Original Article
International Journal of Obesity (2007) 31, 1567–1570; doi:10.1038/sj.ijo.0803631; published online 10 April 2007
Long-term persistence with orlistat and sibutramine in a population-based cohort
Note: This paper was presented as an oral presentation at the International Congress of Obesity in Sydney, Australia in September 2006
R Padwal1, A Kezouh2, M Levine3 and M Etminan4
- 1University of Alberta Hospital, Edmonton, Alberta, Canada
- 2McGill University Health Center, Montreal, Quebec, Canada
- 3Center for Evaluation of Medicines, McMaster University, Hamilton, Canada
- 4Center for Clinical Epidemiology and Evaluation, Vancouver Hospital, Vancouver, Canada
Correspondence: Dr R Padwal, Division of General Internal Medicine, 2E3.22 Walter C. Mackenzie Health Sciences Center, University of Alberta Hospital, 8440-112th Street, Edmonton, Alberta T6G 2B7, Canada. E-mail: rpadwal@ualberta.ca
Received 18 September 2006; Revised 3 December 2006; Accepted 26 February 2007; Published online 10 April 2007.
Abstract
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.
Design, setting and patients:
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.
Main outcome measure:
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%.
Conclusion:
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.
Keywords:
orlistat, sibutramine, adherence, population health, endocrinology, metabolism
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