Efficacy and safety of ezetimibe plus orlistat or rimonabant in statin-intolerant nondiabetic overweight/obese patients with dyslipidemia.
OBJECTIVE
To compare the effects of ezetimibe plus orlistat or rimonabant on anthropometric and lipid parameters in nondiabetic statin-intolerant overweight/obese patients with dyslipidemia.


RESULTS
Thirty participants received a hypocaloric diet and were randomized to open-label combination of ezetimibe (10 mg/day) with orlistat (120 mg, 3 times a day with meals; ezetimibe/orlistat [EO], n = 15) or rimonabant (20 mg/day; ezetimibe/rimonabant [ER], n = 15). Anthropometric and metabolic variables were assessed at baseline and 3 months posttreatment. Similar reductions in body weight, body mass index, and waist circumference were recorded in both groups (-8.3%, -8.6%, and -5.2% in the EO group and -7.3%, -7.2%, and -7.0% in the ER group, P < .01 vs baseline for all). Low-density lipoprotein cholesterol (LDL-C) levels decreased in both treatment groups, but this reduction tended to be more pronounced in the EO group (28.4% vs 15.3%, respectively; P < .01 vs baseline for both). Triglycerides tended to decrease more in the ER compared with the EO group (-20.4% vs -14.1%, P < .01 vs baseline for both). High-density lipoprotein cholesterol (HDL-C) levels tended to decrease in EO group, but remained unaltered with ER treatment. Apolipoprotein B levels were equally reduced in both treatment groups.


CONCLUSIONS
For similar body weight reduction, the combination of ezetimibe with orlistat may be more efficient in LDL-C lowering, whereas the combination of ezetimibe with rimonabant may be more potent in terms of improving HDL-C and triglycerides.
Florentin
Matilda
M
Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Kostapanos
Michael S
MS
Nakou
Eleni S
ES
Elisaf
Moses
M
Liberopoulos
Evangelos N
EN
D019440:Anti-Obesity Agents / Q000008:administration & dosage*; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D001384:Azetidines / Q000008:administration & dosage*; D001835:Body Weight / Q000187:drug effects; D004359:Drug Therapy, Combination / Q000009:adverse effects; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D000069438:Ezetimibe; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007783:Lactones / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy*; D000077403:Orlistat; D050177:Overweight / Q000150:complications / Q000188:drug therapy*; D010880:Piperidines / Q000008:administration & dosage*; D011720:Pyrazoles / Q000008:administration & dosage*; D000077285:Rimonabant
D019440:Anti-Obesity Agents; D000924:Anticholesteremic Agents; D001384:Azetidines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007783:Lactones; D010880:Piperidines; D011720:Pyrazoles; D000077403:Orlistat; D000069438:Ezetimibe; D000077285:Rimonabant