New drug claimed to trim more than obesity

A new anti-obesity prescription drug, which has just gone on sale in Malta, has caused a flurry of excitement among doctors worldwide who are hoping it will help solve a global epidemic.

The interest has been sparked by the fact that this drug has been proven to also reduce the risk factors for heart disease, such as type 2 diabetes and dyslipidaemia (cholesterol imbalance) associated with obesity.

The European Commission approved the use of Acomplia (rimonabant), the first in a new class of drugs called CB1 blockers, last year for the treatment of obese and overweight persons.

Developed by the French firm Sanofi-aventis, this drug is claimed to be especially useful in treating obese people whose body mass index is over 30, or overweight patients with a BMI of 27, but who have associated risk factors.

Matthias Blüher, a professor of internal medicine at the University of Cologne's Department of Molecular Endocrinology, is one doctor, independent of Sanofi-aventis, who is enthusiastic about the drug's results.

In Malta to speak to doctors about Germany's experience with the drug, he said that Acomplia had produced major overall benefits in the seven to eight months since it was launched in his country.

"A person can lose four to five kilogrammes without much effort. However, the most interesting thing is that the expected benefit of a 10 per cent weight loss, is that mortality of heart disease decreases by 20 per cent," he explained.

The drug is noteworthy because it takes a different approach to helping people overcome their cravings for food. It works by blocking the endocannabinoid receptors (CB1), both in the central nervous system and in the peripheral organs. This results not only in weight loss, but also in improving the risk factors associated with heart disease such as blood sugars, cholesterol imbalance and triglycerides.

"This drug is no Slim-Fast. Primarily it's a medication that reduces weight and targets the risk factors associated with weight gain," Prof. Blüher said.

Josanne Vassallo, consultant physician and endocrinologist, echoes the sentiment, adding that there are no drugs that will achieve weight loss without a change in lifestyle.

"Studies have shown that this drug helps to decrease body weight, improve cholesterol levels, decrease blood pressure and improve control of blood glucose. There is evidence that these additional effects are not solely the result of weight loss," she said.

Prof. Vassallo stressed that this drug should not be prescribed unless the individual is willing to reduce calorie intake and exercise regularly, these two changes in lifestyle being fundamental to a healthy weight loss.

Prof. Blüher said: "We are hopeful that this drug will also one day serve to reduce the burden on a country's health infrastructure and reduce complications from diabetes and heart disease," he said.

On this point, Prof. Vassallo feels it is still too early to say what impact this drug would have on the infrastructural and financial burden to health service provision, adding that long-term studies still had to be carried out.

Prof. Blüher said that prevention programmes in most countries had failed and the drug could be a precautionary treatment against the risks of obesity.

Germany had taken the decision to subsidise the drug for the first six months and France was reimbursing patients some of the cost. In Malta, the drug is distributed by Charles Degiorgio Ltd and costs Lm40 a month.

Maltese authorities are following the results. However, Director General for Health Ray Busuttil said when contacted that at the moment the government was not considering subsidising the use of Acomplia.

"Drugs are not the only solution to obesity," Dr Busuttil said.