title: Weight loss, HbA1c reduction, and tolerability of cetilistat in a randomized, placebo-controlled phase 2 trial in obese diabetics: comparison with orlistat (Xenical).
abstract: The objective of this multicenter, randomized, double-blind study was to determine the efficacy and safety of cetilistat and orlistat relative to placebo in obese patients with type 2 diabetes, on metformin. Following a 2-week run-in, patients were randomized to placebo, cetilistat (40, 80, or 120 mg three times daily), or orlistat 120 mg t.i.d., for 12 weeks. The primary endpoint was absolute change in body weight from baseline. Secondary endpoints included other measures of obesity and glycemic control. Similar reductions in body weight were observed in patients receiving cetilistat 80 or 120 mg t.i.d. or 120 mg t.i.d. orlistat; these reductions were significant vs. placebo (3.85 kg, P = 0.01; 4.32 kg, P = 0.0002; 3.78 kg, P = 0.008). In the 40 mg t.i.d. and placebo groups, reductions were 2.94 kg, P = 0.958 and 2.86 kg, respectively. Statistically significant reductions in glycosylated hemoglobin (HbA(1c)) were noted. Cetilistat was well tolerated, and showed fewer discontinuations due to adverse events (AEs) than in the placebo and orlistat groups. Discontinuation in the orlistat group was significantly worse than in the 120 mg cetilistat and placebo groups and was entirely due to gastrointestinal (GI) AEs. Treatment with cetilistat 80 or 120 mg t.i.d., or with orlistat 120 mg t.i.d., significantly reduced body weight and improved glycemic control relative to placebo in obese diabetic patients. Cetilistat was well tolerated with the number of discontinuations due to AEs being similar to placebo.
authors.affiliation: St Georges, University of London, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Kopelman
authors.forename: Gerrit de H
authors.initials: Gde H
authors.lastname: Groot
authors.forename: Aila
authors.initials: A
authors.lastname: Rissanen
authors.forename: Stephan
authors.initials: S
authors.lastname: Rossner
authors.forename: Soren
authors.initials: S
authors.lastname: Toubro
authors.forename: Richard
authors.initials: R
authors.lastname: Palmer
authors.forename: Rob
authors.initials: R
authors.lastname: Hallam
authors.forename: Andrew
authors.initials: A
authors.lastname: Bryson
authors.forename: Roger I
authors.initials: RI
authors.lastname: Hickling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D048588:Benzoxazines / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D057194:Intention to Treat Analysis; D007783:Lactones / Q000627:therapeutic use*; D008049:Lipase / Q000037:antagonists & inhibitors; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000077403:Orlistat; D018579:Patient Selection; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D048588:Benzoxazines; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007783:Lactones; D008049:Lipase; D008687:Metformin; D000077403:Orlistat; C517652:hemoglobin A1c protein, human; C520092:cetilistat