O'MEARA S, RIEMSMA R, SHIRRAN L, MATHER L, RIET GT; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2001; 17: abstract no. 177.
NHS Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK
Introduction - Objective: to assess the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity.Methods - A systematic review was undertaken. Nineteen electronic databases were searched, internet sites were accessed, and bibliographies of retrieved articles were examined. Randomised controlled trials (RCTs) of orlistat used for weight loss or maintenance of weight loss in overweight or obese patients were included. Primary outcomes were changes in body weight, fat content, and fat distribution. Secondary outcomes were changes in obesity-related risk factors. Each included trial was assessed for methodological quality. Statistical pooling was undertaken in homogenous groups of trials.Results - Eleven RCTs and one economic evaluation were included. The methodological quality of trials was moderate to good. Orlistat produced statistically significant greater weight loss and better weight maintenance versus placebo at all observed endpoints. Weighted mean difference for orlistat 360 mg/day at one year:-2.90 kg (95% CI: -3.61, -2.19, p<0.00001). Group differences in changes in obesity related risk factors varied across the trials. Orlistat use was associated with gastrointestinal adverse events and lower serum levels of fat-soluble vitamins. The cost per QALY for orlistat was L45,881.Conclusions - Future trials should be designed to match protocols observed in clinical practice regarding patient selection and treatment. Although many trials demonstrated statistically significant differences between groups in terms of weight loss and other outcomes in favour of orlsitat versus placebo, the clinical significance of findings was not confirmed. Adverse effect profiles should be considered when prescribing orlistat.
Publication Types:
Keywords:
- Anti-Obesity Agents
- Body Weight
- Case-Control Studies
- Clinical Trials as Topic
- Cost-Benefit Analysis
- Humans
- Lactones
- Obesity
- Placebos
- Treatment Outcome
- Weight Loss
- economics
- orlistat
- hsrmtgs
Other ID:
UI: 102274509
From Meeting Abstracts