Chilton M, Dunkley A, Carter P, Davies M J, Khunti K, Gray L J
Department of Health Sciences, University of Leicester, Leicester, UK.
Diabetes Obes Metab. 2014 Mar;16(3):237-47. doi: 10.1111/dom.12198. Epub 2013 Sep 15.
To use meta-analytic techniques to quantitatively evaluate the efficacy of orlistat and lorcaserin in the treatment of people who are overweight and obese.
We identified publications from searches of electronic databases and extracted data from studies that compared orlistat or lorcaserin to lifestyle advice (standard care), placebo, sibutramine, rimonabant or metformin and collected information on waist circumference change or withdrawals due to adverse events (AEs). A mixed treatment comparison (MTC) meta-analysis was performed on the data extracted.
Orlistat was found to be significantly better than placebo and standard care in reducing waist circumference at 6 and 12 months; orlistat reduced waist circumference by -6.96 cm [95% credible interval (CrI): -8.93, -4.96 cm] compared to standard care at 6 months. The results suggested that lorcaserin reduced waist circumference by a greater amount than all other interventions at 12 months, for example, lorcaserin lead to a greater reduction of -2.45 cm (95% CrI: -4.99, 0.08 cm) in comparison to placebo, although these differences were not statistically significant. Although data were very limited, metformin reduced waist circumference by a greater amount (-2.11 cm, 95% CI: -1.00, -3.22 cm) than orlistat at 6 months. On average, 6.5% of patients on orlistat and 5.4% of those on lorcaserin discontinued their treatment due to AEs at 12 months.
Orlistat should be considered as an addition to lifestyle interventions in the treatment of obesity. Lorcaserin has recently been approved by the US Food and Drug Administration (FDA) and these results suggest that it is similar in both efficacy and safety compared to orlistat.
运用荟萃分析技术定量评估奥利司他和氯卡色林治疗超重及肥胖人群的疗效。
通过检索电子数据库确定相关出版物，并从将奥利司他或氯卡色林与生活方式建议（标准护理）、安慰剂、西布曲明、利莫那班或二甲双胍进行比较的研究中提取数据，收集腰围变化或因不良事件（AE）停药的信息。对提取的数据进行混合治疗比较（MTC）荟萃分析。
发现奥利司他在6个月和12个月时减少腰围方面显著优于安慰剂和标准护理；与6个月时的标准护理相比，奥利司他使腰围减少了-6.96厘米[95%可信区间（CrI）：-8.93，-4.96厘米]。结果表明，氯卡色林在12个月时比所有其他干预措施减少腰围的幅度更大，例如，与安慰剂相比，氯卡色林导致腰围更大幅度减少-2.45厘米（95% CrI：-4.99，0.08厘米），尽管这些差异无统计学意义。虽然数据非常有限，但二甲双胍在6个月时比奥利司他减少腰围的幅度更大（-2.11厘米，95% CI：-1.00，-3.22厘米）。平均而言，12个月时，服用奥利司他的患者中有6.5%、服用氯卡色林的患者中有5.4%因不良事件停药。
在肥胖治疗中，奥利司他应被视为生活方式干预的补充。氯卡色林最近已获美国食品药品监督管理局（FDA）批准，这些结果表明其在疗效和安全性方面与奥利司他相似。
