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Efficacy and Safety of Ezetimibe Plus Orlistat or Rimonabant in Statin-Intolerant Nondiabetic Overweight/Obese Patients With Dyslipidemia

Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece

Michael S. Kostapanos, MD

Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece

Eleni S. Nakou, MD

Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece

Moses Elisaf, MD

Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece, egepi{at}cc.uoi.gr

Evangelos N. Liberopoulos, MD

Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece

Aims: To compare the effects of ezetimibe plus orlistat or rimonabant on anthropometric and lipid parameters in nondiabetic statin-intolerant overweight/obese patients with dyslipidemia.

Methods and results: Thirty participants received a hypocaloric diet and were randomized to open-label combination of ezetimibe (10 mg/day) with orlistat (120 mg, 3 times a day with meals; ezetimibe/orlistat [EO], n = 15) or rimonabant (20 mg/day; ezetimibe/ rimonabant [ER], n = 15). Anthropometric and metabolic variables were assessed at baseline and 3 months posttreatment. Similar reductions in body weight, body mass index, and waist circumference were recorded in both groups (—8.3%, —8.6%, and —5.2% in the EO group and —7.3%, —7.2%, and —7.0% in the ER group, P < .01 vs baseline for all). Low-density lipoprotein cholesterol (LDL-C) levels decreased in both treatment groups, but this reduction tended to be more pronounced in the EO group (28.4% vs 15.3%, respectively; P < .01 vs baseline for both). Triglycerides tended to decrease more in the ER compared with the EO group (—20.4% vs —14.1%, P < .01 vs baseline for both). High-density lipoprotein cholesterol (HDL-C) levels tended to decrease in EO group, but remained unaltered with ER treatment. Apolipoprotein B levels were equally reduced in both treatment groups. Conclusion: For similar body weight reduction, the combination of ezetimibe with orlistat may be more efficient in LDL-C lowering, whereas the combination of ezetimibe with rimonabant may be more potent in terms of improving HDL-C and triglycerides.

Key Words: dyslipidemia • ezetimibe • obesity • orlistat • rimonabant

This version was published on December 1, 2009

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 14, No. 4, 274-282 (2009)
DOI: 10.1177/1074248409343935


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