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Cited by 1,392Pharmacology and Obesity TreatmentCannabis and Cannabinoid ResearchAdipokines, Inflammation, and Metabolic Diseases

Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia

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Després, Jean-Pierre, Golay, Alain, Sjöström, Lars·2005·New England Journal of Medicine
DOI 10.1056/nejmoa044537
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Abstract

BACKGROUND: Rimonabant, a selective cannabinoid-1 receptor (CB1) blocker, has been shown to reduce body weight and improve cardiovascular risk factors in obese patients. The Rimonabant in Obesity-Lipids (RIO-Lipids) study examined the effects of rimonabant on metabolic risk factors, including adiponectin levels, in high-risk patients who are overweight or obese and have dyslipidemia. METHODS: We randomly assigned 1036 overweight or obese patients (body-mass index [the weight in kilograms divided by the square of the height in meters], 27 to 40) with untreated dyslipidemia (triglyceride levels >1.69 to 7.90 mmol per liter, or a ratio of cholesterol to high-density lipoprotein [HDL] cholesterol of >4.5 among women and >5 among men) to double-blinded therapy with either placebo or rimonabant at a dose of 5 mg or 20 mg daily for 12 months in addition to a hypocaloric diet. RESULTS: The rates of completion of the study were 62.6 percent, 60.3 percent, and 63.9 percent in the placebo group, the group receiving 5 mg of rimonabant, and the group receiving 20 mg of rimonabant, respectively. The most frequent adverse events resulting in discontinuation of the drug were depression, anxiety, and nausea. As compared with placebo, rimonabant at a dose of 20 mg was associated with a significant (P<0.001) mean weight loss (repeated-measures method, -6.7+/-0.5 kg, and last-observation-carried-forward analyses, -5.4+/-0.4 kg), reduction in waist circumference (repeated-measures method, -5.8+/-0.5 cm, and last-observation-carried-forward analyses, -4.7+/-0.5 cm), increase in HDL cholesterol (repeated-measures method, +10.0+/-1.6 percent, and last-observation-carried-forward analyses, +8.1+/-1.5 percent), and reduction in triglycerides (repeated-measures method, -13.0+/-3.5 percent, and last-observation-carried-forward analyses, -12.4+/-3.2 percent). Rimonabant at a dose of 20 mg also resulted in an increase in plasma adiponectin levels (repeated-measures method, 57.7 percent, and last-observation-carried-forward analyses, 46.2 percent; P<0.001), for a change that was partly independent of weight loss alone. CONCLUSIONS: Selective CB1-receptor blockade with rimonabant significantly reduces body weight and waist circumference and improves the profile of several metabolic risk factors in high-risk patients who are overweight or obese and have an atherogenic dyslipidemia.

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  • Psychiatric side effects associated with CB1 antagonists/inverse agonists, such as depression- and anxiety-like states, have been reported, leading patients to drop out and discontinue treatment.

    “psychiatric side effects associated with CB1 antagonists/inverse agonists, such as depression- and anxiety-like states, have been reported in several studies, leading patients to drop out of studies and discontinue treatment 63– 65.”

    From Psychosocial and pharmacological interventions for the treatment of cannabis use disorder (2018) · cites this paper as [63]

  • Use of the CB1 receptor antagonist rimonabant as an anti-obesity drug has been associated with a significant increase in the risk for depression.

    “and that the use of the CB1 receptor antagonist rimonabant as an anti-obesity drug has been associated with a significant increase in the risk for depression.”

    From Plasma concentrations of endocannabinoids and related primary fatty acid amides in patients with post-traumatic stress disorder (2013) · cites this paper as [5]

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Authors
Després, J.-P., Golay, A., & Sjöström, L.
Affiliations
  • Université Laval (CA)
  • University Hospital of Geneva (CH)
  • Sahlgrenska University Hospital (SE)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2005-11-17
Volume
353
Issue
20
Pages
2121-2134
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa044537
OpenAlex
W2087587748
Cited by
1,392
References
38
Citations by year
2026: 17 · 2025: 19 · 2024: 18 · 2023: 26 · 2022: 20 · 2021: 28 · 2020: 27 · 2019: 26 · 2018: 32 · 2017: 24 · 2016: 25 · 2015: 34 · 2014: 31 · 2013: 53 · 2012: 63
FWCI
138.02
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
rimonabant, cannabinoid-1 receptor antagonist, dyslipidemia, overweight, obesity, weight loss, adiponectin, HDL cholesterol, triglycerides, waist circumference, hypocaloric diet, cardiovascular risk factors, dose comparison, body mass index, lipid-lowering therapy
MeSH terms
Rimonabant, Adult, Aged, Blood Glucose, Cholesterol, Double-Blind Method, Female, Humans, Insulin, Male, Middle Aged, Obesity, Piperidines, Pyrazoles, Risk Factors, Triglycerides, Weight Loss, Anti-Obesity Agents, Leptin, Metabolic Syndrome, Dyslipidemias, Overweight, Adiponectin, Cannabinoid Receptor Antagonists

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