Long Term Cardiovascular Outcomes in Patients with Obesity after Orlistat Therapy

Pavankumar Kamat


June 04, 2021


Why this matters

  • Despite the established efficacy of orlistat in achieving weight loss in patients with obesity, there is limited evidence quantifying its long-term effect on cardiovascular outcomes.

Study design

  • A nation-wide, propensity-score matched cohort study of 73 752 patients with obesity from the UK Clinical Practice Research Datalink (CPRD).

  • 36,876 orlistat-treated patients with obesity were matched (1:1) with control participants who had not taken orlistat during the median follow-up 6 years.

  • Primary outcome: MACE (composite of fatal or non-fatal MI and IS).

  • Secondary outcomes: MACE individual components, new-onset HF and CKD3+, coronary revascularisation, and all-cause mortality.

  • Funding: None disclosed.

Key results

  • During the median study follow-up of 6 years, orlistat vs control group had lower rates of MACE (HR, 0.74; 95% CI, 0.66-0.83; P<.001).

  • Similarly, orlistat vs control group had lower rates of (HR; 95% CI):

    • fatal or non-fatal MI (0.77; 0.66-0.88) and IS (0.68; 0.56-0.84; P<.001 for both);

    • new-onset HF (0.79; 0.67-0.94; P=.007) and CKD3+ (0.78; 0.73-0.83; P<.001); and

    • all-cause mortality (0.39; 0.36-0.41; P<.001).

  • No significant difference was seen in revascularization rates between both the 2 groups (HR, 1.12; 95% CI, 0.91-1.38; P=.27).


  • Retrospective design.

  • Risk of bias.


Ardissino M, Vincent M, Hines O, Amin R, Eichhorn C, Tang AR, Collins P, Moussa O, Purkayastha S. Long-term cardiovascular outcomes after orlistat therapy in patients with obesity: a nationwide, propensity-score matched cohort study. Eur Heart J Cardiovasc Pharmacother. 2021 May 15 [Epub ahead of print]. doi: 10.1093/ehjcvp/pvaa133. PMID: 33991094.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: