Pramlintide treatment reduces 24-h caloric intake and meal sizes and improves control of eating in obese subjects: a 6-wk translational research study.
Evidence from rodent studies indicates that the beta-cell-derived neurohormone amylin exerts multiple effects on eating behavior, including reductions in meal size, intake of highly palatable foods, and stress-induced sucrose consumption. To assess the effect of amylin agonism on human eating behavior we conducted a randomized, blinded, placebo-controlled, multicenter study investigating the effects of the amylin analog pramlintide on body weight, 24-h caloric intake, portion sizes, "fast food" intake, and perceived control of eating in 88 obese subjects. After a 2-day placebo lead-in, subjects self-administered pramlintide (180 microg) or placebo by subcutaneous injection 15 min before meals for 6 wk without concomitant lifestyle modifications. Compared with placebo, pramlintide treatment elicited significant mean reductions from baseline in body weight on day 44 (-2.1 +/- 0.3 vs. +0.1 +/- 0.4%, P < 0.001), 24-h caloric intake (-990 +/- 94 vs. -243 +/- 126 kcal on day 3, P < 0.0001; -680 +/- 86 vs. -191 +/- 161 kcal on day 43, P < 0.01), portion sizes, and caloric intake at a "fast food challenge" (-385 +/- 61 vs. -109 +/- 88 kcal on day 44, P < 0.05). Pramlintide treatment also improved perceived control of eating, as demonstrated by a 45% placebo-corrected reduction in binge eating scores (P < 0.01). The results of this translational research study confirm in humans various preclinical effects of amylin agonism, demonstrating that pramlintide-mediated weight loss in obese subjects is accompanied by sustained reductions in 24-h food intake, portion sizes, fast food intake, and binge eating tendencies.
Smith
Steven R
SR
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
Blundell
John E
JE
Burns
Colleen
C
Ellero
Cinzia
C
Schroeder
Brock E
BE
Kesty
Nicole C
NC
Chen
Kim S
KS
Halseth
Amy E
AE
Lush
Cameron W
CW
Weyer
Christian
C
D000328:Adult; D000682:Amyloid / Q000009:adverse effects / Q000627:therapeutic use*; D019440:Anti-Obesity Agents / Q000009:adverse effects / Q000627:therapeutic use; D001069:Appetite Regulation / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D004311:Double-Blind Method; D002149:Energy Intake / Q000187:drug effects*; D005247:Feeding Behavior / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006815:Hunger / Q000187:drug effects; D058228:Islet Amyloid Polypeptide; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009765:Obesity / Q000188:drug therapy*; D010919:Placebos; D012527:Satiation / Q000187:drug effects
D000682:Amyloid; D019440:Anti-Obesity Agents; D058228:Islet Amyloid Polypeptide; D010919:Placebos; C105254:pramlintide