Long Term Cardiovascular Outcomes in Patients with Obesity after Orlistat Therapy

Pavankumar Kamat

Disclosures

June 04, 2021

Takeaway

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).

Limitations

  • 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.

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