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氯卡色林的安全性与有效性:BLOOM和BLOSSOM试验的联合分析

Safety and efficacy of lorcaserin: a combined analysis of the BLOOM and BLOSSOM trials.

作者信息

Aronne Louis, Shanahan William, Fain Randi, Glicklich Alan, Soliman William, Li Yuhan, Smith Steven

机构信息

Department of Medicine, Weill Cornell Medical College, New York City, NY.

出版信息

Postgrad Med. 2014 Oct;126(6):7-18. doi: 10.3810/pgm.2014.10.2817.

Abstract

BACKGROUND

Lorcaserin, a novel selective 5-HT2C receptor agonist, is approved by the US Food and Drug Administration (FDA) for weight management in combination with lifestyle modification for adults with obesity and adults with overweight and ≥ 1 weight-related comorbid condition. The safety and effectiveness of lorcaserin in adult patients without type 2 diabetes mellitus was established based on 2 phase III clinical trials of similar design: Behavioral Modification and Lorcaserin for Overweight and Obesity Management (BLOOM) and Behavioral Modification and Lorcaserin Second Study for Obesity Management (BLOSSOM). This report presents a prespecified analysis of pooled data from these trials.

METHODS

Co-primary end points in this analysis include the proportion of patients with a reduction in baseline body weight of ≥ 5% and ≥ 10%, and a change in weight from baseline. Key secondary end points include changes from baseline values in lipid parameters, quality-of-life measures, glycemic indicators, and vital signs.

RESULTS

At week 52, more than twice as many lorcaserin-treated patients achieved a weight loss of ≥ 5% compared with placebo (lorcaserin, 47.1%; placebo, 22.6%), and lorcaserin-treated patients lost significantly more body weight (lorcaserin, -5.8%; placebo, -2.5%). A significantly greater proportion of lorcaserin-treated patients achieved a weight loss of ≥ 10% (lorcaserin, 22.4%; placebo, 8.7%). There were statistically significant improvements in lipid parameters, glycemic indicators, quality-of-life measures, and vital signs in the lorcaserin group compared with placebo. The most common adverse events associated with lorcaserin treatment were headache, upper respiratory tract infection, and nasopharyngitis. Lorcaserin-treated patients had a rate of FDA-defined valvulopathy similar to placebo.

CONCLUSIONS

This pooled analysis of the phase III BLOOM and BLOSSOM trials shows that lorcaserin 10 mg twice daily, in combination with diet and exercise, is safe and tolerable, and is associated with statistically significant weight loss and clinically relevant improvements in cardiometabolic parameters.

摘要

背景

洛卡塞林是一种新型的选择性5-羟色胺2C(5-HT2C)受体激动剂,已获美国食品药品监督管理局(FDA)批准,用于联合生活方式改变,帮助患有肥胖症的成人以及超重且伴有≥1种与体重相关合并症的成人进行体重管理。基于两项设计相似的III期临床试验:行为改变与洛卡塞林用于超重和肥胖管理(BLOOM)试验以及行为改变与洛卡塞林用于肥胖管理的第二项研究(BLOSSOM)试验,确定了洛卡塞林在无2型糖尿病的成年患者中的安全性和有效性。本报告展示了对这些试验汇总数据的预先设定分析。

方法

本分析中的共同主要终点包括基线体重降低≥5%和≥10%的患者比例以及体重相对于基线的变化。关键次要终点包括脂质参数、生活质量指标、血糖指标和生命体征相对于基线值的变化。

结果

在第52周时,与安慰剂组相比,接受洛卡塞林治疗的患者体重减轻≥5%的人数是安慰剂组的两倍多(洛卡塞林组为47.1%,安慰剂组为22.6%),且接受洛卡塞林治疗的患者体重减轻显著更多(洛卡塞林组为-5.8%,安慰剂组为-2.5%)。接受洛卡塞林治疗的患者体重减轻≥10%的比例显著更高(洛卡塞林组为22.4%,安慰剂组为8.7%)。与安慰剂组相比,洛卡塞林组在脂质参数、血糖指标、生活质量指标和生命体征方面有统计学上的显著改善。与洛卡塞林治疗相关的最常见不良事件为头痛、上呼吸道感染和鼻咽炎。接受洛卡塞林治疗的患者发生FDA定义的瓣膜病的发生率与安慰剂组相似。

结论

对III期BLOOM和BLOSSOM试验的这项汇总分析表明,每日两次服用10 mg洛卡塞林,联合饮食和运动,是安全且可耐受的,并且与统计学上显著的体重减轻以及心脏代谢参数的临床相关改善相关。

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