terms: D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007783:Lactones / Q000009:adverse effects*; D008055:Lipids / Q000097:blood; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D000077403:Orlistat; D050177:Overweight; D010865:Pilot Projects; D011446:Prospective Studies; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D019440:Anti-Obesity Agents; D007783:Lactones; D008055:Lipids; D000077403:Orlistat; D016559:Tacrolimus