Long-term persistence with orlistat and sibutramine in a population-based cohort.

Author(s): Padwal R, Kezouh A, Levine M, Etminan M

Affiliation(s): Division of General Internal Medicine, Walter C. Mackenzie Health Sciences Center, University of Alberta Hospital, 8440-112th Street, Edmonton, Alberta, Canada. rpadwal@ualberta.ca

Publication date & source: 2007-10, Int J Obes (Lond)., 31(10):1567-70. Epub 2007 Apr 10.

Publication type:

OBJECTIVE: Orlistat and sibutramine are widely prescribed antiobesity agents that are approved for 2 years of continuous use. Previous 1-4-year randomized, placebo-controlled trials of these drugs have reported average weight losses of <5 kg, significant adverse effects and attrition rates of up to 60%. The objective of this study was to determine the long-term persistence with orlistat and sibutramine therapy outside a clinical trial setting. DESIGN, SETTING AND PATIENTS: Population-based administrative data from British Columbia, Canada, were used to create an inception cohort of orlistat and sibutramine users and determine the 2-year persistence with therapy. MAIN OUTCOME MEASURE: Persistence with therapy at 2 years. Drug discontinuation was defined as the failure to refill a prescription within 120 days. Patients discontinuing therapy were censored at the 60-day mark. RESULTS: Nearly 17 000 users of orlistat and 3500 users of sibutramine were identified. For both orlistat and sibutramine, 1-year persistence rates were <10% and 2-year persistence rates were 2%. CONCLUSION: This population-based, retrospective cohort analysis demonstrated very poor long-term persistence rates with orlistat and sibutramine and discontinuation rates that were much higher than those reported in clinical trials.