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1c]," he noted. Statistical analysis showed that weight loss accounted for 0. 3 of the 0. 7 percentage point drop in Hb[A.sub. 1c] among patients in the 20-mg arm. It could not explain the other 0. 4, suggesting an intrinsic weight-independent metabolic effect of rimonabant. The mechanism may involve cannabinoid receptor blockage in adipocytes in skeletal muscle and/or liver, Dr. Scheen said. Lipid improvements also occurred with rimonabant in the intent-to-treat analysis, similar to what was seen among nondiabetics in the other RIO trials. Levels of HDL cholesterol increased by 15. 4% from baseline with 20-mg rimonabant, compared with 9. 2% with 5 mg and 7. 1% with placebo. As in the other trials, more than half of the increase in HDL cholesterol could not be attributed to weight loss.
Of those remaining in the study, one fourth lost a clinically significant amount of weight, and, as with other weight loss drugs, the patients who stopped taking the medicine after one year regained the weight.(Level of Evidence: 1b-) DAVID SLAWSON, M. D. Study Reference: Pi-Sunyer FX, et al., for the RIO-North America Study Group. Effect of rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients [Published correction appears in JAMA 2006;295:1252]. JAMA February 15, 2006;295:761-75. Used with permission from Slawson D. Rimonabant (Acomplia) minimally effective for weight loss. Accessed March 29, 2006, at: http://www. InfoPOEMs.com. COPYRIGHT 2006 American Academy of Family Physicians COPYRIGHT 2008 Gale, Cengage Learning.
