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Weight loss drug may cut diabetes likelihood in at-risk patients

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A weight-loss drug may help bring down blood sugar levels and reduce the risk of diabetes in obese and overweight patients, according to new US research.

The findings, published in The Lancet, are the latest to emerge from a major trial of the appetite suppressant drug lorcaserin, which is available in the US but not currently licensed in the UK.

“Lorcaserin is approved in the United States but not in most European counties”

Study authors

The CAMELLIA-TIMI 61 trial, which compared the effect of the drug with a placebo, followed 12,000 patients in eight different countries for roughly three years.

Participants were overweight or obese with – or at high risk of – diabetes and serious cardiovascular problems that could lead to heart attack or stroke.

Results published to date suggest the drug helps facilitate modest but sustained weight loss – as part of a wider weight management programme – without increasing the risk of adverse cardiovascular events.

This latest data indicates the drug could, therefore, have a role in diabetes prevention and reduction.

The study, led by researchers from the Thrombolysis in Myocardial Infarction Study Group at the Brigham and Women’s Hospital in Boston, found taking lorcaserin reduced the risk of being diagnosed with diabetes by 19% in patients with prediabetes.

The drug also appeared to speed up the rate people with pre-diabetes achieved normal blood sugar levels and increased the rate at which hyperglycaemia reduced in people with diabetes.

Meanwhile, the risk of microvascular complications, such as diabetic retinopathy and neuropathy, were reduced by 21% in those with diabetes.

However, incidents of severe hypoglycaemia with complications were more common among patients with diabetes taking lorcaserin, with 12 such events compared to four among those not on the drug.

“Effective weight management delivered in the primary care setting can produce sustained remission in type 2 diabetes”

Xabier Unamuno and Gema Frühbeck

The study authors said their findings showed modest, sustained weight loss could improve cardiometabolic health and “supports the role of lorcaserin as an adjunctive therapy in chronic weight management and metabolic health”.

The research also strengthened the case for licensing the drug in the UK and other European countries,” they maintained.

“Lorcaserin is approved in the United States but not in most European counties,” the authors highlighted.

They said: “We feel that the results from CAMELLIA-TIMI 61 provide clinicians, patients, and regulatory officials with extensive data from a large, well-characterised patient population at high risk for cardiovascular events, so they can make the most informed decisions as possible regarding efficacy and safety.”

However, other experts suggested the benefits of the drug were still unclear especially given the amount weight lost by users was not that great.

“For some physicians, the overall magnitude of the effects of lorcaserin might seem moderate; the resulting weight loss might be disappointing, especially if it does not lower the risk of cardiovascular disease, and evidence exists that effective weight management delivered in the primary care setting can produce sustained remission in type 2 diabetes,” said endocrinologists Xabier Unamuno and Gema Frühbeck, from the University of Navarra in Spain, in a linked comment in The Lancet.

They suggested clinicians “might be uncomfortable prescribing lorcaserin on a general basis” and should instead prescribe it temporarily to identify if a patient responded well and the treatment was worth pursuing.

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