Monday, March 18, 2019

Lorcaserin, the Anti-Obesity Drug

Over the past several years, four anti-obesity drugs have been approved by the FDA. These drugs are: contrave, which is a combination of bupropion and naltrexone; qsymia, which is a combination of phentermine and topiramate; saxenda, which contains the active ingredient liraglutide that is used to treat type 2 diabetes; and lorcaserin which has the brand name Belviq. In this post, we are going to focus on lorcaserin.
In the past, some weight loss drugs were found to be harmful. Fen-phen was one of those drugs. Phentermine, which is one of the components of qsymia, was also one of the components of fen-phen. Fenfluramine was the other component drug. Fen-phen was taken off the market in the 1990s. While fen-phen was effective for weight loss, the drug was found to cause heart related problems. Fenfluramine was deemed the culprit in the combination, while phentermine was not. So fenfluramine was removed from the market.
To some extent, because of the problems fen-phen caused, all anti-obesity drugs are subjected to intense skepticism and research regarding their potential side effects. However, lorcaserin has been shown to lead to weight loss, while creating no cardiovascular safety issues. Further, the drug has been shown to have positive metabolic effects.
In a one year study of 12,000 overweight and obese subjects, a portion of the participants were randomly assigned to one group that was given a 10 mg dose of lorcaserin per day, while the other participants were assigned to a placebo group. And 38.7% of the participants in the lorcaserin group lost at least 5% of their body weight compared to 17.4% of the placebo group. The cardiovascular events in the lorcaserin group were no higher than the cardiovascular events in the placebo group.
Furthermore, when used in combination with phentermine, lorcaserin can lower food cravings during short-term energy restrictions, as shown in a study consisting of 235 participants during a 12 week treatment session.
Also, lorcaserin has been found to improve metabolic parameters. In one study, it was found that lorcaserin can lower fasting glucose and A1c with or without weight loss. And in another study, investigators concluded that lorcaserin "improved multiple cardio metabolic parameters through both weight loss dependent and independent mechanisms.”
Therefore, lorcaserin should be considered by practitioners when they are treating a patient who is overweight or obese, or who experiences overweight or obesity related metabolic diseases. 


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