People taking some of the newest weight loss drugs on the market today seem to lose around 5 percent of their body weight over a year, with some medication appearing to be more effective than others, a new review shows.
The drug Qsymia – a combination of phentermine and topiramate – emerged as the top-performing in the analysis that covered 30,000 overweight or obese individuals and pitted prescription drugs phentermine-topiramate (Qsymia), orlistat, lorcaserin (Belviq), naltrexone-bupropion (Contrave) and liraglutide (Saxendra) against each other.
Over the last four years, the Food and Drug Administration has approved the new drugs Qsymia, Belviq, Contrave and Saxendra for weight loss, but many patients continue to use over-the-counter weight loss medication orlistat, first approved in 1999 and commercially known as Alli.
The greatly deliberated approval and aggressive marketing of these drugs come as obesity rates continue to rise in the United States and afflict 600 million adults worldwide.
In the new meta-analysis or review of existing studies, researchers collected and analyzed data from 28 clinical trials where one or more of the drugs were tested for at least a year against a placebo or each other. The median baseline BMI of the 29,018 patients, 74 percent of whom are women, is 36.1, well into the obese category.
Qsymia fared best in the analysis, particularly in promoting 5 percent body weight loss in the patients. Three-quarters of those taking it lost 5 percent, compared to 63 percent taking Saxendra and 55 percent taking Contrave. The same results were seen in 49 percent taking Belviq and 44 percent taking Alli.
A median of 23 percent of individuals on placebo lost 5 percent body weight.
"Ultimately, given the differences in safety, efficacy and response to therapy, the ideal approach to weight loss should be highly individualized,” recommended the authors.
How about for the drugs' link to adverse effects, or those that are severe enough for patients to discontinue the medication? Qsymia surfaced as neither the best nor the worst, while Saxendra and Contrave were tied to the most adverse events. Statistically, the likelihood of adverse events did not differ much among the three.
The authors added that patients may choose a weight loss drug based on their own circumstances, such as picking Saxendra – starting out as a diabetes drug – if one is obese with metabolic problems. Recently, a four-year study concluded that this drug can safely lower cardiovascular risk by 13 patients among type 2 diabetes patients.
Contrave, a mix of an antidepressant and anti-addiction medication, may however risk a number of complications for those with substance abuse issues.
The findings were detailed in the journal JAMA on June 14.
Photo: Tony Alter | Flickr
