Long-term persistence with orlistat and sibutramine in a population-based cohort.
OBJECTIVE
Orlistat and sibutramine are widely prescribed antiobesity agents that are approved for 2 years of continuous use. Previous 1-4-year randomized, placebo-controlled trials of these drugs have reported average weight losses of <5 kg, significant adverse effects and attrition rates of up to 60%. The objective of this study was to determine the long-term persistence with orlistat and sibutramine therapy outside a clinical trial setting.


METHODS
Population-based administrative data from British Columbia, Canada, were used to create an inception cohort of orlistat and sibutramine users and determine the 2-year persistence with therapy.


METHODS
Persistence with therapy at 2 years. Drug discontinuation was defined as the failure to refill a prescription within 120 days. Patients discontinuing therapy were censored at the 60-day mark.


RESULTS
Nearly 17 000 users of orlistat and 3500 users of sibutramine were identified. For both orlistat and sibutramine, 1-year persistence rates were <10% and 2-year persistence rates were 2%.


CONCLUSIONS
This population-based, retrospective cohort analysis demonstrated very poor long-term persistence rates with orlistat and sibutramine and discontinuation rates that were much higher than those reported in clinical trials.
Padwal
R
R
Division of General Internal Medicine, Walter C. Mackenzie Health Sciences Center, University of Alberta Hospital, 8440-112th Street, Edmonton, Alberta, Canada. rpadwal@ualberta.ca
Kezouh
A
A
Levine
M
M
Etminan
M
M
D000328:Adult; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001955:British Columbia; D003503:Cyclobutanes / Q000627:therapeutic use*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007783:Lactones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D000077403:Orlistat; D010349:Patient Compliance / Q000706:statistics & numerical data*; D013997:Time Factors
D019440:Anti-Obesity Agents; D003503:Cyclobutanes; D007783:Lactones; D000077403:Orlistat; C058254:sibutramine